According to the World Health Organization (WHO) there are more than 300 million smokers in China, nearly one-third of the world’s total. A new study recently published by Lancet medical journal warns that if current smoking rates in the country prevails, two million people – meaning one out of three Chinese men – will die per year from smoking by 2030.

While the news has been widely spread on headlines in the western media, in China it has largely been ignored by the main news sources, including the state organ Xinhua. At the same time, comments and posts about the news on the major social networks had mix reactions from the public.

The study found that two-thirds of young men in China start to smoke, mostly of them before age 20, and that unless they quit for good, around half of them will eventually die from their habit. The researchers conducted two large, nationally representative studies 15 years apart, studying the consequences of smoking on Chinese population. The first study dates back in the 1990s, while the second one is still ongoing and involved half a million men and women. The proportion of all male deaths at age 40 to 79 attributed to smoking has doubled to around 20 percent now from about 10 percent in the early 1990s. Moreover, in urban areas this proportion is even higher, at 25 percent and rising.

Smoking has over the decades become a cultural tenet in China. Cigarettes, beyond serving as a means to de-stress, are customarily used as gifts in professional and personal encounters. Even if awareness of the health risks of smoking is rising, data released by the WHO overall awareness is still disconcertingly low. According to the World Health Organization (WHO) shows that only 25 percent of adults population in China has a comprehensive understanding of the health threats associated to smoking, and less than a third is aware of the dangers of second-hand smoking. Therefore it is not surprising that the percentage of smokers who quit by choice accounts for less than 10 percent of the total.

A characteristic of the tobacco epidemic in China is its gender distribution: 68 percent of men and 32 percent of women are, producing a correspondingly large effect on tobacco-attributed mortality, which is rising in men and falling in women. Moreover, women are at the forefront on China’s anti-smoking crusade among tobacco-control groups in the government, where key deputies who drafted the recently introduced new restrictions are all women.

The situation is made even more complicated in China by the fact that the country is the world’s largest grower, manufacturer and consumer of tobacco, and the state-owned China National Tobacco Corporation generates 7-10% of GDP in revenue. While the Health Minister is trying to restrict tobacco consumption, this would be counterproductive for all the other agencies profiting from the industry, therefore putting the government in a very uncomfortable position.

As we already sustained in a previous editorial, an alternative strategy could be the enforcement of the use of e-cigarettes. E-cigarettes are a homegrown product with a lower impact on health, which could be an appealing substitute also to chain smokers. If supported by effective regulation and accompanied by the example of officials turning to e-cigarettes, e-cigarettes industry could provide a sustainable alternative , finding a solution suitable for both smokers and revenues.