Nov. 11 issue — The curtains are drawn in the lung-cancer ward of Shanghai No. 6 People’s Hospital. The 30 metal beds, installed when the ward opened last year, are all occupied now, mostly by older men in striped pajamas staring forlornly at the ceil

QIAN’S HUSBAND WAS so spooked by Xu’s brush with death he quit smoking—”yesterday,” she says. But not everybody has gotten the message. Outside the cancer ward, a 29-year-old doctor in scrubs takes a break after an operation—and lights up a cigarette. Chinese men are literally dying for a smoke. With 320 million smokers—more than 90 percent of them male—China consumes a whopping one third of the world’s cigarettes each year, the equivalent of a pack a day, every day, for every man, woman and child in the United States. And Chinese smokers are starting to pay the price. Already one in every eight male deaths in China is caused by smoking, and scientists predict the ratio will rise sharply, to one in three by the year 2050. In Beijing, where smoking and smog are a deadly combination, deaths from lung cancer have doubled in the past 10 years; in Shanghai, they have risen tenfold. The epidemic, scientists warn, will fuel a crisis that results in staggering health-care costs—and millions of lonely widows. Kicking the habit is not an easy proposition in China, where cigarettes are a fixture of daily life. Need to find a wedding gift, pay a bribe or welcome guests into your home? In China, cigarettes will do the trick every time. Chinese icons Mao and Deng chain-smoked into their 80s, and a recent survey showed that 57 percent of Chinese doctors smoke. No wonder the dangers of smoking are only dimly understood. In a 1999 survey by the Journal of the American Medical Association, 40 percent of Chinese did not know that smoking can cause lung cancer. And kids don’t seem to be getting the message: a recent survey in Beijing found that, among teen smokers, the first puff usually came at the tender age of 10. “China is 20 years behind the United States in terms of awareness,” says Chen Haiquan, a U.S.-trained surgeon who opened the new ward at No. 6 People’s Hospital. Chen is the lone surgeon in the ward, performing more than 200 operations a year. “By the time I see patients,” he says, “they understand how bad smoking is for their health. But it’s often too late.” Beijing’s response may also be too little, too late. The government banned smoking and cigarette ads in public places several years ago, but the rules are still only sporadically enforced. Chinese officials like to point out that the country’s tobacco industry has made cigarettes healthier, dramatically lowering the tar content and putting filters on nearly every cigarette. But the government has done little to raise public consciousness. The Chinese Association of Smoking and Health is the only antismoking organization in China, a tiny outfit run on a shoestring budget out of the Health Ministry. CASH, as it is called, has nothing of the sort. “We have no money and no power,” says Qu Yuzeng, a charismatic 71-year-old CASH activist. Qu complains that the government pays attention only to the $12 billion it receives in cigarette taxes—not to tobacco’s toll in human misery. As long as that remains the case, Qu says, the epidemic will continue. And the cancer ward in People’s No. 6 Hospital will always be full.

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