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      Special communication: China’s first historic efforts to develop a tobacco control advocacy workforce via schools of public health

      editorial
      Author(s): 1 , 2 , 1 , 1 , 1
      Publication date (Electronic):
      Journal: Tobacco Control
      Publisher: BMJ Group

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          Abstract

          This paper provides an overview of a recent 18-month project which set out for the first time to introduce training on tobacco control into the curricula of public health courses in Chinese universities. The aim was to produce graduates with appropriate knowledge and skills to be effective in advocating for policies that could lead to the reduction of tobacco use. Results from this initial project involving seven universities have been encouraging and the new curriculum is to be implemented, with some changes, on a wider scale throughout China. Each of the universities also successfully introduced a smoke-free campus policy and the aim is to extend this policy.

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          Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths.

          Malachy Campbell, Qingsheng Liu, Yuan-Yuan Li … (1998)
          To assess the hazards at an early phase of the growing epidemic of deaths from tobacco in China. Smoking habits before 1980 (obtained from family or other informants) of 0.7 million adults who had died of neoplastic, respiratory, or vascular causes were compared with those of a reference group of 0.2 million who had died of other causes. 24 urban and 74 rural areas of China. One million people who had died during 1986-8 and whose families could be interviewed. Tobacco attributable mortality in middle or old age from neoplastic, respiratory, or vascular disease. Among male smokers aged 35-69 there was a 51% (SE 2) excess of neoplastic deaths, a 31% (2) excess of respiratory deaths, and a 15% (2) excess of vascular deaths. All three excesses were significant (P /70 there was a 39% (3) excess of neoplastic deaths, a 54% (2) excess of respiratory deaths, and a 6% (2) excess of vascular deaths. Fewer women smoked, but those who did had tobacco attributable risks of lung cancer and respiratory disease about the same as men. For both sexes, the lung cancer rates at ages 35-69 were about three times as great in smokers as in non-smokers, but because the rates among non-smokers in different parts of China varied widely the absolute excesses of lung cancer in smokers also varied. Of all deaths attributed to tobacco, 45% were due to chronic obstructive pulmonary disease and 15% to lung cancer; oesophageal cancer, stomach cancer, liver cancer, tuberculosis, stroke, and ischaemic heart disease each caused 5-8%. Tobacco caused about 0.6 million Chinese deaths in 1990 (0.5 million men). This will rise to 0.8 million in 2000 (0.4 million at ages 35-69) or to more if the tobacco attributed fractions increase. At current age specific death rates in smokers and non-smokers one in four smokers would be killed by tobacco, but as the epidemic grows this proportion will roughly double. If current smoking uptake rates persist in China (where about two thirds of men but few women become smokers) tobacco will kill about 100 million of the 0.3 billion males now aged 0-29, with half these deaths in middle age and half in old age.
          Article 0 comments Cited 125 times – based on 0 reviews     Review now
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            Emerging tobacco hazards in China: 2. Early mortality results from a prospective study.

            R. Peto, Mon-Gy Chen, X.-P. He … (1998)
            To monitor the evolving epidemic of mortality from tobacco in China following the large increase in male cigarette use in recent decades. Prospective study of smoking and mortality starting with 224 500 interviewees who should eventually be followed for some decades. 45 nationally representative small urban or rural areas distributed across China. Male population aged 40 or over in 1991, of whom about 80% were interviewed about smoking, drinking, and medical history. Cause specific mortality, initially to 1995 but later to continue, with smoker versus non-smoker risk ratios standardised for area, age, and use of alcohol. 74% were smokers (73% current, only 1% former), but few of this generation would have smoked substantial numbers of cigarettes since early adult life. Overall mortality is increased among smokers (risk ratio 1.19; 95% confidence interval 1.13 to 1.25, P<0.0001). Almost all the increased mortality involved neoplastic, respiratory, or vascular disease. The overall risk ratios currently associated with smoking are less extreme in rural areas (1.26, 1.12, or 1.02 respectively for smokers who started before age 20, at 20-24, or at older ages) than in urban areas (1.73, 1.40, or 1.16 respectively). This prospective study and the accompanying retrospective study show that by 1990 smoking was already causing about 12% of Chinese male mortality in middle age. This proportion is predicted to rise to about 33% by 2030. Long term continuation of the prospective study (with periodic resurveys) can monitor the evolution of this epidemic.
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              Tobacco--the growing epidemic.

              Richard Peto, Zheng-Ming Chen, Jillian Boreham (1999)
              Article 0 comments Cited 23 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Tob Control
                Journal ID (publisher-id): tc
                Journal ID (hwp): tobaccocontrol
                Title: Tobacco Control
                Publisher: BMJ Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Print): 0964-4563
                ISSN (Electronic): 1468-3318
                Publication date Collection: 2009
                Publication date (Print): October 2009
                Publication date (Electronic): 20 July 2009
                Publication date PMC-release: 20 July 2009
                Volume: 18
                Issue: 5
                Pages: 422-424
                Affiliations
                [1 ]Center for Tobacco Control Research, Zhejiang University School of Medicine, China
                [2 ]Department of Sociology, Zhejiang University, China
                Author notes
                Correspondence to: Dr Tingzhong Yang, Center for Tobacco Control Research, Zhejiang University School of Medicine, China; Ytingzhongyang@ 123456yahoo.com
                Article
                Publisher ID: tc31815
                DOI: 10.1136/tc.2009.031815
                PMC ID: 2745560
                PubMed ID: 19622521
                SO-VID: 06ede0dc-4fda-49ac-9dcb-745a9e65904b
                Copyright © © Yang et al 2009
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 26 May 2009
                Date accepted : 1 July 2009
                Categories
                Subject: Special Communication
                Subject: 1506

                ScienceOpen disciplines: Public health
                Data availability:
                ScienceOpen disciplines: Public health

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