China, which accounts for just under a third of the world's smokers, presents an almost untapped market to U.S. cigarette manufacturers stung by a drop-off in smoking in America and Europe. "Some in Asia charge that because U.S. companies are being frozen out of American markets, they're turning to the Third World to keep the business going," says TIME correspondent William Dowell. But China's smoking problem may have a lot less to do with the allure of Western cigarette advertising than with prevailing social conditions. "If you're an ordinary worker in a Chinese industrial city, there are so many other more immediate threats to your health and well-being that smoking may seem like a relatively minor danger," says Dowell. It may be some time, though, before the Chinese follow the JAMA study's recommendations. After all, as any smoker or ex-smoker can attest, the habit is hardest to resist in times of stress — and a China in the throes of an epic transition to capitalism looks set to be a very stressful place for a long time to come.
Come up to where the cancer is. That would be China, according to a study released Wednesday in the Journal of the American Medical Association, which found that 2 million people a year will be dying of smoking-related illnesses in China 20 years from now. Based on projections developed from illness patterns in the West, the study's authors predict that 50 million of China's 320 million smokers will die prematurely as a result of their habit. Equally disturbing, the surveys found that most Chinese smokers were woefully uneducated about the health risks posed by smoking, with only a third aware of its links to cancer and less than 5 percent realizing that tobacco use can cause heart disease.