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China is the world’s largest producer of cigarettes. It is also the world’s largest consumer of cigarettes, burning some 1.7 trillion sticks a year. The World Health Organization estimates that smoking kills 1.2 million Chinese a year (over 3,000 people per day). Unfortunately it seems that in China, the health care industry is a big part of the problem. The Tobacco Control Office of the Chinese Center for Disease Control and Prevention conducted a survey and concluded that:

• More than 23% of Chinese doctors smoke daily (that’s only about 1% lower than the average rate for the whole population)
• As many as 57% of Chinese male medical professionals smoke
• In some areas of the country, fewer than half of the doctors truly understand the medical dangers of smoking, or techniques to help people quit smoking

As one reporter exclaimed, “If one in five Chinese doctors smokes, how can China’s army of 350 million smokers be persuaded to kick the habit?”

Good question. But anti-smoking activists not only have to confront a compromised health care system — there is also some official concern about how China’s smokers would react to restrictions on their habit. Recently Reuters quoted China’s Deputy Chief of the State Tobacco Monopoly Division, Zhang Baozhen saying that “restraining smokers threatens social stability.” His comments came in response to proposals from members of China’s parliamentary advisory body to curtail the smoking industry.

“Smokers rioted when the former Soviet Union collapsed because they could not get any cigarettes… The principle applies in China as well,” Zhang said.

This fear may well have a basis in truth, but this ends up being a deadly Faustian trade-off. To deal with this immense challenge, the health care system needs the strongest of official moral and political support: first to heal itself, and then the patients who need their care.