One-third of doctors in the country do not know smoking causes coronary heart disease, and nearly four in five do not know passive smoking can cause sudden infant death syndrome, a report revealed yesterday.

Also, three in five smokers do not know that smoking causes heart disease, and four in five do not know it could lead to a stroke, the national tobacco control office of the Ministry of Health said in the report.

The figures have not changed much since 2002 and "the country faces an extremely difficult situation in tobacco control", Yang Gonghuan, director of the office, said as she released the report to mark yesterday's World No Tobacco Day.

Anti-tobacco campaigners are calling for graphic warnings on cigarette packs, which are the norm in 23 countries and regions. But insiders say the authorities have shied away for fear that terrifying pictures could scare away people who buy expensive cigarettes as gifts - which account for a huge chunk of tobacco companies' profits - and cause a slump in sales.

The tobacco industry sold at least 42 million boxes of cigarettes and paid more than 430 billion yuan ($62 billion) in taxes last year, media reports said.

The national tax revenue in the same period was 5.42 trillion yuan.

Further complicating the situation is that the Ministry of Industry and Information Technology (of which the State Tobacco Monopoly Administration is a part), instead of the health ministry, is responsible for implementing the World Health Organization (WHO) Framework Convention on Tobacco Control, Yang said.

China tops the world in tobacco planting area, cigarette production and consumption, as well as tax revenues generated by the industry.

As a result, the country has the highest number of smokers and deaths caused by smoking-related diseases, said Zhi Xiuyi, a leading lung-cancer expert in China.

The report said the country has more than 300 millions smokers, and more than 1 million people die from smoking-related diseases each year, or two deaths every minute.

Around the world, tobacco - the leading preventable cause of death - kills more than 5 million people every year, the WHO said.

Graphic warnings are believed to be an effective deterrent and "we strongly support picture warnings on cigarette packs," Zhi said.

"This message should reach not only the public, but also decision-makers in government."

"If China uses graphic warnings, it would become the largest anti-tobacco promotion in the world," Yang said.

"And it will also be good to change the habit of giving cigarettes as gifts and help curb corruption."

A survey of 16,000 people in the country showed that nine in 10 learned of the illnesses and suffering caused by tobacco use only after seeing foreign cigarette packs with graphic warnings.

Source: China Daily