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Zhang was diagnosed with chronic obstructive pulmonary disease, which is caused by noxious particles, most commonly from tobacco smoke, at a tobacco cessation clinic at the China-Japan Friendship Hospital in Beijing.

Worldwide, the disease was the sixth leading cause of death in 1990 and is projected to be the fourth by 2030, according to Yu Hongxia, a doctor at the clinic.

Like Zhang, most of the patients there are transferred from the respiratory medicine department once they have already become sick from smoking, said Yu.

"Few of them know the health impacts of smoking, including cancer, and even fewer understand that tobacco addiction is a disease requiring medical treatment to quit," she noted.

Most of the 100 or so such clinics nationwide receive a dozen patients each day on average, making them the slowest departments in Chinese hospitals, which are usually crowded all day long, she said.

In a recent online survey by the news portal Sohu.com and Life Times, nearly half of the 16,000 smokers polled said will power and perseverance are crucial to quitting. It also found only 5 percent had tried smoking cessation medicine.

Professor Liu Youning, head of the respiratory medicine sector in the Chinese PLA General Hospital, cited scientific research showing less than 3 percent of smokers can stop smoking for more than one year without treatment.

Each treatment session, including testing and counseling, usually lasts 40 minutes. During that time, the doctor helps the individual smoker find the most effective medication and solve side effects like depression and anxiety, Liu explained.

"Tobacco is addictive and quitting smoking is hard even with professional help," he emphasized, adding that the success rate is around 30 percent for such services.

In the current clinical guidelines for smoking cessation endorsed by the Ministry of Health, several drugs such as Chantix by Pfizer and the over-the-counter Nicorette Patch by Johnson & Johnson are included.

But Pfizer's Cissy Wang said smoking cessation drugs do not sell well in China, despite a huge smoking population.

"The market in China for smoking cessation drugs is just beginning," she noted.

These drugs cost several hundred to several thousand yuan and currently cannot be reimbursed by health insurance policies, which also drives away smokers, Liu said.

In Japan, the government began to cover the medical cost for smoking cessation in 2006, a move which encourages smokers who want to quit to seek professional help, according to Masakazu Nakamura, a smoking cessation doctor in Osaka.

In response to rising demand from smokers, the number of smoking cessation clinics there has increased from 300 to 8,000, he told China Daily.

China Daily

(China Daily 05/31/2010 page4)