China is failing to deliver on pledges to help its 300 million smokers kick the habit, according to health experts who warned of a sharp rise in tobacco-linked deaths if strong steps are not taken.
By 2030, more than 3.5 million Chinese could die from smoking-related illnesses each year, compared with 1.2 million in 2005, a joint report by Chinese and foreign medical experts said.
The report, "Tobacco Control and the Future of China", was officially released on Thursday and said China would almost certainly miss a January 9 deadline to impose an indoor ban on smoking.
China, the world's largest tobacco producer and consumer, pledged to enact the ban when it became a party to the World Health Organization's Framework Convention on Tobacco Control (FCTC) five years ago.
"China's score remains low in terms of its implementation of tobacco control and FCTC obligations. China significantly lags behind in its implementation of the FCTC's requirements," the report said.
The report was sponsored by the Chinese Center for Disease Control and Prevention.
Despite its pledge, no such indoor smoking ban has been put in place and smokers in China continue to light up freely in restaurants and office buildings.
Tobacco is the country's top killer, and smoking and exposure to second-hand smoke result in a huge medical and social cost, the report said.
"Medical costs and labour losses caused by smoking are increasing year by year and at an ever-faster rate," the report said.
Smoking is deeply ingrained in Chinese society and widely accepted, with the offering of cigarette a common gesture of greeting.
As a result, the report said, an estimated 738 million Chinese are exposed to second-hand smoke, including 182 million children.
Government agencies are the largest buyer of high-grade cigarettes, which are often given as official gifts, sometimes as bribes, according to the report.
It singled out the Chinese cigarette industry for particular blame, saying it had seriously undermined anti-smoking efforts and was a key barrier to effective tobacco controls, it said.
"The tobacco industry has become the largest 'health-hazard' industry," said the report.
"Although it is a major taxpayer, the industry is generating a much greater social burden."
China's tobacco monopoly acts as the lead entity in implementing the tobacco control framework, which effectively allows it to impede adoption of anti-smoking policies and laws, it added.
The report called for the establishment of a high-level tobacco control bureau to implement rigorous anti-smoking activities and for the government to discourage smoking by hiking cigarette taxes and other market measures.