Patterns of smoking seen in the West after the Second World War, when 80 per cent of British and American men smoked, are being repeated in developing countries such as China, with the inevitable consequence of a surge in smoking-related deaths in decades to come.
The death-toll is set to shift from the developed to the developing world over the next 30 years. This will include a sharp rise in tobacco-related fatalities in China, where 320 million smokers puff their way through one in three of all cigarettes smoked world-wide.
Richard Peto, Professor of Medical Statistics at Oxford University and an authority on smoking, told the 1,800 delegates that he estimated that this year 3.5 million people worldwide will die of smoking, of whom 2 million are in the developed countries.
By about 2025 the annual global death-toll will reach 10 million, of whom 7 million will be in the developing countries. World-wide over the next 20 years there will be about 100 million deaths from smoking unless adult smokers stop.
China, where three-quarters of middle-aged men smoke, will see one of the biggest increases. "I know Deng Xiaoping survived to the age of 90, but he was an exception," said Mr Peto, referring to the chain-smoking Chinese patriarch, who died in February aged 92. But just as Deng eventually gave up, so should others. Those who stop before the age of 35 have a survival rate almost identical to lifelong non-smokers, and those who stop at a later age still show big benefits.
Mr Peto said figures indicated that 700,000 Chinese people are dying of tobacco-related diseases a year, compared with 500,000 in the US and 500,000 in the European Union. "China already has more tobacco deaths than any other country," said Mr Peto.
Next century the annual toll in China will rise to 3 million; a third of all Chinese males under the age of 30 will be killed by tobacco.
China has seen an big increase in cigarette consumption over the past 20 years and is viewed by tobacco companies as the world's most enticing market. The director-general of the World Health Organisation, Hiroshi Nakajima, yesterday welcomed recent lawsuits against cigarette-makers in the US and the admission by the Ligget Group that tobacco was addictive.
Last week Geoffrey Bible, chairman of Philip Morris, conceded that some American deaths might have been caused "in part" by smoking. But Mr Nakajima warned: "We must demand that the large multinational tobacco companies that experience controls in their home countries are not free to expand into markets in other countries."
China's domestic tobacco industry is run by the government as a state monopoly, producing 1,700,000,000,000 cigarettes a year. Tobacco taxes are the biggest single contributor to central-government coffers in China. This may explain the often lax implementation of China's anti-smoking regulations. More than 70 cities have banned smoking in public places and from 1 May smoking was supposed to stop on all public transport, but in reality these rules are routinely disregarded. Yesterday's overall message was bleak. Half of long-term smokers will be killed by smoking diseases. It is "like flipping a coin", said Mr Peto. Half of those who die will do so before the age of 70, losing 20 to 25 years of their normal life expectancy.