China has experienced an epidemiological transition shifting from the infectious to the chronic diseases in much
shorter time than many other countries. The pace and spread of behavioural changes, including changing diets,
decreased physical activity, high rates of male smoking, and other high risk behaviours, has accelerated to an
unprecedented degree. As a result, the burden of chronic diseases, preventable morbidity and mortality, and associated
health-care costs could now increase substantially. China already has 177 million adults with hypertension;
furthermore, 303 million adults smoke, which is a third of the world’s total number of smokers, and 530 million
people in China are passively exposed to second-hand smoke. The prevalence of overweight people and obesity is
increasing in Chinese adults and children, because of dietary changes and reduced physical activity. Emergence of
chronic diseases presents special challenges for China’s ongoing reform of health care, given the large numbers who
require curative treatment and the narrow window of opportunity for timely prevention of disease