Production and sales of manufactured cigarettes are increasing in China; furthermore, the proportion of filtered cigarettes is still low, and the tar yield thus remains high. The prevalence of smoking in the general population aged 20 and over is estimated to be 68.9% of men and 8.3% of women. Case-control studies carried out in major cities in China all showed a close relationship between lung cancer incidence and smoking. In Shanghai, the population attributable risks for lung cancer due to smoking were 0.69 in men and 0.24 in women. A limited number of case-control studies indicate that the incidences of cancers of the bladder, oesophagus and pancreas are also associated with smoking. Some studies on coronary heart disease reveal unequivocally a significant risk for this disease associated with smoking. Cancer, chronic obstructive lung diseases and coronary heart disease are now important causes of death in some large cities in China. More comprehensive investigations are needed in order to evaluate thoroughly the effect of smoking on health in China.