Smoking has long been deeply woven into mainland China’s social fabric, and many of the factors that drive people to smoke come from culture, economics and government policy rather than a unique genetic predisposition.  In fact, the latest national data show that smoking in China is not universal but highly concentrated among men, with most women remaining non‑smokers – in 2024 the current smoking rate among adults ≥15 was 23.2 % overall, but 43.9 % of men smoked compared with only 1.8 % of women, and prevalence was higher in rural areas than in cities .  The youthful generation is also smoking less; the lowest rates were seen in the 15‑29 age group .  Here are the main reasons why adult men still smoke so much:

1. Smoking is a social courtesy and a “social lubricant”.  In Chinese culture cigarette gifting and sharing are ways to show respect, hospitality and maturity.  A 2022 study described cigarette gifting as “deeply rooted” in Chinese culture; gifts of cigarettes are exchanged both in daily interactions and at special occasions and are used to maintain interpersonal relationships .  These exchanges normalise smoking and make it harder to refuse cigarettes .  Premium cigarettes are even given as presents for hosts, teachers or security guards, handed out at weddings and ritually exchanged during business deals .  In social settings, particularly among men, refusing a cigarette can feel rude; smokers in one investigation said the hardest part of quitting was the fear of losing friends .
2. Smoking is tied to masculine identity and workplace networking.  Qualitative research shows that in China “smoking is an accepted social activity, especially among men”; cigarettes are routinely offered at social gatherings, and female smoking is considered socially inappropriate .  This gender‑linked norm means smoking becomes part of male bonding at workplaces and dinners, and it explains why male smoking rates are so much higher than female rates .
3. Cigarette gifting and sharing fuel consumption.  Studies of cigarette gifting found that it is widespread: one rural survey noted that around three‑quarters of households with smoking heads both gifted and received cigarettes at Chinese New Year , while an online survey in 2017‑18 reported that 89 % of current smokers and 61.4 % of nonsmokers had given cigarettes as gifts, and 92.1 % of smokers had received them .  This practice increases access to cigarettes for both smokers and nonsmokers and has been identified as a major barrier to tobacco control .
4. Stress relief and workplace pressures.  Many Chinese men cite smoking as a way to cope with stress or to fit into male‑dominated workplaces.  When asked why they started smoking, some workers said it helps them connect with colleagues and reduce stress.  Social pressure to join colleagues in a smoking break can outweigh personal health concerns, and in a society where relationships are vital for business, lighting up often feels like part of the job.
5. Low prices and easy availability.  Domestic cigarettes remain relatively inexpensive compared with income, making it easy to smoke frequently.  The state‑owned China National Tobacco Corporation (“China Tobacco”) controls 96 % of the cigarette market and produces more cigarettes than the next eleven largest global companies combined .  As the world’s largest tobacco company and also the industry regulator, China Tobacco sets production quotas, issues retail licences and controls marketing .  In 2022 it generated US$ 213 billion in profits and tax revenues for the central government – roughly 7 % of government revenue .  This huge fiscal contribution makes cigarettes cheap for consumers and creates a conflict of interest that slows the implementation of strong tobacco‑control policies .
6. Weak enforcement of tobacco‑control laws.  China ratified the WHO Framework Convention on Tobacco Control, yet national smoke‑free legislation and strong advertising bans have not been fully enacted or are poorly enforced.  Local bans often include carve‑outs for restaurants and entertainment venues after lobbying by the tobacco monopoly .  Deceptive marketing of “slim” cigarettes and other so‑called harm‑reduction products continues, prompting the China CDC to call for tighter regulation .

Although these factors keep smoking rates high, there are reasons to feel optimistic!  Smoking prevalence has declined from 26.6 % of adults in 2018 to 23.2 % in 2024 , and the lowest rates are among young adults .  Public health campaigns and growing awareness of health risks are slowly changing attitudes.  Many urban centres have adopted smoke‑free laws, and researchers are advocating to “change the norms around cigarette gifting” .  With sustained efforts—such as raising cigarette taxes, strengthening smoke‑free policies, promoting cessation services and challenging the social rituals that link cigarettes with hospitality—China’s smoking epidemic can continue to be turned around.