From 1990 to 2000, the proportion of people living in urban settings in China increased from 26% to 36%, the number of cities increased to 663, and the number of towns also soared. It is expected that urbanization in China will reach 45% by 2010, and 60% by 2030, with an extra 200 million more people expected in the urban areas before 2010. This growth comes at a cost in health terms. For example, a clear relation exists between urbanization and the prevalence of diabetes in China (diabetes defined as diabetic symptoms and a random blood glucose concentration of 11.1 mmol/L or more, a fasting blood glucose of 7.0 mmol/L or more, or an abnormal result of 2-h oral glucose tolerance test). Studies suggest that patients in China who were diagnosed with diabetes in middle age eventually lost an average nine years of life, and that risk of mortality was much higher than in Western populations. The rapid environmental changes that follow urbanization are increasing the prevalence of the major risk factors for chronic disease. Tobacco use, unhealthy nutrition, and physical inactivity leading to obesity and hypertension are already common, and physical inactivity is increasing. The prevalence of current cigarette smoking in men (smoked in the past 30 days) was 57% in 2002, but had fallen from 63% in 1996; less than 3% of women are current smokers. This favorable trend must be continued, because lung cancer death rates are calculated to have more than doubled in men between 1991 and 1995, and are increasing at 2–5% per year in urban and rural working men aged 15–54 years. The decrease in smoking is the only encouraging risk factor trend, and is consistent with the plateau of tobacco consumption over this same period in the face of a rising adult population, as has occurred in other countries where tobacco taxes have been raised sharply. In 1999 the first Global Youth Tobacco Survey in China showed that 22% of students aged 13–15 years had ever tried to smoke; the current smoking rate was only 5%. China's first comprehensive survey in the fields of nutrition and health was done in 2002. 71,971 households were chosen from 132 counties of 31 provinces, autonomous regions, and the municipalities, using the Central Government household census, and 243,479 people were included in the survey. The prevalence of hypertension (blood pressure 140/90 or higher) in people aged 18 years or older was 19%—a 30% increase since 1991. The prevalence of adult overweight (23%) and obesity (7%) had increased by 39% and 97%, respectively, over a 10-year period.