BMC Public Health 2006, 6:65 http://www.biomedcentral.com/1471-2458/6/65 tioned quitters, but this explanation may have masked a more personal sense of failure to exercise sufficient will power at a moment of social pressure to light up. In addi- tion, the perceived lack of cessation resources may have been due to a paucity of tax supported public health agen- cies and environmental support systems (e.g., cigarette taxes, smoke free ordinances) for smoking cessation in China. Compared to most western societies where public health promotion initiatives and revenue from tobacco sales have provided educational, fiscal and regulatory sup- port to curb smoking attitudes and behaviours, public health efforts in Chinese society have not yet succeeded in setting a social agenda that supports the reduction of tobacco use. Competing interests The author(s) declare that they have no competing inter- ests. Authors' contributions TY conceived of the study, conceptualized ideas, super- vised its conduct, and designed and coordinated the data collection phase. KF, FL, and BD all helped to interpret findings and contributed to the text. All authors reviewed drafts of the manuscript and approved the version to be published. Additional material Additional File 1 Relapse Survey. A copy of the survey instrument (translated into English) is presented as a Microsoft Word document. Click here for file [http://www.biomedcentral.com/content/supplementary/1471- 2458-6-65-S1.doc] Acknowledgements We thank the married men and their families who agreed to participate in this household survey Hangzhou City and the medical students who con- ducted the household interviews. We also thank Edward Lichtenstein for his comments on an earlier draft of this paper. 5. References 1. Lopez AD, Collishaw NE, Piha T: A descriptive model of the cig- arette epidemic in developed countries. Tob Control 1994, 3:242-247. 2. ACS: The 12th World Conference on Tobacco or Health: Tobacco control country profiles 2nd edition. American Cancer Society; 2003. 3. Cheng TO: The current state of cardiology in China. Int J Car- diol 2004, 96:425-439. 4. Peto R, Chen Z, Boreham J: Tobacco--the growing epidemic in China. JAMA 1996, 275:1683-1684. Tran GD, Sun XD, Abnet CC, Fan JH, Dawsey SM, Dong ZW, Mark SD, Qiao YL, Taylor PR: Prospective study of risk factors for esophageal and gastric cancers in the Linxian general popu- lation trial cohort in China. Int J Cancer 2005, 113:456-463. 6. Zhang H, Cai B: The impact of tobacco on lung health in China. Respirology 2003, 8:17-21. 7. Salo PM, Xia J, Johnson CA, Li Y, Kissling GE, Avol EL, Liu C, London SJ: Respiratory symptoms in relation to residential coal burn- ing and environmental tobacco smoke among early adoles- cents in Wuhan, China: A cross-sectional study. Environ Health 2004, 3:14. 8. Chen ZM, Liu BQ, Boreham J, Wu YP, Chen JS, Peto R: Smoking and liver cancer in China: Case-control comparison of 36,000 liver cancer deaths vs. 17,000 cirrhosis deaths. Int J Cancer 2003, 107:106-112. 9. Peto R, Lopez J, Boreham M: Mortality from smoking in developed coun- tries: 1950-2000 New York, Oxford University Press; 1994. 10. Yang G, Ma J, Chen A, Zhang Y, Samet JM, Taylor CE, Becker K: Smoking cessation in China: Findings from the 1996 National Prevalence Survey. Tob Control 2001, 10:170-174. 11. O'Connor K, Langlois R: Situational typing and graded smoking reduction. Psychol Rep 1993, 72:747-751. 12. Bliss RE, Garvey AJ, Heinold JW, Hitchcock JL: The influence of sit- uation and coping on relapse crisis outcomes after smoking cessation. J Consult Clin Psychol 1989, 57:443-449. 13. Fiore MC, Bailey WC, Cohen SJ, Dorfman SF, Goldstein MG, Gritz ER, Heyman RB, Jaen CR, Kottke TE, Lando HA, Mecklenburg RE, Mullen PD, Nett LM, Robinson L, Stitzer ML, Tommasello AC, Villejo L, Wewers ME: Treating tobacco use and dependence. Clinical practice guidelines Rockville: MD, U.S. Department of Health and Human Serv- ices, Public Health Service; 2000. 14. Gu D, Wu X, Reynolds K, Duan X, Xin X, Reynolds RF, Whelton PK, He J: Cigarette smoking and exposure to environmental tobacco smoke in China: The international collaborative study of cardiovascular disease in Asia. Am J Public Health 2004, 94:1972-1976. 15. Chen X, Li X, Stanton B, Fang X, Lin D, Cole M, Liu H, Yang H: Cig- arette smoking among rural-to-urban migrants in Beijing, China. Prev Med 2004, 39:666-673. 16. Yang TZ: Study on stress of urban residents during social tran- sition. Chinese Epidemiology 2002, 23:473-475. 17. Marlatt GA: Situational determinants of relapse and skill- training interventions. In Relapse prevention: Maintenance strategies in the treatment of addictive behaviors Edited by: Marlatt GA and Gor- don JR. New York, Guilford; 1985:71-127. 18. Shakib S, Zheng H, Johnson CA, Chen X, Sun P, Palmer PH, Yan L, Jie G, Unger JB: Family characteristics and smoking among urban and rural adolescents living in China. Prev Med 2005, 40:83-91. 19. Yang TZ, Miao B: Evaluation of the smoking cessation program of "Wives' help". Chinese Social Medicine 1993:47-48. 20. Unger JB, Yan L, Shakib S, Rohrbach LA, Chen X, Qian G, Chou CP, Jianguo S, Azen S, Zheng H, Johnson CA: Peer influences and access to cigarettes as correlates of adolescent smoking: A cross-cultural comparison of Wuhan, China, and California. Prev Med 2002, 34:476-484. 21. Trinidad DR, Chou CP, Unger JB, Johnson CA, Li Y: Family har- mony as a protective factor against adolescent tobacco and alcohol use in Wuhan, China. Subst Use Misuse 2003, 38:1159-1171. 22. Guindon GE, Tobin S, Yach D: Trends and affordability of ciga- rette prices: Ample room for tax increases and related health gains. Tob Control 2002, 11:35-43. 23. Tseng WS, Wu DYH: Chinese culture and mental health New York, Academic Press; 1985. 24. Yang TZ: Health education theory and method Hangzhou, Zhejiang Uni- versity Press; 2004:102-108. 25. WHO: Combating the tobacco epidemic. In World health report Geneva, World Health Organization; 1999. 26. Yang G, Fan L, Tan J, Qi G, Zhang Y, Samet JM, Taylor CE, Becker K, Xu J: Smoking in China: Findings of the 1996 National Preva- lence Survey. JAMA 1999, 282:1247-1253. 27. Pan Z: Socioeconomic predictors of smoking and smoking frequency in urban China: Evidence of smoking as a social function. Health Promot Int 2004, 19:309-315. 28. Zheng H, Sussman S, Chen X, Wang Y, Xia J, Gong J, Liu C, Shan J, Unger J, Johnson CA: Project EX--a teen smoking cessation ini- tial study in Wuhan, China. Addict Behav 2004, 29:1725-1733. 29. Hesketh T, Ding QJ, Tomkins A: Smoking among youths in China. Am J Public Health 2001, 91:1653-1655. Page 6 of 7 (page number not for citation purposes)