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Outline 1 Influencing Factors on Cardiovascular Health 1.1 Tobacco Use The smoking prevalence among Chinese residents has shown a downward trend. According to the Chinese Adult Tobacco Survey in 2018�� the current smoking prevalence among Chinese residents �� 15 years of age was 26.6%�� which was higher in rural areas (28.9%) than in urban areas (25.1%)�� and the daily consumption by each smoker was 16.0 cigarettes on average. The highest prevalence was found in the 45-64 age group (30.2%)�� while the lowest was among people with college education or above (20.5%). According to the Global Youth Tobacco Survey (GYTS)-China 2014�� the overall prevalence of tobacco use among Chinese adolescents was 6.9%. It was higher among boys (11.2%) than girls (2.2%) in junior high school�� and higher in rural areas (7.8%) than in cities (4.8%). The proportion of attempt to smoke in students was 18.8%�� 28.9% for boys and 7.7% for girls. The top three provinces with the highest prevalence of smoking were Tibet (19.0%)�� Yunnan (16.1%)�� and Guizhou (14.9%). In general�� the rate of second-hand smoke exposure among non-smokers in China has been declining�� with 72.4% in 2010 and 68.1% in 2018. 35.5% were exposed to second-hand smoke almost every day. 44.9% of the respondents reported seeing someone smoking in their own homes. 50.9% of indoor workers witnessed people smoking in their workplaces. Internet cafes (89.3%)�� bars and nightclubs (87.5%)�� and restaurants (73.3%) were the most common indoor public sites with severe exposure to second-hand smoke. The proportion of non-smokers who witnessed smoking in co.ee shops and teahouses�� universities�� government o. ices�� medical and health institutions�� taxis�� primary and secondary schools�� and public transport were 48.4%�� 33.3%�� 31.1%�� 24.4%�� 23.5%�� 23.4%�� and 12.9%�� respectively. In 2018�� 86.0% of the people believed that smoking could cause serious diseases. The awareness rates of speci.c diseases caused by smoking ranked from high to low were lung cancer (82.8%)�� heart disease (50.8%)�� stroke (41.4%)�� and impotence (26.0%). 20.1% of the people realized that smoking was a common trigger for all the above four diseases. 71.4% of the people thought that second-hand smoke would cause serious diseases. The awareness of these diseases ranked from high to low as children lung disease (66.7%)�� adult lung cancer (65.8%)�� and adult heart disease (39.7%). 36.1% of the people knew that second-hand smoke was the common cause for all the above three diseases. In 2015�� the prevalence of smoking cessation among Chinese smokers was 18.7%. In 2018�� it increased to 20.1%�� lower in men (19.6%) than in women (30.2%). There was no signi.cant di.erence between urban (20.0%) and rural areas (20.3%). The prevalence of smoking cessation in young age group was relatively low. Cigarette smoking and exposure to second-hand smoke is one of the major preventable risk factors for death of adults in China. The relative risk (RR) of death associated with cigarette smoking in Chinese population was 1.23 (95% con.dence interval [CI]: 1.18-1.27)�� and the population attributable risk (PAR) was 7.9%. The RR was 1.18 (95% CI: 1.13-1.23) among men and 1.27 (95% CI: 1.19-1.34) among women. The PAR was 10.0% among men and 3.5% among women. 1.2 Healthy Diet During the 30 years from 1982 to 2012�� the main diet pattern in Chinese residents changed signi.cantly. It was characterized by the facts that the intake of re.ned grains and whole grains decreased�� especially the coarse cereals. The intake of animal products and edible oil increased significantly. The amount of salt and soy sauce used in family cooking decreased�� but the salt intake was still as high as 10.5g/d. The intake of fresh vegetables was decreasing. Although the fruit intake in 2012 was higher than that in 1982�� it also showed a downward trend compared with 1992 and 2002. The daily per capita intake of fruit was less than 50g. China Health and Nutrition Survey (CHNS) had been conducted four times during 1982-2012. The results showed that the energy intake from dietary fat was rising in Chinese residents�� with the national average of 32.9% in 2012�� which exceeded the upper limit recommended by dietary guidelines (recommended range: 20%-30%); while that from carbohydrates decreased signi.cantly�� with the national average of 55% in 2012�� which dropped to the lower limit of recommendation (recommended range: 55%-65%). According to data of CHNS 2010-2012�� among all dietary factors attributable to the deaths from cardiovascular metabolic diseases�� high sodium intake (�� 2g/d�� accounting for 17.3%) ranked .rst�� followed by inadequate intake of fruits (�� 300g/d�� 11.5%)�� omega-3 fatty acids (�� 250mg/d�� 9.7%)�� nuts (�� 250mg/d�� 8.2%)�� whole grains (�� 125g/d�� 8.1%)�� and vegetables (�� 400g/d�� 7.3%). According to the data of CHNS in 1982�� 1992�� 2002�� and 2010-2012�� the PAR of dietary factors for the mortal