The actions of citizens themselves also cause problems for the struggling healthcare system. China has struggled for many years to establish regulations on smoking in public places, but without success. With 300 million people smoking up to 22 cigarettes a day, the risk of preventable health problems increases dramatically (BBC News October, 2015). It doesn't help that China is also the largest producer of tobacco, offering a wide range of brands to suit any budget. Smoking has also been deeply ingrained in Chinese culture. Within a family, a child whose father and grandfather smoked will most likely smoke himself. Smoking not only affects the smoker, but everyone else around them, including family members, friends, and even those who are in the smoker's vicinity for any length of time. The period of exposure increases the risk of conditions such as heart disease, diabetes, many types of cancer and even death. Many of these diseases require long-term care and often at moderate to high expense costs (CDC, 2012). And with only about 10% of smokers quitting by choice and the remaining 90% being forced to quit due to the decline in smoking