Wearing a face mask on the streets of Chinese cities has been de rigueur for an eternity due to the air pollution. If one lives there, one is for all practical purposes a smoker. It’ just industrial generated rather than tobacco.
Between the air pollution and the 52% smoking rate, it’s not hard to understand that many Chinese who get this start with lungs below full health.
I believe a majority of the men smoke cigarettes as well.
I suspect there will be a close correlation between mortality and ‘lung condition’ due to smoking or exposure to pollution.