We explored the relationship between the standardized mortality of pulmonary heart disease (PHD) and smoking at Shifang county through a five-year follow-up study of 29,498 farmers over 35 years old. The death ratio of PHD was 30.35%, which stood first in all causes of death. The mortality of PHD for cigar/cigarette smokers regardless of sex was not significantly different from that for nonsmokers (P > 0.05). The RR was 1 or so. The analysis of data stratified by age showed that the specific mortality increased with age in spite of some inequalities smoking; the RR of PHD for cigar/cigarette smokers in all age groups were 1 or so revealing no significant differences (P > 0.05). However, the standardized mortality of PHD increased with the accumulated amount of smoking. The relationship between the mortality of PHD and short-term smoking with small dose was not significant (P > 0.05), but when the accumulated amount reached certain level, i.e. the smoker consumed cigar more than 270 kg or consumed cigarette more than 20,000 packs, the relationship between the behavior of cigar/cigarette smoking and the mortality of PHD became apparent. The RRs were 1.40-3.94 and the ARs 171-1610 per 100,000 person years (P < 0.05-0.01).