We present C ii observations of 20 strongly lensed dusty star-forming galaxies at 2.1 < z < 5.7 using Atacama Pathfinder EXperiment and Herschel. The sources were selected on their 1.4 mm flux (S 1.4 mm > 20 mJy) from the South Pole Telescope (SPT) survey, with far-infrared (FIR) luminosities determined from extensive photometric data. The C ii line is robustly detected in 17 sources, all but one being spectrally resolved. 11 out of 20 sources observed in C ii also have low-J CO detections from Australia Telescope Compact Array. A comparison with mid- and high-J CO lines from Atacama Large Millimeter/submillimeter Array reveals consistent C ii and CO velocity profiles, suggesting that there is little differential lensing between these species. The C ii, low-J CO and FIR data allow us to constrain the properties of the interstellar medium. We find C ii to CO(1–0) luminosity ratios in the SPT sample of 5200 ± 1800, with significantly less scatter than in other samples. This line ratio can be best described by a medium of C ii and CO emitting gas with a higher C ii than CO excitation temperature, high CO optical depth τCO(1–0) ≫ 1, and low to moderate C ii optical depth $\tau _{{\rm C\,\small {II}}}$ ≲ 1. The geometric structure of photodissociation regions allows for such conditions.