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Giving up smoking

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.   

Tobacco smoke contains the addictive drug nicotine, as well as a range of poisonous chemicals that can damage your health. Giving up smoking brings many immediate and long-term benefits.

It takes just one smoking-free day for blood pressure to return to normal and for carbon monoxide to be eliminated from the body.

Within a few more days, energy levels are increased, the skin can appear healthier and there is less chance of developing coughs and colds. Smell and taste improve and clothes smell fresher.

And of course, there are good financial reasons for quitting.

Tobacco kills about 16 persons per day in Hong Kong. Stopping smoking at any age can increase life expectancy. The chances of developing cancer, heart disease and lung disease are reduced.

Quitting also reduces the health risks to other people. Passive smoking causes irritations to eyes and respiratory tracts, as well as respiratory problems in children, heart disease, and low birth weight. It also increases the risk of having lung cancer.

Passive smoking, which is when a non-smoker breathes in someone else smoke. This smoke contains the same 4000 chemicals that the smoker inhales.

If you are pregnant, there are even more reasons to give up. Smoking when pregnant can cause low birth weight, premature birth, bleeding and even miscarriage. Smoking during pregnancy also increases the child risk of developing a range of illnesses throughout their life, from serious respiratory infection to cardiovascular disease.

Smoking is both a physical addiction and a psychological habit. This is what makes it so difficult to stop.

The nicotine in tobacco smoke is addictive. The "pleasure" of smoking for regular smokers is really the relief of satisfying the body craving for nicotine.

As well as being a powerful addiction, smoking is also a habit – it becomes associated with various emotions, situations and events. The habit can be even harder to break than the physical addiction.

But, despite these challenges, it can be done.

Its helpful to choose a date for stopping (perhaps a month ahead). During that time, keep a "smoking diary" of the times, places and emotions associated with having a cigarette.

Its best to give up completely rather than cut down gradually. Nicotine is eliminated from the body as quickly as 48 hours after a person has their last cigarette, so the withdrawal symptoms tend to be most intense for the first two or three days, then subside over the next two or three weeks. Trying to cut down gradually just prolongs the withdrawal process.

Giving up smoking is easier if there is support available, even if its just encouragement from friends and family. But the chances of successfully quitting are much better with the use of nicotine replacement products, and the drug amfebutamone (Zyban), or complementary approaches may also be helpful.

Nicotine Replacement Therapy (NRT)

NRT products provide a supply of nicotine at a controlled dose to help reduce withdrawal symptoms. Research shows that NRT can nearly double a smokers chances of quitting. It can be used in different forms:

  • chewing gum
  • patches applied to the skin
  • inhalator (a mouthpiece containing a replaceable nicotine cartridge)
  • tablets or lozenges
  • nasal spray

All are available over the counter at pharmacies and in some supermarkets, except for the nasal spray, which is only available with a doctors prescription. The brand names include Nicorette and Nicotinell.

Amfebutamone (Zyban)

Originally developed as an antidepressant, amfebutamone works by adjusting the brains chemistry during nicotine withdrawal. Research has shown that it can double a smokers chances of quitting when used together with regular counselling. It can cause side-effects such as insomnia and dry mouth. It is not suitable for people who have epilepsy.

Complementary approaches

Methods available include:

  • acupuncture
  • hypnotherapy
  • laser treatment

Although there is little scientific evidence to prove that these approaches are effective, some smokers find them valuable.

Withdrawal symptoms

Most people giving up smoking will experience some – although probably not all – of the following withdrawal and recovery symptoms. All are normal and will pass in 2-4 weeks.

  • Mood swings
  • Weight gain – nicotine suppresses appetite, so when people stop smoking and they usually put on 6-8lbs. Its best to address any weight gain after quitting successfully
  • Insomnia – sleep can be disturbed for the first few days
  • Coughing – this is a sign that the lungs are rejecting the tar and debris that have built up
  • Constipation
  • Headaches and dizziness
  • Difficulty concentrating
  • Fatigue

Coping with difficult situations:

Because smoking has been part of the normal routine for so long, there will occasions when is it especially difficult to resist cigarettes. Here are some tips to help:

Try to avoid places where lots of other people smoke or that you associate with smoking, such as pubs, for a while. Smoking is often associated with alcohol

If people offer cigarettes, ask them not to. Remind yourself that most smokers wish they too could stop. Say "No thanks, I am not a smoker"

Break the usual routines. Avoid situations that you associate with smoking. For example, if you usually smoke after dinner, leave the table and do something else instead

If you do have a lapse, do not use it as an excuse to start smoking regularly. Many ex-smokers admit to the odd mistake

Tobacco Control Office
Department of Health
21/ F, Wu Chung House, 213 Queens Road East, Hong Kong
Cessation Hotline : (852) 2961 8883
Enquiries : (852) 2961 8823
Fax : (852) 2575 8944
Website : http://www.tobaccocontrol.gov.hk/eng/index.html

Department of Health – Central Health Education Unit
http://www.cheu.gov.hk/eng/info/smoking_03.htm
http://www.hkmenshealth.com/eng/lifestyle/smoke.asp

National Cancer Institute
http://dccps.nci.nih.gov/TCRB/Smoking_Facts/facts.html

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