Tobacco was once considered a universal remedy for a slew of ills. Between 1935 and the early 60s, cigarette advertising had images of doctors and nurses apparently encouraging smoking, with copy that read: “More doctors smoke Camels than any other cigarette” and “Why physicians call our new brand a Health Cigar”.

In many countries today, tobacco advertising is mostly banned. Cigarette packages have strongly worded health warnings with graphic images of diseased organs and sick people, warning of the smoking’s dangers.

In Hong Kong, these include “Smoking causes peripheral vascular disease” with a photo of blackened, diseased toes, a call to “Quit smoking for future generations”, and the phone number for the Hong Kong government’s Quitline: 1833 183.

Smoking also causes cancer. On this, Professor Tony Mok, chairman of the clinical oncology department at the Chinese University of Hong Kong, is clear.

Called a giant of cancer care for his contribution to advancing global healthcare in lung cancer, he says: “Smoking is a sure way to introduce carcinogens into the body.”

“The first stop is obviously the airways and lungs, initially causing inflammation and damage to the normal tissues. Over time the carcinogens induce DNA damage (mutations) that would directly or indirectly cause cancer. But that is only the first stop,” Mok says.

“The same toxic material would reach the stomach via saliva, and be absorbed into the [blood] circulation, reaching many parts of the body. The final station is the bladder, accounting for the higher incidence of bladder cancer among smokers.”

Why, though? Tobacco use was once considered just a nasty habit; now we know that nicotine is highly addictive. Smoke from cigarettes delivers nicotine to the brain within 20 seconds of its inhalation. It then acts on receptors in the brain which trigger the release of the feel-good hormone dopamine that lifts a person’s mood – for a short time.

Despite how antisocial smoking has become – think of all the smoke-free zones now – the WHO said that in 2020, 22.3 per cent of the world’s population still used tobacco, a number that looks set to rise.

According to some figures, the global number of smokers is forecast to increase between 2024 and 2029, to 1.1 billion.

Yet many smokers really do want to give up – nearly 70 per cent.

Perhaps they are not getting the right help. According to the US Centres for Disease Control and Prevention (CDC), fewer than a third of adult cigarette smokers use cessation counselling or medications approved for cessation by the Food and Drug Administration when trying to stop.

Smokers have the best chance of quitting through such programmes or one-on-one counselling rather than trying to go it alone. Counselling helps smokers understand their habit and the triggers that drive it.

In addition to some form of counselling, doctors recommend two types of medication. One is nicotine replacement therapy in the form of patches, chewing gum or lozenges. Less frequently they prescribe oral medications.

E-cigarettes, or vapes, are as dangerous as cigarettes

Many vapes come in fruit flavours that might seduce users into thinking there’s something healthy about them: strawberry, melon and apple sound pretty harmless.

Even if it did not contain nicotine, every vape tested revealed at least one hazardous chemical.

Stop smoking to restore health

Mok warns that the potential damage and cancer risk from smoking is in direct proportion to pack year – the number of packets of cigarettes smoked per day multiplied by the number of years of smoking. The higher the pack year, the higher the cancer risk.

• After 20 minutes: Blood pressure and heart rate drop to normal, and the circulation in the extremities – hands and feet -starts to improve.
• After 12 hours: Cigarettes contain about 7,000 different and dangerous chemicals, including carbon monoxide, which limits the body’s ability to deliver oxygen to organs. High levels in the blood contribute over time to cardiovascular disease. Within 12 hours of a last cigarette, carbon monoxide levels in the blood fall, and the oxygen levels return to normal.

• After one day: The lower levels of carbon monoxide and increased oxygen in the body also boost cardiovascular function, lowering the risk of having a heart attack.

• After two days: The senses of taste and smell begin to improve because the damaged nerve endings responsible for these begin to heal. There may be nicotine cravings, but food will be much more enjoyable.

• On day three: Breathing will ease as lungs start to heal, and within two weeks, they will function about 30 per cent better than they did while smoking.