Bureau of Health Promotion, Department of Health, Executive Yuan
Mobilizing All People
Tobacco Free, Yes Taiwan
Tobacco Hazards Prevention & Control Handbook
Bureau of Health Promotion, Department of Health, Executive Yuan
3/23
INDEX
Major International Trend – Say No to Cigarettes
Anti-smoking Warfare – Rescuing the Health of Our Next Generation
High Quality Life Begins in Smoke- Free Homes
No Smoking, More Flavors
Beauty Says No to Cigarettes
Professionals Helping You to Say Goodbye to Smoking Hazards
Say No to Cigarettes, Revitalize Your Personal Workplace Network
Easy Quit, Full Energy
4/23
INTRODUCTION
According to data in a 2002 survey, there are currently 4.9 million smokers in Taiwan. Research
also shows that more than 18,800 people die from smoking related diseases every year. And the
payout from National Health Insurance (NHI) for smoking related diseases reaches an estimate of
20 billion NT dollars, costing a social and economic loss as high as 50 billion NT dollars. Therefore,
tobacco hazards not only put our people’s health in risk, their causing an economic downfall also
severely impact Taiwan’s competitiveness.
Before 1980, “polite smoking” was a social etiquette in the Taiwan society, and people had no
idea about the hazards of smoking. Starting from 1984, the government and private associations
began to advocate anti-smoking, hoping to implant in people’s mind the concepts of “smoking is
harmful to health” and “refusing second hand smoke.” In 1997, legislation of the Tobacco Hazards
Prevention Act was passed to form the legal basis for promoting tobacco prevention and control. In
2002, “Welfare donation of tobacco products for health” efforts were open to the public to enable
works on tobacco control to continue with ample funding.
Promoting tobacco control is an arduous task, regardless whether it is opposing the intense
marketing of the global tobacco industry, persuading and assisting the people to quit, or even
changing the deeply-rooted culture of smoking. However, after the World Health Organization
(WHO) passed the Framework Convention on Tobacco Control (FCTC) in 2003, tobacco
prevention and control has become a global issue. Therefore, creating a quality and vibrant living
environment, and maintaining our people’s health are tasks that demand the government’s
immediate attention. They are also in line with the global concepts of public hygiene and human
rights to health care.
At present, the government, academics and private associations are in cooperation to promote
various major undertakings step by step. These include communicating anti-smoking education to
the people, provision of quit services, promotion of smoke-free restaurants, homes, workplaces and
campuses; and the environment building, law enforcement and amendment, monitoring and
inspection, and basic setup for these premises. Furthermore, in order to fulfill our responsibility as a
member of the international community, we have also proactively presented the efforts and results
of tobacco control in Taiwan. For example, approval of the Framework Convention on Tobacco
Control was promoted within the country, “World NO Tobacco Day” and “Quit & Win” campaigns
were conducted. There is also our participation in international academic exchange in the field of
tobacco hazards, and our assistance to Southeast Asian countries in dealing with tobacco hazards.
By offering our experience of tobacco control, we seek to engage in substantial diplomatic relations
and thus gaining international recognition and support.
All these efforts are expended to meet the public’s needs for a smoke-free environment and
offer the people protection from the hazards of second hand smoke. In the future, the Bureau of
Health Promotion (BHP) will continue to promote works on tobacco control with the vision of
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“Tobacco Free, Yes Taiwan.” And with joint efforts from the people, we could enable our children,
families, colleagues, and friends to study, work, play and grow in clean and healthy environments,
and make no-smoking the new living mainstream culture.
Director General
Bureau of Health Promotion
Department of Health
Hsiu-chuan Lin
3/8
Major International Trend
Say
NO to Tobacco
(pictures)
Anti-tobacco warning signs on the streets of Thailand
Anti-tobacco youth workshop conducted by the Department of Health in Thailand
Taiwan’s stall at the 2003 “Tobacco Hazards Prevention or Healthcare Convention” organized by the Cancer
Society of Finland.
The World Health Organization (WHO) points out that 4.9 million people died from
tobacco hazards in 2002; and if tobacco control is not toughened, as many as 10
million people will die from tobacco hazards every year by 2030. Therefore, second
hand smoke has now been announced by the WHO as the number one carcinogen.
Under the full-fledged efforts of the Bureau of Health Promotion (BHP), Taiwan is
also in step with the world in saying NO to tobacco!
Tobacco Toxins Ravage the Globe
Not long ago, anti-smoking advocates in
India held a grand funeral for tobacco products
in the capital New Delhi. The advocates carried
a fake coffin in the form of a cigarette package
on their shoulder and slowly delivered it into
the crematorium to symbolize tobacco products
going into the grave. Research has shown that
India is one of the 25 most aggressive
consumers of tobacco products, with at least
800,000 people dying from tobacco hazards
every year.
WHO has pointed out that 84% of
smokers are located in developing countries, so
epidemics caused by smoking and their
consequent depletion of national power must be
addressed. The theme of the World NO
Tobacco Day in 2004 was “Tobacco control
and poverty,” which served as a desperate
reminder that the tobacco industry has brought
poverty, not economic development. For
example, mainland China may have levied 5
billion taxes on tobacco products in 1993, but
lost nearly 8 billion on decreased productivity
and medical payouts due to tobacco hazards.
Globally Synchronized Prevention
and Control on An Active Front
For developed country Singapore with a
population of only 3.4 million, the increasing
proportion of the smoking population has
meant that seven people die every day from
tobacco hazards. Smoking-related cancers,
heart diseases and strokes are all major causes
of death in Singapore. It is estimated that
medical payouts and productivity lost to
smoking are costing the Singaporean
government 500 million USD per year.
Therefore, in order to be more effective in
intimidating their people about smoking, the
Singaporean government, which has always
been strict on smoking ban, has asked its health
department to set up six sets of pictures to be
placed “clearly and obtrusively” on all cigarette
packaging. Besides showing a baby with a
3/8
bloodily grotesque brain relying on life support,
other pictures include a close-up of cancerous
lungs, and possible damages from second hand
smoke caused by men smoking in front of their
families. Tobacco companies are forced to put
“convulsive” labels that educate the consumers
on tobacco hazards, and the labels must cover
at least 50% of the total area on the packaging.
At the same time, toll-free, multi-lingual quit
smoking hotlines must be printed to provide
consultations on quit smoking.
As for Taiwan, since the enforcement of
the Tobacco Hazards Prevention Act in
September 1997, promotion and advertisement
of tobacco products, methods and targets of
sales, age eligible and place for smoking, health
warning and label of nicotine contents, have all
been expressly regulated by law. The said Act
was amended in 2000 to broaden the number of
smoke-free environments, and regulate
workplace and restaurants with closed space to
prohibit smoking outside smoking rooms.
Remove Billboards to Unveil the
Demon’s Mask
In the United States, April 1999 was the new
milestone for the anti-smoking movement. All
outdoor large-sized billboards advertising
tobacco products were removed and replaced
by No-smoking ads. From then on outdoor
large-sized cigarette advertisement became
history. The Academy Award Association also
designed a TV ad for “The Demon Awards,”
where a tobacco merchant went to hell to
receive a prize and was commended for causing
people’s deaths from his cigarette sales. The
large outdoor billboard in the ad, meanwhile,
has a tobacco company CEO wearing a bikini,
lying next to a lake with a cigarette in his
mouth, and sneering at the audience. Across the
board is the text “Don’t Doubt,” meaning
tobacco merchants earning big bucks have no
conscience and hide behind the sexy models in
the everyday tobacco advertisements.
Taiwan Playing An Active and
Instrumental Role in the Global
Anti-tobacco Wave
Results from surveys conducted by the
Bureau of Health Promotion show that there are
about 4.9 million smokers in Taiwan. Adult
male smokers smoking everyday consist of
45.3%, whilst adult females and teenagers who
smoke every day make up 4.3% and 8.5%
respectively, and increasing too. More than
18,800 people die every year from
smoking-related diseases. And National Health
Insurance (NHI) payout for medical treatment
related to smoking reaches about 20 billion
dollars per year with an overall social and
economic cost reaching as high as 50 billion
dollars. The financial burden cast on families
and the society is enormous.
Hand in Hand with the World, Taiwan
Combats Tobacco Hazards
As cigarette prices are relatively cheap in
Taiwan as compared to other places in the
world, the government propels the policy of
“Welfare donation of tobacco products for
health” with the aims to reduce people’s
consumption on tobacco products and increase
the funding for works on tobacco control.
In terms of active participation in the
international anti-tobacco movement, the
government is involved in the exchange
projects of tobacco hazards prevention with the
US Center for Disease Control (CDC) and Asia
Pacific Association for the Control of Tobacco
(APACT), and global and regional tobacco
control conferences. It also conducts
international youth anti-tobacco workshops,
transnational academics tobacco hazards
research projects, and l friendly countries
assistance programs.
In order to effectively control tobacco
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hazards from causing global health, social,
economic and environmental problems, the
WHO passed the Framework Convention of
Tobacco Control (TCTC) in May 2003 during
its 56th World Health Assembly (WHA). Up
until September 17th, 2004, a total of 168
countries have endorsed it, 31 of which have
completed their approval procedure. The
Convention is expected to come into effect by
the end of 2004. At present, Taiwan is also
actively abiding by the Convention to legislate
and modify domestic laws. Such gesture,
besides declaring our country’s willingness to
observe international regulations as a
responsible international member, will also
advocate the effectiveness of our work on
tobacco prevention and control, thereby
increasing our visibility in the international
arena.
Moreover, the Bureau of Health
Promotion, Department of Health, conducted
the “Quit Smoking Therapy Service Program”
in September 2002 and built a service network
for “outpatient quit smoking.” More than 3,000
doctors of Family Medicine and Internal
Medicine who had been trained in quit smoking
therapies joined the Program. Since its
implementation, the average success rate of
quitting amongst those who sought this service
is about 21%.
Anti-smoking is an important area of
public hygiene, and also lays the foundation for
national safety and health. Let us act in step
with the international community and stridently
say No to tobacco for the creation of a
smoke-free environment.
4/8
Anti-tobacco Warfare –
Rescuing the Health of Our Next Generation
Smoking not only causes lung cancer and cardiovascular diseases, the degree of its
damage on the respiratory system is far greater than that caused by air pollution. It
simply cannot be ignored.
Let’s try to imagine the black smoke and exhaust fume coming out of a motor
car’ exhaust pipe. Smoking is like placing one such pipe in the mouth, only that the
smoke has no air to dilute it; it will circulate in the lungs and erode the flesh slowly.
When a cigarette is lit, it produces about four thousand types of chemical
substances. According to research reports, at least two hundred of these are harmful
to the human body, with at least 40 of them carcinogenic.
Smoking Light Cigarettes Won’t
Hurt – A 5.2 Billion Dollar Lesson
Schwarz, an American lady, smoked “light
cigarettes” (Merit) produced by the tobacco
company Philip Morris and died from lung
cancer. The Oregon Supreme Court in Portland
ruled that the company must pay punitive
damages in the amount of 150 million US
dollars (equivalent to 5.25 billion NT dollars)
to Schwarz’ family.
The jury upholds that the company's
advertisements mislead consumers in thinking
that light cigarettes are healthier than regular
cigarettes, and thus ruled that the company was
to pay a large sum of damages. Schwarz
changed from smoking classic filter cigarettes
to smoking this type of light cigarettes as she
believed that they were better for her health.
The plaintiff’s lawyer Wobbrock pointed
out that if the smoker inhaled more smoke, or
her mouth was closer to the mouthpiece, then
the amount of tar inhaled would be equal to that
from regular cigarettes.
The 53 year old Schwarz had been
smoking the light cigarette “Merit” for many
years, developed lung cancer and died in 1999.
Her husband was a doctor of Internal Medicine,
so she worked in his medical office for many
years and was fully aware of the risks of
smoking. Yet she still could not escape the
wrongful promotion by tobacco merchants and
lost her precious life as a result.
Taiwan’s First Compensatory
Lawsuit Founded the Rights to be
Free from Tobacco Hazards
America’s earliest lawsuit against tobacco
hazards began in 1954, yet it was not until 1996
that a case was won. For our country, on the
contrary, the victim, Pei-min Wu, of the
nation’s first lawsuit against tobacco companies
spent more than 700,000 on legal fees and was
awarded only 60,000 in damages, but an
example for tobacco prevention had thus been
established. Individual health rights are since
protected from second hand smoke.
Wu emphasizes that asking compensation
from tobacco manufacturers is like constantly
hitting on the city gates with a battering ram.
The success of breaking open the gates is an
accumulated group effort, and he is simply
leading the first hit.
Wu took his family with him to the US
five years ago. During check-in at the
Northwest Airlines desk, he asked for
non-smoking seats but was arranged to sit only
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one row apart from smoking seats. This caused
his youngest daughter to develop asthma and
bronchitis after the flight. The Supreme Court
ruled that Northwest Airlines was to pay
damages to all five members of the Wu family
by compensating them half of their ticket price
from Taipei to Los Angeles, which was about
60,000 NT dollars.
Wu commented that if it was himself
suffering from second hand smoke, he may
have dropped the case to save the hassle of
litigation; but seeing the youngest daughter
suffering from severe asthma, he decided to file
for justice. So he sued Northwest Airlines and
asked for 10 million NT dollars in damages. At
the time, his friends sneered at him, “Are you
out of your mind?”
Wu said that no matter how large the
compensation was, it could not make up the
damage caused to the child. He went on to
emphasize, “I just hope I can depend on the law
to protect my children and fulfill my
responsibility as a father!”
Second Hand Smoke
Number One Carcinogen
Main cause for Poor Indoor Air
Quality
The damage done to health by second
hand smoke has caused the WHO to list it as
the “number one carcinogen.” According to
Bureau of Health Promotion statistics, there are
about 4.5 million smokers in Taiwan. When
these people light their cigarettes, they become
the source of pollution for tobacco hazards
contamination. The dangers of second hand
smoke are pervasive.
Many addicts are oblivious to No
Smoking signs in the restaurants, toilets,
stairways, elevators, department stores and
hospital entrances and exits, and they smoke in
people’s faces as they walk by. Some parents
even smoke as they rear their children in their
arms. While public places may have isolated
smoking areas from non-smoking areas, no
physical partition is actually set up, or the same
air conditioning system is still being used,
allowing harmful smoke to adrift everywhere.
“Second hand smoke is the main source of
indoor air pollution,” said Chi-kuang Lai, the
director of Community Health Center in Taipei
Municipal Gan-Dau Hospital, who has long
devoted efforts in the quit smoking movement.
Hsiu-chuan Lin, director general of the
Bureau of Health Promotion indicates that a
research conducted by Chang Jung Christian
University has found that as high as 70% of our
school children are exposed to second hand
smoke environments. The main place of
pollution is in the homes. Besides smokers in
the family, second hand smoke from visitors is
also one of the sources of smoke hazards. The
director general points out that second hand
smoke created by family members, neighbors,
and visitors are beyond the jurisdiction of the
Tobacco Hazards Prevention Act. And therefore,
the Bureau adopts a soft appeal and advances
the “Smoke-Free Homes” activities to promote
health consciousness in families. This is so that
“no smoking” will not only be realized in
public places but also extends to every home.
Research indicates that Taiwan spends
about 16 billion NT dollars (467.3 million US
dollars) of medical costs on smoking related
diseases. If we calculate the 5-6% NHI payouts
based on the costs used for treating smoking
related diseases, then the annual cost is an
estimated 20 billion NT dollars. Inducing the
estimate using WHO calculations, by 2031, our
country’s deaths from smoking related diseases
may reach 35,000 per year, with over 100
billion NT dollars expended in medical
resources and social costs.
4/8
Stern Yet Polite
Refusing Second Hand Smoke
The Department of Health once did a
survey, which showed that 80% of the public
knew and supported no smoking in public
places but only 30% would openly reprove
smoking in non-smoking areas. Taiwanese
people are polite; non-smokers who spot
smoking in public places will only voice their
opposition when it is no longer tolerable.
Therefore, the Bureau of Health Promotion has
proposed slogans such as “I am 17, I don’t
smoke,” “No cigarette for me, I am cool,” and
“New health idea, no second hand smoke,”
together with the pervasive mass media to
educate the general public. Hence, talk shows
and anti-tobacco advertisement on tobacco
control can be seen on TV; “smoke-free
workplace” and “smoke-free restaurants” are
introduced in newspapers; interviews on quit
smoking hotlines can be heard on radios;
box-lit advertisements of “outpatient quit
smoking service” can be seen in Taipei Metro
stations and the airports. Through these means,
the correct message of tobacco prevention will
be infiltrated to every corner and hopefully
rooted in the minds of the public.
So long as inappropriate smoking
behaviors are reproved sternly yet politely, you
can realize the objective of refusing second
hand smoke; not just for yourselves but also for
our next generation who is not yet able to
protect their own rights!
5/8
Quality Life
Begins in Smoke-Free Homes
The promotional poster of “Frequency” writes, “What would you do if you could
change the past?” In the movie, the actor goes back to the past and says to his father,
“I can’t lose you in that way again.” So the father, Frank, decides to quit smoking and
is able to watch his son married with kids, harboring no life regrets.
No Regrets in Love
Yes, this is only a movie. But cigarettes have
indeed caused many regrets in countless
families. Statistics show that smokers are twice
as likely to develop heart disease as
non-smokers. For smokers under 45 who
smoke 15-24 cigarettes per day, their chance of
developing coronary heart diseases is 9 times
higher than non-smokers of the same age. And
for those who smoke at least 25 cigarettes per
day, the likelihood increases to as much as 14
times. Furthermore, the number of smokers
who die from respiratory-related diseases such
as pulmonary emphysema, chronic bronchitis,
is at least 20 times more than non-smokers.
If you think smoking is a self-adventure,
then you are wrong.
environments ranks in the top three. Natural
miscarriage in pregnant smokers inevitably
increases as smoking damages placenta
functions and causes early miscarriage. For
these women, their perinatal mortality rate is
four times more than that of pregnant
non-smokers, while their probability of giving
birth to a deformed baby is twice that of
pregnant non-smokers, with the child most
likely to develop cleft lip and palate,
cardiovascular abnormities and urinary system
disorders.
Children are the source of family joy, but
one cigarette can destroy all that. New parents’
biggest nightmare – Sudden Infant Death
Syndrome (SIDS) has still no clear cause, but
clinical statistics show that the proportion of
sudden infant death is higher in families with
smokers than those without. Could you build
your happiness at the family’s remorse?
Child, I Want You to Grow Healthily
On the cigarette packets sold in Singapore
prints a picture of a baby born of a smoker
mother. Due to premature birth, the baby in the
size of a palm is on life support with
monitoring equipment all around him. It is a
very sympathetic sight. Even if the baby can
develop the internal organs fully in the
incubator, there is still a big chance of him
developing cardiovascular diseases.
Clinical statistics show that amongst
non-genetic factors that cause premature birth
and newborn deformity, pregnant woman
smoking or constantly in second hand smoke
Smoke-free Homes
Priceless Bliss
According to a survey conducted by
Chang Jung Christian University in a sample of
1564 elementary school kids and parents, 70%
of our school children are exposed to second
hand smoke environments. Nicotine metabolite,
“cotinine,” is also found in the children’s urines.
This substance severely hinders children’s
learning abilities. A research by the University
of Minnesota has found that children growing
up in homes with cigarette smoke not only have
a greater chance of developing asthma before 6,
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but also are likely to become smokers before
the age of 15.
The director general of the Bureau of
Health Promotion has pointed out that the
“Smoke-free Homes’ movement is already
underway in the US, Australia and Canada to
protect the elderly, pregnant women and
children from the hazards of second hand
smoke. According to annual complaint cases
compiled by the “Tobacco Hazards Complaint
Service Center,” “home” was found to rank 3rd
on the list complaint against. This shows that
we ought to work harder in preventing and
controlling second hand smoke in our homes.
Additionally, according to statistics from the
National Fire Agency, Ministry of the Interior,
there were as high as 1399 fires caused by
cigarette butts in Taiwan in 2003, with an
average of 4 fires per day. Most of these
occurred in the homes, making many people
homeless.
Drive the Unwelcome Third Party Out
of the House
Through the promotion of smoke-free
restaurants, smoke-free workplaces, smoke-free
homes and other policies enforced by the
Department of Health, the ratio of adult
smokers is on a yearly decreasing trend. Yet the
number of teenage smokers is on the rise. One
of the most important reasons of this is because
the adults are not setting an example.
A third party in a relationship will destroy
the harmony in the family. Yet smoking may
well destroy happiness for the whole family.
Long term inhalation of second hand smoke
does tremendous harm to the developing bodies
of teenagers. Parents, while knowing that
cigarettes are harmful to health, cannot get rid
of the addiction, thus serving as a negative
example to their adolescents. This often
confuses their concept that “smoking is bad.”
So when provoked by peers, they would find it
difficult to resist.
Talk is cheap. To raise a healthy and
happy next generation, simply don’t smoke at
home and remind relatives and friends to do the
same. If smoking cannot be helped, then go
outdoors, so that the unwelcome third party –
cigarette smoke, can be driven out of the house.
Every family has its own problems, yet
health problems are the most difficult to resolve.
In order to maintain a perfect family, many
fathers are wiling to spend all their lives’
energy on work just to give their children a
material life that is worry free. But what they
do not know is that as their pressures dissipate
with the tobacco smoke in the air, they have
also jeopardized the future welfare of the whole
family. As they smoke, they have also built a
thick wall, shutting out the children who long
to come close to them. In order to prevent
second hand smoke from harming your families
and in order to be closer to your children, it is
absolutely necessary to drive cigarettes out of
the homes!
Building a superbly beautiful home is easy;
say NO to cigarettes would be the first step!
6/8
No Cigarette Smoke,
More Flavors
You are in a restaurant with friends and having great talks, then someone on the next
table begins to light a cigarette…
Experience says that 50% of people encountering such scene would chose to finish
the food and leave as soon as possible; and 30% would change seats. Mr. Lin, the
owner of Alice’ Artistic Delicacies, a fine eatery situated in Tamsui, places utmost
insistence on clean air. “Cigarette smoke destroys customers’ sense of taste, and
nothing is delicious anymore!” he says.
Create Smoke-free Restaurants with
Humor
The WHO promoted the “Clean Air”
movement in various cities in 2001. In response
to this world trend, the BHP of Taiwan’s
Department of Health encourages domestic
restaurant owners to go beyond the regulations
in the Tobacco Hazards Prevention Act and
participate in the contest of “Healthy
Smoke-free
Restaurants.”
Together
a
smoke-free restaurant setting may be created in
Taiwan to protect the health and rights of
consumers for refusing second hand smoke.
Mr. Hsu, owner of Fu-chuan Restaurant,
which won the smoke-free restaurant
innovation contest last year, devised many
smoke-free slogans, posters and even wishing
trees, which amused many people.
Hsu designed many slogans, posters and
even held mini-events, set up “wishing trees”
that hung little cards couples and friends wrote
to their beloved as reminders to addressing
tobacco hazards and health problems. Even in
the toilets, Hsu wrote in large calligraphy, “No
Smoking Applies Even to President Chen!” The
humorous tone makes it the visual focus to
customers visiting the toilets. The wall is hung
with little broomsticks and bamboo baskets on
which several cigarette butts are stuck with a
label “sweeping butts” next to them. The visual
design and simple words playfully preaches the
practice of “No Smoking” throughout the
restaurant.
No Smoking for Chefs and Diners
A Healthy Street
In the smoke-free restaurants of Wuxing
Street, neither can you see smoke addicts nor
chefs cooking with cigarettes. People can enjoy
quality dining settings and taste the chefs’
diligence in preparing the food.
A research conducted by the Public Health
Faculty of Taipei Medical University finds that
the nicotine concentration in restaurants with
no smoking sections is three times as high as
restaurants that observe total smoking ban.
Therefore, through the efforts of staff and
students in the medical university by visiting
every restaurant on Wuxing Street, the
restaurants become smoke-free one by one.
Now Wuxing Street has the highest
concentration of smoke-free restaurants across
the whole country (approx. 100 shops). The
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director of Taipei University Hospital
Chih-hsiung Wu says that 90% of the
non-smoking public and over 70% of the
smoking population all agree with the
promotion of “smoke-free restaurants,”
indicating that the majority of the public have
had unpleasant dining experience with “second
hand smoke.”
Students have also commented that an
owner of smoke-free restaurant on Wuxing
Street has started as an addict, but after their
many sincere visits and active persuasion, he
no longer smokes in the restaurant. For as soon
as he starts smoking in the restaurant, the
students eager faces will pop up in his head,
making him feel guilty.
Driven by Popular Trend
No Smoke More Customers
The fact is, Lin, the owner of Alice’
Artistic Delicacies, was also a big addict once
who smoked for 20-30 years and developed the
habit of collecting cigarette packages. However,
after alarming signs of short breath and ill
health, he joined quit smoking campaigns for
the sake of his and his children’s health.
Having established the place for ten years,
total smoking ban in the restaurant did give rise
to partial customer loss, but also brought more
loyal customers. Lin grins, “No worries,
customers who smoke are a minority, but
80-90% of customers are weary of the smell.”
Smoke-free restaurants are now the new trend.
Only no smoke can live up to the presentations
of delicious foods.
“Sushi Express” is renowned for its fresh
sushi presented on a circling track. Upon its
establishment, rules were set so that all of its
franchises, including dining areas, kitchens,
toilets and common rooms for employees,
would observe a total ban on smoking. The
manager of the Sanchong franchise, Mr. Wang,
says that promoting a smoke-free work
environment is not difficult at all. Some people
even quitted smoking this way. And
“smoke-free restaurants” also entice parents to
take their children and elderly out for a meal
together, thereby broadening the age groups of
customers and prospering the business. It also
saves the hassle of setting up smoking areas or
seat arrangement, which is more advantageous
for the businesses.
Smoke-free Restaurants Require
Your Support
In recent years, the age of smokers has
continued to drop in Taiwan. Lung cancer is on
the top ten causes of death and at least 10,000
people die from tobacco hazards every year in
Taiwan. The WHO has even predicted that, by
2020, the world will have at least a 100 million
smoker population, and 10 million will die
from tobacco hazards.
Second hand smoke is made up toxins
from the cigarette and the gas exhaled by the
smoker. Therefore the damage it causes will not
be less than that placed upon smokers. The
harmful oxidizing substances in the cigarette
are very powerful in attacking the cells, thereby
increasing the oxidizing pressure within the
body and causing damages to the elasticity of
collagen in the skin. Smokers thus have
relatively early signs of skin roughness,
wrinkles, brain power degeneration, and
increased chances of developing cardiovascular
or cancerous diseases.
“Human rights to health” are God-given,
so you have the right to refuse second hand
smoke in any setting. As a consumer, you are to
enjoy the service you pay for. In the face of
cigarette smoke, you can do more than being a
second class restaurant diner. Please support
“smoke-free restaurants”!
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Beauty Says NO to Smoking
“I know smoking is not good for my health, but I just can’t help it….” Since 18, Ling
has been smoking for six years now. Smoking has caused her skin to look dull. With
no cosmetics on, she would look older than her actual age.
Presentation with Cigarette Smoke
Performance Undermined
Not long ago, the “Workplace female
smoker indicator survey” jointly conducted by
Taipei Songshan District Center of Public
Health and 1111 manpower bank indicates that
47.03% of workplace females had their first
smoke between ages 16 and 19, and 26.94%
between ages 13 to 15. 49.32% had their initial
smoke out of curiosity while 47.95% were due
to emotional needs.
Nevertheless, the general public tends not
to be too impressed with woman smokers.
34.69% think woman smokers are not ladylike,
31.81% think it is annoying, totaling up to 70%
for these two groups. Coughing and addictive
behaviors also undermine performance for
woman smokers in the workplace. Many
woman smokers know that smoking will dull
the skin and increase aging (82.19%), as well
as worsen pulmonary functions (82.19%). Yet
only very few women know that smoking will
cause irregular menstrual periods (15.98%),
early menopause (8.22%) and increase the
likelihood of breast cancer (6.39%).
Smoking
Fashionable Pursuit Fashion at
the Expense of Life
Behind
tobacco
companies’
advertisements of glamorous and fashionable
image of tobacco products lies the grotesque
damage done to the human body. According to
the WHO’s publication “Tobacco Domain” in
2002, lit cigarettes produce some four thousand
chemical compounds and 43 carcinogenic
substances, posing severe threats to the human
body. In particular, for female smokers, there is
more likelihood of developing breast cancer
and osteoporosis. Moreover, a research has
shown that in a group of 2500 people aged
forty and above, women were found to be twice
as likely to develop lung cancer as men.
Woman smokers in the workplace may
think they find consolation amidst hectic
schedule or intense pressure by smoking. What
they don’t know is that the carcinogens in the
cigarette cause even more damage to their skins
under tired physical conditions. Beauty expert
Niu-er points out that when women smoke, free
radicals are produced, which slow the
absorption of vitamin C and no cosmetics are
enough to reverse it. This will affect the
moisture content of the skin, making it look dry
and withered. The nicotine in cigarette is an
even greater killer to the skin as it dulls and
darkens the skin.
Quit Smoking
Boosting Beauty and
Professionalism
Besides affecting your appearance, long
years of smoking will make you an addict
without you even realizing it.
One day, writer Jen was looking out the
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window from her office. As she smoked, she
realized she was as bleak as those ghettos out
there. She was then determined to undergo an
overhaul, and quit smoking was a major part of
it. So that cigarette was the last cigarette of her
life. She extinguished it, washed her hands,
prepared herself a pot of tea, and began a new
life.
Do you feel weary about your life? Quit
smoking is a good start!
Starting from this moment, you can be like
Jen. You can give yourself a whole new life, a
whole new opportunity! Once you are
determined to quit, you can go through self-quit,
group psychological therapy, education courses,
quit smoking hotline consultations, clinical quit
smoking service and other means of help. One
week after quitting, you no longer have the
unpleasant smell of tobacco smoke; the
nicotine residues in your body will also be
flushed out. One month after quitting, your
physical strength will return, respiratory
discomfort and illness will reduce, the
likelihood of contracting cold and stomach
ulcers will also decrease and the skin will
become more elastic. After three months, your
pulmonary functions will gradually recover.
After five years, your risk of developing oral
cavity cancer, esophageal cancer, and laryngeal
cancer will be halved; after ten years, your risk
of developing lung cancer will be halved.
Would you like to be a youthful looking
beauty? Begins quit smoking now!
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Professionalism
Helping You Cast Off the Shadow of
Tobacco Hazards
Chen began smoking just to be fashionable as she was a model then and she wanted
to show her colleagues that she was in the same league. She first thought she would
never become addicted, but it was all too late.
What’s worse was that every time she failed to make a breakthrough in quitting, she
smoked even more. At one stage it was so bad that she had to have her fifth cigarette
half way through her breakfast coffee.
Smoking grows on you and, without it, you even feel unfulfilled. Writer Sun
describes smoking as “Innate nostalgia with nicotine serving as a necessity in the
blood to stimulate muse, dissipate despair and pursue maturity.”
Cigarettes are Addictive
Quit smoking is difficult due to its
addition. The addictive element in cigarettes is
nicotine, a stimulant which makes you feel
uplifted and happy.
Psychiatrist Dr. Chiu of Changhua
Christian Hospital explains that those who are
addicted to certain substances also develop
psychological and physiological dependence
for them. Physiological dependence refers to
that the amount of substance administered must
be increased after a certain period of time to
maintain the same effect. Psychological
dependence is where the addict longs for these
substances when deprived of them and find it
unbearable. “It is as if living a normal life is
impossible without it,” says Chiu.
When people begin quitting, their hands
will unconsciously reach for the pockets and
mouths, for they have been doing the smoking
act for a million times and the sudden lack of it
will make them feel something is lost.
With the Help of Doctors
Success Rate of Quitting is 22.1%
According to the Department of Health’s
2002 survey, 46% of smokers in Taiwan
expressed their wish to quit. And 57% had at
least quitted once, or had been asked to quit by
doctors, or had quitted as a result of physicians’
advice.
The Government has conducted the
“Outpatient Quit Smoking Therapy Service
Program” since September 1, 2002, to offer
partial subsidies for medical treatment as an
encouragement to smokers seeking professional
medical quit service. Smokers above 18
smoking an average of at least 10 cigarettes, or
with a nicotine addiction of at least 5 points and
above, are eligible for one quit smoking
therapy per year (8 weeks). Until December
2003, 27,350 people have used the service and
the success rate of quitting in six months time
is 22.1%.
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Breaking Up with Nicotine
Never Get Together Again
Quit smoking is not easy, but in Taiwan,
many who want to quit are shy to ask for help.
Quit experts have kept reiterating that quitting
should not be done alone, that one has to come
out and utilize all the professional help possible.
At present, the most common way of quitting is
“nicotine replacement therapy.” That is to
minimize the discomfort of nicotine withdrawal
as nicotine has been released slowly into the
body when smoking. Current methods include
the use of nicotine lozenges, nicotine patches
and inhalers.
Jun, who is a business manager at an
international trade company, has been smoking
for over eight years with an average of 12
cigarettes per day. After many failed attempts at
quitting, she sought help in the outpatient quit
smoking division of a hospital. In the first three
days of using nicotine patches, she still smoked
a couple. After the fourth day, she ceased. On
the 15th day, she decided that she wouldn’t need
the patches. Till this day, she has not smoked.
She commented that having the patches was
much easier than using conventional methods
to quit.
If you want to quit but don’t know where
to start, pay a visit to the hospital!
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Say No to Cigarette
Revitalize Your Personal Workplace
Network
The Myth of Cigarette and
Interpersonal Relationship
“Catch you at the same place!” said David,
the engineer, as he walked into the stairways.
Dennis, who had his head buried in the
financial reports thought, “Well, I really need
David’s help in this case. Just treat it as a social
engagement….” Dennis followed after David,
dare not tell him that he has quitted already.
Yet does smoking really make Dennis
better and more successful in the workplace?
What Dennis didn’t know was that his direct
supervisor, Susan, would instinctively assume
that he went out for a smoke and mucked
around with others whenever Dennis was not at
his desk. “How can you expect self-discipline
and responsibility from an employee who
cannot even quit with determination?” Susan
thought during performance appraisal, despite
Dennis’ seniority.
The Elite Class Does Not Smoke
The conference room is full of tobacco
smoke while the men engage in brainstorming
ideas; a bunch of colleagues puffing cigarettes
on the balcony are sharing the gossips and
trivia at work; and a successful businessman
with a lit cigar in his mouth is sitting on his
leather chair behind the executive cypress desk.
These familiar scenes in the 1980s movies have
misled people to think that smoking is
synonym for success, group identification and
elite.
In fact, data from within the country and
abroad both shows that the social economic
status of the smoker population is relatively
lower than that of the non-smoking population.
Taking the UK for example, ratios of male and
female smokers with high social and economic
status are 12% and 10% respectively; but for
those with relatively low social and economic
status are 40% and 35% respectively. The
Bureau of Health Promotion’s 2001 “Major
National Health Survey” also shows that
amongst adult males who smoke everyday,
those with junior high school education and
below make up 61.8%, 2.5 times higher than
those with vocational school, university
education and above (24.9%). Blue collar
workers also smoke more than white collar
workers.
So if smoking is harmful to the body and
not beneficial for work, why smoke at all?
The fact is that many males developed
smoking habit when they were in the army. The
Community Medicine Division of the Armed
Forces General Hospital and the National
Defense Public Hygiene Faculty have jointly
executed the “Voluntary Soldiers Smoking
Prevalence and Epidemics Survey” and found
that the percentage of male soldier smoker was
48.7%. That is, on an average of two voluntary
soldiers, one of them has the smoking habit.
Chu, a professor at the Armed Forces
General Hospital points out that the closed
environment, peer influence, killing time and
boredom are amongst the reasons for high
smoking rate in the Armed Forces. However,
research results also show that smoking will
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undermine the physical strength of the Armed
Forces and interfere with training. At present,
the Armed Forces are on their way to promote
smoking cessation for a month for their new
recruits’ training program. Both the US and
Sweden have pushed for a three-month
smoking cessation period during their new
recruits training. This has significantly reduced
the number of new recruit smokers by one third
to half.
For a Sober Mind
Coffee is Even Better
“Smoking gives me inspiration,” and “Nicotine
in the cigarette revitalizes the brain cells” are
the most common excuses for long-time
smokers who won’t admit that smoking is
slowly suicidal. Nevertheless, to relax from
work pressures, it is not necessary to smoke. A
cup of coffee also gives the desired effect. The
bitterness in coffee will stimulate the
parasympathetic nerve through the salivary
glands, which in turn will maintain the balance
of the autonomic nerve system (ANS) and
alleviate tiredness felt by the sympathetic nerve.
Moreover, taking a coffee break at work with
colleagues can also enhance interpersonal
relationships and relieve anxiety. One sip of
coffee in exchange of a better mood and health
is definitely worthy.
Most importantly, coffee does not give
you the tobacco smell and cause second hand
smoke hazards. You will become more
approachable and cease to be the public enemy
at work. Would you like to feel welcome at
work? Start by saying NO to cigarettes!
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Easy Quit
Full Energy
“It was only after quitting that I began to realize how bad it was for those around me.
Smokers stink so much!” says 36 year old director Kenneth Yan of Yulong Group. He
was very apologetic.
The truth is, the majority of long-time smokers do feel very apologetic, but they
simply cannot resist the craving.
Quit smoking is indeed difficult. A person usually goes through many attempts
before quitting the habit completely. The physical and psychological dependence
tobacco products cause is rather serious. With external help, quit smoking can be
easy.
“There would most likely be many attempts before success,” says Doctor Lai of
Family Medicine at Gan-Dau Hospital, who is responsible for coordinating the BHP’s
Outpatient Quit Smoking Therapy Management Project. Despite so, he emphasized,
“The door to quit smoking is always open.”
Will Power Alone May Not be
Sufficient
Many smokers think that quitting the
addiction simply involves chewing nicotine
gum form the pharmacies, or sticking nicotine
patches on the arm.
However, Dr. Lai, who helps outpatients
quit smoking, clarifies that the use of
medication or chewing gum or patches are just
supplementary means to quit smoking. The
issue of addiction involves complicated
physical, psychological and social problems.
Those addicted who suddenly undergo a
decrease or cessation of cigarette smoking can
develop various withdrawal syndromes. The
body may develop many conditions, such as
drooling, constipation, lethargic, weight
increase.
Contemporary music artist Jonathan Lee
describes the agony of quitting as “there are no
words to describe it.” His shoulders would
become numb, scalp feel like pins and needles,
and spirit go adrift in the ceiling looking down
at his own sweating body.
Find the Motive
Shift Behavior
Of course, quitting is different to every
one. Some people quit easily, but the key to
successful quitting all depends on the
motivation. Psychiatrist Dr. Chiu from the
Changhua Christian Hospital emphasizes,
“Quitting without motivation will never
succeed.”
Chen shares her experience of quitting
which is to give oneself a strong reason. The
key to her success in quitting is that she told
herself, “I have never done one thing in this life
with perseverance.” She faced up to the will
power challenge and finally succeeded.
Dr. Lai of Gan-Dau Hospital in the Family
Medicine Division shares his experience in
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treating smoker patients who come to
consultation for other illness. He would seize
the opportunity to inform them their illness is
smoke-related. For example, to coughing
patients, he would advise, “If you don’t quit,
your coughing will not recover.” Usually, those
with an addiction would be willing to quit.
At the same time, those quitting smoking
can find ways to divert their behaviors and
emotional outlets. When the craving for a
cigarette overwhelms, one can take deep breath
10 to 14 times coupled with chewing carrot or
cucumber sticks to replace the desire of
smoking.
Drink Water
Exercise
Accelerating Elimination of Toxic
Substances
Generally
speaking,
withdrawal
syndromes are symbolic of recovering physical
fitness and will remain for 2-4 weeks. Usually
after a few days, discomfort will start to
decrease until all ceases.
As far as the agony of withdrawal
syndromes is concerned, besides seeing the
doctor and using supplementary quitting
methods for relief, drinking water is also
helpful. Water can moist the throat and
effectively suppress the cravings. Exercise by
stretching the limbs, chest and jumping, or
wash face will also make you sober.
By drinking more water, urinating more,
exercising more and sweating more, the
cravings for a cigarette can be effectively
decreased and the elimination of toxic
substances such as nicotine in the body can be
sped up.
Meanwhile, don’t forget to seek help from
professional support groups. Some groups and
hospitals have quit smoking classes. These
classes enable the members to share
experiences and encourage each other, thereby
providing stronger support!