Quit Smoking!

By: Mr Sean Ang, Pharmacist at Unity Toa Payoh MRT Station

First seen in Lifestyle Magazine (December 2013), pg 102. This article is an unbreached version of the printed edition.


Smoking is hazardous, not only to smokers themselves (first hand smoke), but also to others inhaling the smoke (second hand smoke). Smoking can cause health hazards such as increase in mortality (death), cancer, lung diseases, heart diseases and oral diseases. We all know about first and second hand smoke, but a relatively new hazard of smoking has emerged over the years; third hand smoke.

What is First, Second and Third hand Smoke?

1. First hand smoke: The direct inhalation of smoke from burning tobacco in cigarettes, pipes and cigars. Cigarettes contain more than 4000 chemicals, many of which are cancer-causing. On average, a smoker dies 14 years earlier than a non-smoker.

2. Second hand smoke: This is a combination of two different types of smoke – “side-stream smoke” (Smoke given out by the burning of the tobacco product) and “mainstream smoke” (Smoke exhaled by the smoker). In 2004, approximately 603,000 deaths were attributed to second-hand tobacco smoke worldwide. It was also estimated that living with a tobacco user increases the non-smokers’ risk of developing lung cancer by 20% to 30%.

3. Third hand smoke: Residual tobacco smoke that remains on almost any surface like walls, toys, carpets and curtains long after the cigarette has been extinguished.

How Can Third hand Smoke Harm A Person?

A) “By direct inhalation of such chemicals”. Smoking causes many chemicals to be left behind on virtually any surface much longer than after the second hand smoke has cleared.

B) “Off-gassing”. Off-gassing occurs when substances from smoke that have been deposited on surfaces, such as nicotine, are released back into the air as gases.

C) “By reacting with normal indoor air to produce new toxic gases”. The interaction of substances from third hand smoke can produce new toxins that have been recently shown to be cancer causing.

How Can We Get Rid Of Third Hand Smoke?

Third hand smoke builds up over time and is notoriously difficult to get rid of by normal cleaning methods. It cannot be gotten rid of by ventilation, vacuuming or confining smoking to only certain areas. Studies have found that it can still be detected in dust and surfaces of apartments more than two months after smokers moved out.

A possible way to get rid of residual nicotine is through using acidic substances such as Vinegar. However, it may also cause stains and residual smell. At the moment, the only option to get rid of third hand smoke appears to be to change the entire carpet, or to repaint the wall.

Who is most affected by third hand smoke?

Everyone can be affected by third hand smoke, including smokers themselves. However, the greatest concern would be amongst young children living in tobacco-using households.

The cancer-causing chemicals from third hand smoke tend to “stick” to dust which settles on the floor – where children are sitting and playing. They are also more likely to put their fingers to their mouths after touching surfaces contaminated by third hand smoke.

Quit Smoking

The best way to avoid various health hazards of smoking is to QUIT SMOKING!

Ways to quit smoking

1) Cold Turkey

- Choose a date to completely stop smoking (0 cigarettes).

2) Count down method

- Gradually reduce the number of cigarettes per day (eg. to cut down 1 cigarette per day). Aim to reach 0 cigarette by a certain date and work towards the goal.

3) Delay smoking

- Try to delay the next cigarette by a certain period (eg delay for 1 hour or more) per day. Slowly cut down number of cigarettes smoked until you reached smoke free day.

4) Pharmacotherapy

- Nicotine patches, gums, lozenges, inhalers are readily available through the pharmacies. These can help to relieve withdrawal symptoms, reduce cravings and allow the body to slowly cut down its dependence on nicotine.

- Prescription only medications are available through the doctors to help with cravings and withdrawal symptoms.

5) Getting help and advice from smoking cessation trained advisors.

- Feel free to talk to any trained smoking cessation advisors, such as pharmacists and doctors.

In addition, getting support from family members and friends can increase the chances to quit smoking completely. Let them know about your decision and get support from them. Quit smoking is not immediate. Most ex-smokers attempted a few unsuccessful times before quitting completely. The most important factor is not to give up.

Other avenues of getting help and advice:

Health Promotion Board



HPB Quitline

1800 438 2000


HPB Website On Tobacco Use And Cessation


Tobacco Use And
Cessation Website For
Youth Smokers



1. American Cancer Society – Guide to Quitting Smoking.

2. Treating Tobacco Use and Dependence - HPB-MOH Clinical Practice Guidelines 1/2013.

3. Lowell Dale, M.D. What is third hand smoke, and why is it a concern?

4. Lynne Eldridge MD What is Third-Hand Smoke.

5. Julie Chao. Berkeley Lab Confirms Third hand Smoke Causes DNA Damage.

6. Bahar Gholipour. Third hand smoke damages human cells.