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Chloe Loung

There is no convincing a smoker to quit. So what was the secret for Betania Victor, who used to burn through a pack a day just six years ago?
“Find something that makes quitting feel like a fair trade.”
Born in Brazil and now living in Canada, Victor, 44, is an engineer by training who today works in the maritime industry. For much of her adult life, she had been sedentary and exhausted, and she had been hooked on smoking since the age of 14.
“As a smoker, we like to smoke,” Victor says. “People say, ‘You’re going to die fast.’ We don’t care. Quitting is a sacrifice. To give up something that made me feel so good, I had to exchange it for something bigger.”
Going cold turkey
That “something bigger” began in her thirties when she discovered callisthenics and dance. Yet she remained a closet smoker.
When a shoulder injury sidelined her from callisthenics in 2020, a friend suggested trail running and planted an absurd seed: training for an ultra-marathon.
Every smoker’s biggest enemy is cardio – but Victor was determined.
Having previously failed to quit multiple times, she went cold turkey. No nicotine patches. No last vape. She threw everything away.
“I never smoked again,” she says, six years after her last cigarette. “You really feel the withdrawals from nicotine. My body has never been the same.”
The trade-off meant battling bloating, restlessness, constipation and weight gain, experienced alongside months of gruelling training. It took her a whole month just to run 5km (3.1 miles) non-stop.
About six months after quitting, she completed her first ultra-marathon, in late 2020. She has also run five half marathons and two full marathons since her last cigarette and, at age 42, decided to learn to swim so she could do a triathlon.

A gateway to smoking
Victor had previously tried swapping cigarettes for vapes to taper off her nicotine intake, but it backfired. “I was just smoking more, because you can smoke [vapes] everywhere,” she says.
This highlights a global dilemma: instead of a gateway out of smoking, alternative products often become a gateway in.
Hong Kong is trying to address the problem. The city’s recent ban on possessing e-cigarettes in public places is more than a regulatory tweak. Leading smoking cessation researchers hail it as the cornerstone of a future tobacco-free generation.
Dr William Li Ho-cheung, a professor at The Nethersole School of Nursing at the Chinese University of Hong Kong, and Dr Kelvin Wang, a professor at the University of Hong Kong’s School of Nursing, say the ban is designed to disrupt the exact pathway Victor experienced, preventing vaping from acting as a feeder system to conventional smoking.
The science behind the ban is straightforward, Wang says. Local and overseas studies suggest that “many young people start with electronic cigarettes and then transition to conventional cigarettes”.

Both professors are part of the Youth Quitline, which has been running for two decades and hears that story from callers repeatedly.
By removing e-cigarettes from public spaces – and later from private places – the government is severing that gateway.
“Banning the possession and use of e-cigarettes will help to lower the use of vaping, which means it will also remove some of the risks for youth to take up conventional cigarettes,” Wang says.
The feared mass switch to cigarettes as a result of the ban will not happen in Hong Kong, Li agrees, where a pack of 20 cigarettes from a major brand costs about HK$105 (US$13.40). That, plus strong smoking restrictions and the already low smoking prevalence among youth, make a large-scale return unlikely, he adds.
“Most young smokers have mild to moderate nicotine dependency – they are not heavily addicted. When access to e-cigarettes is cut off, many will simply quit rather than go out and buy an expensive pack of cigarettes.”
A smoke-free generation
A small number of young dual-users, who were smoking traditional cigarettes before they started vaping, might reach for a cigarette in the short term – but the soaring tobacco taxes are a powerful deterrent.
“After tax increases, we consistently see the number of new smokers drop,” Li notes. “They can’t afford it.”
The ultimate goal, Wang says, is not just to suppress vaping but to eliminate tobacco use for people born after a certain year – a policy model the United Kingdom is attempting.
“They are creating a smoke-free generation by banning conventional cigarette sales for people born in a certain year, but they do not ban e-cigarettes. That is not a real smoke-free generation,” he says. “By banning e-cigarettes now in Hong Kong, and later rolling out a full smoke-free-generation law, we will achieve the real thing – a generation that never touches any form of smoking.”
Li sees the ban as a unique opportunity to drive young people to quit.
“With reduced access, this is the right time to step up support. The focus should be on health, not punishment,” he says.

The Youth Quitline uses peer counsellors who understand why young people start smoking – curiosity, peer pressure, stress – and helps them develop strategies to quit without judgment.
Hong Kong offers an unusually rich ecosystem of free quitting services, all accessible through a single number: 1833 183. Callers can choose from Chinese acupuncture, conventional counselling with nicotine replacement therapy (NRT), or specialist medical consultations that can prescribe medications such as bupropion and varenicline.
District Health Centres also dispense free NRT.
Women can access a dedicated quitline that addresses stress, skin damage and reproductive health risks, while young people can connect with the Youth Quitline’s peer counsellors – and, increasingly, with an artificial intelligence chatbot.
AI counselling
Wang’s team has spent years developing AI-driven cessation support, first through WhatsApp and now with a generative AI chatbot that is being piloted within the government’s 1833 183 service.
“We found that young people actually prefer chatting with the AI,” he says. “Most of their messages come after midnight – 1am, 2am, 3am. We could never staff a hotline at those hours.”
The chatbot fills a vital gap by delivering personalised counselling that mimics expert human therapy. It assesses a user’s readiness, identifies triggers and uses motivational techniques to reset behavioural habits. This approach works: a randomised control trial found that the AI group achieved higher quit rates than the human control group. Results will be published soon.
Beyond the well-known risks of cancer and heart disease, smoking and vaping attack the body in ways that often surprise the public. Wang’s team was the first in the world to link e-cigarette use to acute respiratory symptoms.
“It is even more harmful than conventional cigarettes when you look at the respiratory system,” he says.
The devices produce extremely fine particles, including heavy metals, which can penetrate deep into the lungs.
“In the US, there is an epidemic of what’s called ‘popcorn lung’ – those PM2.5 particles enter the ends of the bronchioles and permanently damage the alveoli.”

Wang reels off a list of lesser-known consequences: damage to tiny blood vessels in the eye, leading to cataracts and vision loss; restricted blood flow, causing erectile dysfunction; an increased risk of ectopic pregnancy and miscarriage; and weakened bones, increasing fractures.
Even second- and third-hand smoke carries hidden dangers.
“One-third of schoolchildren in Hong Kong are frequently exposed to second-hand smoke at home,” he says. “This is associated with respiratory symptoms, ear infections and, in infants, a higher risk of sudden infant death syndrome.
“Studies also show that children exposed to second-hand smoke have lower cognitive function – their concentration and academic performance are affected because the chemicals affect blood flow to the brain.”
Third-hand smoke – the residue that clings to clothes, furniture and skin – also sickens others.
“A father who smokes at work brings those substances home on his body. When he holds his baby, the baby touches his shirt, ingesting the toxins,” Wang explains. “The same happens when a baby crawls on a carpet or sofa where someone has smoked.”
No lectures, just reflection
When asked what she would say to someone who is still smoking, Victor does not offer a list of tips. Hearing those only made her want to smoke more.
For those trying to support a loved one, she suggests bringing situations into conversation that might make the person reflect on what matters most – not lecturing, but showing by example.
“You need to find something that’s important to you, that the cigarette is going to get in the way of.”

She offers an example: a smoker who wants to run a 5K with their kids, or be active enough to play with grandchildren. “Something that you feel like you are losing if you don’t quit smoking.”
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On World No Tobacco Day, we discover a marathon runner’s secret to quitting smoking and look at Hong Kong’s goal of a smoke-free generation


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Health & Fitness

Smoking and vaping

Disease

Medicine

How an ex-smoker finally quit and ran an ultra-marathon 6 months after kicking the habit

.css-1c6uqr6{color:inherit;font-weight:inherit;font-size:inherit;font-family:inherit;line-height:inherit;overflow-wrap:break-word;}On World No Tobacco Day, we discover a marathon runner’s secret to quitting smoking and look at Hong Kong’s goal of a smoke-free generation

On World No Tobacco Day, we discover a marathon runner’s secret to quitting smoking and look at Hong Kong’s goal of a smoke-free generation