According to the Health Promotion Administration's 2020 Adult Smoking Behavior Survey, the smoking rate of women over the age of 18 in Taiwan has increased from 2.4% in 2018 to 2.9% in 2020, and the rate of female smokers using flavored cigarettes has increased from 33.6% in 2018 to 41.7% in 2020. Although there were no significant differences between data from the two years, the hazards of tobacco products for women remain an important issue that cannot be neglected. Smoking in women not only results in cardiovascular diseases and cancer, but could also lead to health problems such as decreased fertility and conception issues. Therefore, the Health Promotion Administration encourages female smokers to quit smoking and say no to tobacco hazards for the sake of their health and their children's health.

 Women's Talk: Reasons for Smoking
    To understand women's smoking habits, ways of thinking, and motivations for smoking cessation, the Health Promotion Administration invited eight women (including smokers and successful quitters) to participate in a focus group in May 2021 to learn more about the possible reasons behind the womens smoking rate. The results of the focus group showed that most female smokers' first exposure to tobacco products is due to curiosity and peer pressure during junior high school, high school, and university. They may also continue to smoke or fail to quit smoking because of factors such as peers and workplace social circles. As the women age, increased awareness and family affection tend to prompt the motivation and action to quit smoking. On the other hand, the subculture of the smoking circle should not be ignored. For example, “sense of ritual” and “boredom, stress, or anxiety” are manifestation of conscious or subconscious behaviors; the desire to smoke after work, meals or when alone and bored, etc, are consciously learned behaviors that gradually become subconscious or spontaneous habits, which are then used to rationalize smoking【1】.

Quitting Smoking Is the Best Choice for You and Your Family's Health
    Ms. Chen is a full-time homemaker. Back in junior high school, she was influenced by her classmates and wanted to fit in with them by smoking. She became exposed to tobacco products and started using them. For 24 years, she was part of the smokers' circle. The reason for her continued smoking was the sense of ritual and stress. Smoking represents the ritual of “taking a break” or “completing a task.” Smoking during a break, at the end of a task, or after a meal, gave her a sense of completion. She also felt like smoking when under stress and anxiety. Yet, something happened that made Ms. Chen resolve to quit smoking. Two years ago, a word from her daughter brought about a change. Her daughter has always disliked her mother’s smoking and told her, “Smoking will kill you!” These words drove Ms. Chen to quit smoking, and she finally succeeded【1】.
    Family affection can be a powerful catalyst for smoking cessation. It is not just for the sake of the children. One can also invite their spouse or partner to quit smoking together. In the aforementioned focus group, many interviewees smoked or quit smoking because of their significant other, indicating the strong influence of the partner. Working together to quit smoking can help encourage and support each other, promote health, and strengthen the relationship at the same time.

No Smoking Makes You Beautiful, Healthy, and Energetic
    Smoking will affect one’s appearance immediately: The skin will wrinkle, aging will be accelerated, teeth will turn yellow, and dental plaque will increase. In addition, smoking will cause the body to emit a distinct odor in the breath, fingers, skin, etc. For females, smoking can reduce the production of eggs in the ovaries, thereby diminishing reproductive function and subsequently lowering the estrogen level, even bringing menopause earlier by 1 to 4 years, and increasing the likelihood of infertility. Smoking cessation can reduce the risk of infertility, premature delivery, low birth weight, and miscarriage【2】. “No smoking makes you beautiful.” The benefits of smoking cessation definitely outweigh the disadvantages. It improves not only one's health but also interpersonal relationships.

Professional Services and Multi-Channel Assistance for Smoking Cessation 
    Female smokers who want to quit can take advantage of the diverse smoking cessation services provided by the Health Promotion Administration and seek professional services from hospitals, public health centers, clinics, dentists, and community pharmacies near their homes. There are nearly 3,500 contracted medical institutions in Taiwan, whose doctors, pharmacists, and smoking cessation educators can help you quit smoking. You can also call the toll-free Quitline 0800-636363 and receive convenient and confidential smoking cessation consultations from professional consultants. They will discuss with you to make a personalized plan for smoking cessation, and help you overcome the discomfort of the physical withdrawal symptoms during the process. Dr. Chao-Chun Wu, Director General of the Health Promotion Administration, stresses that smoking cessation makes you beautiful. For the sake of your health and your family's health, be brave and say no to tobacco products, and succeed in quitting!

Smoke Cessation Resources:
Toll-free Quitline: 0800-63-63-63
Taiwan has nearly 3,500 contracted medical institutions that provide smoking cessation services (call 02-2352-0120 for the directory)
Contact the local Health Bureau to receive smoking cessation consultation or services and to request a free brochure on strategies for quitting smoking.

References:
1.Report of the Smoking-Prevention Advocacy Program's focus group discussions on women's smoking cessation. (2021).
2.World Health Organization (2021). More than 100 reasons to quit tobacco. https://who.medium.com/more-than-100-reasons-to-quit-tobacco-e2c4060e64e8