The successful implementation of smokefree legislation in Hong Kong has led to an overall decrease in the total number of smokers but the remaining smokers who are finding it difficult to quit are going on to become "hardcore" smokers, according to a new study from Hong Kong presented at the World Congress of Cardiology.

Hardcore smokers are defined as those smokers that (1) are daily smokers, (2) have a smoking history of at least six years, (3) have never tried to quit, (4) don't want to quit smoking, (5) smoke at least 11 cigarettes, on average, each day and (6) are 26 years or older.

The study found that the number of remaining smokers in Hong Kong who went on to become hardcore smokers grew from 23.8 per cent (2005) to 29.4 per cent (2008) of the male smoking population and from 10.6 per cent (2005) to 16.3 per cent (2008) of women who smoke.

"The increase in hardcore smokers is a worrying trend," said, Dr. Doris Leung, The Chinese University of Hong Kong. "Smokefree legislation has gone a long way in reducing the overall number of smokers in Hong Kong but what we now need is to look more closely at how we can help those remaining individuals with serious tobacco habits to stop smoking."

Tobacco use and cardiovascular disease

Smoking is one of the major causes of cardiovascular disease (CVD) and directly responsible for one-tenth of all CVD worldwide. Smokers are almost twice as likely to have a heart attack as people who have never smoked. Moreover, secondhand smoke exposure is responsible for 600,000 deaths every year.

A person can substantially lower their CVD risk by stopping smoking. The risk of coronary heart disease is cut by half one year after quitting and is nearly the same as someone who never smoked 15 years after quitting. While stroke risk is reduced to that of a person who never smoked after five to 15 years of not smoking.