Just smoking isn't the only problem... people around smokers can also get sick. The show Mission Possible, in collaboration with the Thai Health Promotion Foundation, talks frankly about cigarettes with Dr. Thaney Thaniyawan, a lung specialist in critical care and lung transplantation, and Du Sanya Kunakorn, who has personally experienced heavy smoking and quitting. He admits that during his heavy smoking days, his life revolved around finding places to smoke, causing him to lose both concentration and focus. Meanwhile, the doctor adds clear health information: even non-smokers exposed to secondhand and thirdhand smoke risk lung disease, allergies, and cancer. He emphasizes that the sooner one quits, the better the body's chance to recover, inviting everyone to care for their health and quality of life before it’s too late.
Currently, smoking of traditional and electronic cigarettes in public places is on the rise, causing many to involuntarily inhale smoke despite not smoking themselves. How do you observe the smoking rate these days?
Du Sanya: Comparing my generation to today, clearly today is better. In the past, walking on sidewalks, you’d definitely see smoke everywhere, sometimes including yourself. Now, the chance to encounter smoke is much less, almost none. Walking for a while, you might see some, but clearly it’s different and improved.
Dr. Thaney: Traditional cigarette smoking has decreased, but other forms like e-cigarettes are increasingly seen in many places. Even educational institutions and shopping malls are beginning to see it. Sometimes with marijuana, you might not see the person, but can smell it passing by.
What are the health impacts of being exposed to smoke? Many understand the dangers to smokers themselves, but what risks do people nearby face?
Dr. Thaney: For traditional cigarettes, the smoker is most affected, but those nearby also inhale similar harmful substances, though in smaller amounts. Sensitivity varies: some people are very sensitive, experiencing sore throat, burning sensations, breathing difficulty, nasal voice, or even asthma attacks when smoke penetrates deeply. Traditional cigarettes contain many carcinogens that non-smokers exposed to secondhand smoke also absorb, posing similar cancer risks.
When people hear cancer, they often think of lung cancer due to inhalation, but these cancers can start in the nasal passages and throat. The smoke’s chemicals can enter the bloodstream, affecting other organs. One less-considered cancer is bladder cancer: smoke toxins absorbed into the blood pass through the kidneys and are excreted in urine, exposing the bladder to carcinogens, increasing cancer risk there as well.
If you had heard this 20 years ago, would you have quit then?
Du Sanya: Probably not. As a former smoker, one habit worldwide is self-justification. Speaking from experience, current smokers have a reduced sense of smell for cigarette smoke, so they don't realize that after smoking, just entering a smoke-free room, others can smell smoke on their breath. When I smoked, I didn't realize this, because smokers don’t notice the smell themselves. They’re not trying to harm anyone, but can do so unknowingly, as smoking dulls their sense of smell from daily exposure.
How many years did you smoke?
Du Sanya: Since I am older than Woody, I smoked more. When I entered university, the theory was that your surroundings heavily influence you. Architecture students smoking was normal then. I later learned cigarettes have been warned as harmful for less than 100 years, but have been used for nearly 1,000 years, initially as medicine and in rituals, brought to Europe by Columbus. I smoked about one pack every two days.
What are the differences in harm between smoking firsthand and being exposed to smoke as a bystander?
Dr. Thaney: The smoker is most affected, inhaling directly. Secondhand smoke concentration decreases with distance but still harms bystanders. Many lifelong non-smokers get lung cancer or allergies, sometimes blamed on diet, but cigarette smoke is a major hidden culprit. Thirdhand smoke refers to toxic residues lingering on clothes or surfaces after smoking. Children in such environments inhale these residues, causing significant allergy problems.
So if a father smokes, he brings these toxins home, especially in the child's bedroom, which might be thought smoke-free, but if the father lingers there, the child is exposed?
Dr. Thaney: Exactly, the child is fully exposed.
Du Sanya: Let me ask directly: if a smoker goes outside to smoke and then comes in to hold the child, does the child get exposed?
Dr. Thaney: Yes. These toxins cling to the smoker’s body. As Du Sanya said, smokers don’t smell it themselves, but non-smokers, especially children, are very sensitive and smell it immediately. Young children can’t say it smells bad but will keep inhaling it when held, and over time they become accustomed to the smell like adults.
What effects do the deposited toxins have on children or infants?
Dr. Thaney: Mostly allergies. All the smoke irritates children's respiratory tracts, causing eye irritation, runny noses, and unexplained allergies that doctors can’t diagnose otherwise, often due to smoke exposure.
If someone has smoked for 20 years but quits today, will their lung cancer risk disappear?
Dr. Thaney: It won’t vanish completely but will significantly decrease. However, it won’t be the same as someone who never smoked. Many people ask what happens if they quit after decades of smoking. Certainly, health improves, but not fully back to baseline.
Du Sanya: It’s karma. The consequences of past actions remain, but when you choose to do good, positive effects follow, as the doctor says. Expecting zero risk immediately is unscientific. It’s like throwing a ball and expecting it not to bounce back. I want to encourage those like me—those who want to quit and those who have accepted smoking as part of life—to quit. I once felt I couldn’t quit because I relied on smoking as a stress relief. I was stressed often, and smoking was my helper. Eventually, I lost confidence that I could live without it, even though I was born without it. That’s a strange feeling I want to share.
How did you quit the first time?
Du Sanya: The first time I used medication that made me feel a bit dizzy but helped reduce the pleasure from smoking by slightly releasing dopamine, so smoking tasted like nothing. Smokers expect smoke and taste, but this method removed the taste and smoke. I quit for nearly a year but then relapsed. That relapse feeling is very dangerous. Doctors say quitting is hard and problematic. I argued with my wife about it. We were in France; all the cafes around us had smokers. I only drank coffee from a grocery shop nearby, reserving a table, hoping for just one cigarette. It felt like euphoria and happiness, but not enough. If I had just one cigarette with a coffee, life would be perfect. Old friends returned, and I smoked again for another year.
Dr. Thaney: The damage worsens if you quit and relapse repeatedly. Research shows lungs recover gradually after quitting, but if smoking resumes, lung damage happens faster and recovery slows compared to the first quit. Repeated cycles make lung recovery increasingly slow and damage faster. This is commonly seen in patient care.
From traditional cigarettes to e-cigarettes, what did you tell yourself at each phase?
Du Sanya: I quit traditional cigarettes first. After the France episode, I quit them completely and switched to e-cigarettes, which heat short tobacco strands electrically without burning, producing no ash. I believed this was a health improvement from severe harm to milder harm, at least that’s what I thought.
Are e-cigarettes really made to reduce health damage?
Dr. Thaney: Nicotine causes addiction and is harmful itself, causing blood vessel constriction, raising risks of high blood pressure, heart disease, and stroke. If nicotine reaches a child’s developing brain, it reduces blood flow and may impair brain development. These effects don't require direct smoking; secondhand exposure in young children inside homes also exposes them. Some parents say their kids grew up fine despite their smoking, but children without nicotine exposure might have been smarter or more successful. Nicotine exposure can limit their potential.
What is the best method to quit smoking, including mindset and process, nowadays?
Dr. Thaney: The best way is to quit cold turkey, with a strong mentality and clear reason for quitting. Without a personal purpose, quitting is impossible. This purpose must be meaningful to the individual—some value their birthday, their child’s birthday, or want a New Year’s resolution. Choose one reason and set a clear quit date. Before that date, prepare mentally to quit, and on that day, smoking must stop completely.
Du Sanya: I agree that if you plan to reduce gradually, it only works in a controlled environment with no triggers to cause stress or cravings, which is unrealistic in life. Every day varies; some days are good, some stressful. When stressed, you might reduce cigarettes to 3 or 2, then ask for 3, 5, or 10 again. Reducing causes fluctuations, and reduction and increase tend to go together.
Please share from both the doctor’s perspective and a former smoker’s experience.
Du Sanya: Today, I want to reach those who want to quit but continue smoking. You may feel pleasure due to dopamine release, but deep down, you suffer more than you enjoy. You know this but pretend not to. You can quit because I did, and many others have. You are the group who can quit because you already want to. The method I used: my problem wasn’t weight gain or what the doctor mentioned.
My challenge was that if your work requires interacting with people and you fear irritability—like I did when quitting—you must distract yourself with other things. You have to forget smoking by focusing elsewhere. Also, practice mindfulness: be aware of what you’re doing, your environment, yourself, and your goals. Stay present in that reality. After a few days, in 21 days, it becomes a habit, no longer painful. In 3 months, it becomes second nature—you simply don’t smoke.
Dr. Thaney: Everyone knows smoking is problematic. If we dare to quit, we become strong in our own eyes and to the world. For me, quitting is the greatest gift to oneself, enabling us to fully realize our highest potential with pride.
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