Health: Stub Out That Butt!

More than 42% of adult Americans smoked when the first Surgeon General's Report on Smoking and Health was published. Today, 40 years later, fewer than 23% do. That's good news, but it could be better--a lot better. The drop-off in smoking stalled in 1990 and has hardly budged since then. Surveys show that 70% of tobacco users want to quit, but kicking the nicotine habit isn't easy.

What a lot of smokers don't realize is that the most popular method of quitting--just stopping, a.k.a. going cold turkey--is the least effective. Studies show that getting intensive short-term counseling, taking drugs like Zyban (an antidepressant) or using one of the many nicotine aids (gum, patch, inhaler, nasal spray, lozenge) all double the chance of success. Preliminary results suggest that combining these methods will increase success rates even more.

The trick is to find out what works best for you. For counseling, you don't have to go into full-fledged psychoanalysis; you can pick up practical strategies from various quit-smoking telephone hotlines (for a list of numbers as well as tips, visit smokefree.gov) As for nicotine products, make sure you're using them the right way. You need to chew the gum slowly, for example, not swallowing the saliva until the nicotine can be absorbed through the cheek, says Dr. Elliot Wineburg, who has used everything from drugs to hypnosis at Mount Sinai Medical Center in New York City to help hard-core smokers quit. Many people try to make do with as little nicotine as possible, which is a mistake. "You don't want the brain to go into withdrawal," Wineburg says.

It's never too late to quit. As the years go by, an ex-smoker's risk of heart disease and stroke diminishes until it's essentially the same as that of a person who has never smoked, says Dr. Corinne Husten of the Centers for Disease Control's Office on Smoking and Health. Alas, the risk of lung cancer never quite gets down to what it would have been without smoking. "Even with cancer, people respond better to chemotherapy if they quit," Husten says. Best of all, of course, would be not to take up the habit in the first place.