Calling It Quits

By Christine Gorman

You know you shouldn't smoke. You know all that tar and nicotine are destroying your heart and lungs, not to mention what they will eventually do, if you're a man, to your sex life. But if you, like 48 million other Americans, are still smoking, you've got another chance to quit this Thursday as part of the American Cancer Society's 22nd annual Great American Smokeout. One in 4 smokers is expected at least to try kicking the habit. Nobody says it will be easy. A national survey made public last week by the Hazelden Foundation of Center City, Minn., found that it took former smokers, on average, at least 10 attempts over 18 years before they finally stopped for good. The No. 1 reason for quitting, cited by more than half of all ex-smokers: health concerns or an actual health problem, like suffering a heart attack. Six out of 10 quit the hard way, by going cold turkey (which may give you a clue as to why it took them so long).

Today, however, there's a whole pack of treatments and therapies that can take some of the pain out of quitting. Among them:

Nicotine-replacement therapy is designed to temper the acute symptoms of withdrawal, such as irritability, sleeplessness and anxiety. Nowadays you have a choice between gum, skin patches or nasal sprays. These substitutes still deliver nicotine to your bloodstream, but more slowly than smoking does and at a lower dose. Gums and sprays work more quickly to ease withdrawal, although doctors report that these products are also subject to abuse. Many people find the patches easier to use, and they are better suited to those who suffer from nasal allergies or sinusitis. Pregnant women, heart patients and folks with high blood pressure should not use nicotine substitutes except under a doctor's supervision.

Bupropion, sold under the brand name Zyban, is a prescription drug that works on the brain to lessen the symptoms of nicotine withdrawal. It has also been used under the name Wellbutrin to treat folks with depression. Patients who take Zyban tend not to gain weight when they quit smoking. The drug can be used alone or, to increase your chances of success, in combination with the patch. Zyban is not for you, however, if you suffer a seizure disorder, have ever had a head injury or stroke or already take Wellbutrin or certain other psychotropic medications.

Hypnosis can be used to change those ingrained messages about smoking swirling through your head. Finding a qualified hypnotist can be tricky, however.

Acupuncture helps in the short term, but there hasn't been enough research on its long-term effectiveness.

Whatever method you decide to use, the two most important keys to success are good social support from family and friends or a self-help group like Nicotine Anonymous, and something the experts call skills training. That means having a plan ahead of time for how you're going to cope with stress, the No. 1 obstacle to kicking the habit. The favored techniques include exercise, meditation, counting to 10 while slowly exhaling, and practicing saying "no, thank you" when offered a cigarette.

And should you find yourself feeling frazzled and desperate, just remember the quitter's mantra: "Nobody ever died from giving up smoking."

For more on how to quit smoking, visit time.com/personal You can e-mail Christine about this article at [email protected]