To order reprints please e-mail Newsweek Magazine.
Sponsor Information

Did you light your first cig after watching Bogey smoke one after another in"Casablanca"? Or did you spot supermodel Christy Turlington puffing away and decide if cigarettes kept her so slim they were for you, too? Or maybe you've been smoking so long you don't even remember when or why you first started.

Of course, you've learned Bogey succumbed to cancer of the esophagus, thought related to smoking, and heard Turlington now shuns tobacco. Bottom line: you've been bombarded with evidence cigarettes are bad, even deadly, for your health. But can you kick the habit?

It's obviously not easy. After all, millions of Americans are still puffing away even though CDC statistics reveal that 32 percent will die prematurely because of their addiction. In fact, smoking is the No. 1 preventable cause of morbidity and mortality in the United States, killing 440,000 Americans each year. If you've tried to stop smoking by yourself and failed, it's not surprising, says Corinne Husten, M.D., medical officer in the Centers for Disease Control and Prevention's Office on Smoking and Health. "Less than 5 percent of people who try to quit are actually able to sustain abstinence for three to twelve months. And doing it alone is the least effective method," she says. "People need medical help and support to get through quitting because this is a powerful physiological addiction. Within seconds, nicotine goes straight from the lung to the brain. It acts on the reward centers of the brain just like cocaine and other addictive, euphoric drugs."

When smokers go off nicotine and feel lousy, Husten says they are going through serious drug withdrawal. "That's a big part of why they start smoking again. They don't feel normal without nicotine because it has made physiological changes in the brain," she explains."We've found that nicotine-replacement products in the form of gum, patches and inhalers can help. They don't totally replace all the nicotine you are getting when you smoke, but they provide a more steady level that can reduce withdrawal symptoms."

Quitting smoking can also be made much easier thanks to the antidepressant bupropion hydrochloride, marketed as Zyban. "You start taking it about a week before you stop smoking. Zyban works on the brain chemicals dopamine and norepenephrine and, although the mechanism isn't fully understood, helps stop the cravings for cigarettes," says Terry Jacobson, M.D., director, Office of Health Promotion and Disease Prevention, at Grady Hospital in Atlanta, Ga. "It can be also be very helpful to combine Zyban with nicotine replacement therapies. With these new pharmacological treatments we haven't had before, we can double the quit rate."

Jacobson, associate professor of medicine in Emory University's School of Medicine, says asking your doctor for prescriptions to help you quit smoking may not be enough to kick the habit , however. "In general, physicians just want to give meds. They don't have the time or training to give adequate counseling - but we know medications alone are far less effective unless you also get behavioral counseling and adequate support," notes Jacobson, who heads a smoking-cessation program at Grady that boasts a success rate of double the national average.

Among nondrug approaches to kicking tobacco, Jacobson says, smoking-cessation experts are finding success with the "states of change" behavior-modification model. "The idea is that people need different things to help them quit smoking, depending on their readiness to quit," he explains. "There are 'pre-contemplators' who are just thinking about quitting but not ready to do it, 'contemplators' who are interested in quitting in six months and 'preparers' who want to quit in the next 30 days. The key is to move people through these stages through targeted counseling."

What if you've tried support groups, Zyban, nicotine patches and are still reaching for a cigarette as you read this? "What works for others may not work for you. You may need a higher dose of medication or to use it longer. And there are other medications - clonidine (a high blood pressure medication) and the antidepressant nortriptyline - that aren't specifically for smoking cessation but they can be helpful if first-line pharmacotherapies are not effective," says the CDC's Husten. "You wouldn't give up if you had diabetes and couldn't control your blood sugar on your own-don't give up on kicking cigarettes. It may take several approaches but you can find a way to quit."

Back    Next Page

For Free Information on Our Advertisers Click Here.