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Ready To Toss Those Cancer Sticks?

Personal Business: YOUR HEALTH


Gloria Resto tried everything. But neither the gum nor the patch nor trying to go cold turkey helped her stop smoking. The New York human resources staffer couldn't survive more than a day or two without lighting up--until she joined a support group in September.

Today, Resto "is quit," as ex-smokers put it. But despite efforts by adults like Resto to kick the habit, along with new health warnings and restrictions in public places, nearly 50 million Americans smoke. And new smokers, teenagers mostly, continue to join the ranks.

MANY AIDS. Attempting to stop is a struggle smokers don't often win--especially the first time around. It usually takes five to six attempts. Ultimately, smokers tend to quit on their own, says Harry Lando, professor of epidemiology at the University of Minnesota in Minneapolis, who has studied smoking cessation for more than 25 years. But heavy smokers may need outside help. Fortunately, there's a plethora of programs, techniques, and products.

The most popular products reduce nicotine withdrawal symptoms. First came nicotine gum in 1984, followed by the transdermal nicotine patch in 1991. Both are now sold over the counter. What's next? A nicotine nasal spray, which debuted in July by prescription only. Nicotine replacement doubles a smoker's chances of quitting, says Kay Eberman, a coordinator of the smoking cessation program at the Mayo Clinic in Minnesota.

But they're not for everyone. The patch, which attaches to your skin like a bandage, delivers a steady stream of nicotine. Over many weeks, you reduce the amount flowing through your body, allowing you to quit gradually. It's the most popular choice because it's the easiest to use--but some people complain of anxiety, rashes, and nausea. The gum requires you to keep chewing, and the flavor isn't exactly refreshing. "The spray gives you a quicker hit, much closer to the sensation you feel when you're smoking," says Nancy Rigotti, who heads up the smoking cessation program at Massachusetts General Hospital in Boston.

Using a nicotine replacement therapy isn't enough. "They don't address the psychological aspect of the addiction," says Lirio Covey, a psychologist who specializes in smoking cessation at New York's Columbia Presbyterian Hospital. Medical experts and drug manufacturers agree that all three products work best when used with behavior modification. The American Cancer Society's Fresh Start program runs for four weeks. Smokers meet twice weekly, for about 90 minutes, and are assigned a buddy. The big draw is group support. "You go to the meetings, and you hear other people's stories, and you start thinking: I can do this," says Resto, who quit with the aid of Fresh Start after smoking for 26 years.

HARD CORE? About 25% of participants in support group programs are not smoking after a year. Likewise, smokers can sign up for commercial programs such as Smokenders and Smokeless, which are pricier but not necessarily more effective, Lando says.

Also, many large hospitals run outpatient smoking cessation clinics such as Massachusetts General's three-year-old Quit Smoking Service. For the truly hard-core smoker, there are inpatient programs. Basically, you check yourself in and emerge days later, smoke-free. About a half-dozen such programs operate across the U.S., but the one at the Mayo Clinic's Nicotine Dependence Center is the best known. An eight-day stay will run nearly $3,000, but the results are better than most: 42% of participants remain smoke-free after six months.

If you're interested in less tried-and-true methods, you might want to check out the research clinic of a hospital. Columbia Presbyterian is studying an antidepressant's effect on ex-smokers. At Duke University, researchers recently tested a hypertension drug with a nicotine patch and found fewer withdrawal symptoms than when the patch was used alone. Generally, the drugs used have federal approval, but not for smoking cessation. Essentially, that means you're a guinea pig.

Given the right combination of therapies, even the most hardened smoker can quit. The key? Motivation. Just ask Mickey Keyser, 67, who attended the American Lung Assn.'s Freedom from Smoking program "on a lark." A pack-a-day smoker for some 46 years, she had never tried to stop previously. When the program ended six weeks later, Keyser had quit. That was six years ago, and she hasn't touched a cigarette since. Her explanation: "I was ready."EDITED BY AMY DUNKIN By Barbara HetzerReturn to top

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