On Smokeout Day, What We Know About How to Quit

Researchers think combining meds and counseling works better for many smokers than a single drug can.

Video: Smoking Cessation

Video: How to Stop Smoking

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Today is the American Cancer Society's 34th annual Great American Smokeout—yet Americans seem determined to hang on to their cigarettes. A recent report from the Centers for Disease Control and Prevention found that after years of declining, the number of Americans who smoke headed back up last year. The agency estimates that 46 million adults were smokers in 2008, about 2 million more than the year before—an increase from 19.8 percent of all adults to 20.6 percent. Among Americans 65 and older, the percentage of smokers jumped 12 percent from 2007 to 2008. Good news: The smoking rate fell 3.6 percent in young adults from ages 18 to 24. Nearly half of the smokers surveyed in 2008 said they had quit for at least a day during the year.

[Photo Gallery: America's Smokiest Cities]

For smokers who want to kick the habit, an American Cancer Society interactive Web page offers help on how to quit for good. Better still, call the ACS Quitline at (800) 227-2345; phone counseling may double the chances of success, according to the ACS. A counselor can help you figure out the approach that is best for you, says Tom Glynn, director of cancer science and trends.

Different methods are constantly under discussion. Earlier this month, for example, scientists released study results that compared combinations of products such as nicotine patches and lozenges and bupropion, an antidepressant also approved (as Zyban) to help wean smokers from tobacco. Their findings suggest that the patch plus the lozenge may be the most effective way to help smokers stay smoke free for at least six months. "We know that dual use of nicotine replacement medications is more effective than single use," says Glynn. "But we need to do a lot more research on what the best combinations are." For now, the Food and Drug Administration has not approved the use of more than one nicotine medication at a time. That may change, says Glynn, as evidence of benefit accumulates. Counseling can further improve the odds.

[Read 12 Reasons to Really Quit Smoking.]

You may have considered electronic cigarettes, which are battery-powered and free of tobacco. Glynn calls them very intriguing, because they give smokers nicotine and something to do with their hands. But they haven't been through rigorous testing to show evidence of benefit, he says, and not enough is known about their ingredients. A recent small FDA study found that E-cigs might contain carcinogens.

Glynn advises avoiding social situations that encourage smoking, like hanging out with coworkers on their smoke break or in a bar that lets smokers light up inside. So far, 24 states have enacted laws to ban smoking in all public places such as bars or restaurants. Many of the smokiest metro areas are in states without such a ban; almost all of the least smoky metro areas are in states that have one. To avoid temptation, maybe you should consider a move to the Provo-Orem metro area in Utah, where 95 percent of residents say they are smoke free.

Here are more cities where smoking rates are low.

Most Smoke-free Metro Areas % Who Are Not Current Smokers
Provo/Orem, Utah 95.1
Ogden/Clearfield, Utah 91.6
San Jose/Sunnyvale/Santa Clara, Calif. 91.6
Bethesda/Gaithersburg/Frederick, Md. 90.9
Bridgeport/Stamford/Norwalk, Conn. 89.5
Salt Lake City, Utah 89
San Francisco/San Mateo/Redwood City, Calif. 88.8
Santa Ana/Anaheim/Irvine, Calif. 88.7
Miami/Fort Lauderdale/Miami Beach, Fla. 88.4
Los Angeles/Long Beach/Glendale, Calif. 88.3

Source: CDC