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When you plan your strategy for quitting tobacco, use the U.S. Surgeon General’s five keys to quitting: get ready, get support, learn new skills and behaviors, get and use medication, and be prepared for relapse.

1. Get ready

Contact your local doctor, or health department for information about the kinds of medicines, and help available in your area for people who want to quit smoking. Telephone help lines operated by your state can also help you find information and support for quitting tobacco use.

Check with your insurance provider to find out if medications or counseling are covered under your plan. Then,Prepare your body and mind for the stress that comes with quitting.

• Set a quit date and stick to it. This is an important step toward becoming tobacco-free. Choosing a good time to quit can greatly improve your chances of success. For example, avoid setting your quit date on high-stress days, such as holidays.
• Make some changes. Get rid of all ashtrays and lighters after your last cigarette. Throw away pipes or cans of snuff. Also, get rid of the smell of smoke and other reminders of smoking by cleaning your clothes and your house, including draperies, upholstery, and walls. Don’t let people smoke in your home. Take the lighter out of your car.
• If you have tried to quit in the past, review those past attempts. Think of the things that helped in those attempts, and plan to use those strategies again this time. Think of things that hindered your success, and plan ways to deal with or avoid them.
• Once you quit, don’t even take a puff. You may want to try some methods to reduce smoking before your official quit date. You can use a smoking journal to record what triggers your urge to use tobacco. This gives you important information on when it’s toughest for you to resist. After your quit date, don’t smoke at all-not even a puff.

2. Get help

You will have a better chance of quitting successfully if you have help and support from your doctor, family, friends, and coworkers. The Smoke Away Support is a great and long standing place to get help!

• A doctor, nurse or mental health professional can help you tailor an approach to quitting smoking that best suits your needs. These people are also good sources of motivation and support during the quitting process.
• Tell your friends you are quitting, and talk to ex-smokers about their experiences during and after quitting. Have a friend or ex-smoker check in with you once in a while to ask how you are coping.
• If you live with someone who smokes, let that person know how he or she can support you. Be specific. Talk with him or her about not smoking in front of you. Better yet, ask that person to quit smoking with you. That way you can support each other through the quitting process. Also, family and friends can help support and encourage you while you are quitting.
• Join a support group for people quitting smoking. People who have quit smoking may be particularly helpful, because they know what you are going through.
• Get counseling (telephone, individual, or group). The more counseling you get, the better your chances of quitting. Counseling may help you learn to recognize and cope with situations that tempt you to smoke. They can also offer comfort if you have a relapse.
• You may want to attend a program to help you quit smoking. When choosing a smoking cessation program, look for one that has proven success. Ask your doctor for ideas. You can also check with your local health department or call the national quitline at 1-800-QUITNOW for help.
• Children and teens may respond well to community and school programs based on the social and self-image aspects of smoking.
• Use the Internet. The Internet allows round-the-clock access to information about quitting smoking and to chat rooms that can provide support. These programs are good for people who can’t get to a stop-smoking meeting. They also work well for people who don’t like group meetings.

3. Learn new skills and behaviors

Since you won’t be using tobacco, decide what you are going to do instead. Make a plan to:

• Identify and think about ways you can avoid those things that make you reach for a cigarette (smoking triggers), or change your smoking habits and rituals. Think about situations in which you will be at greatest risk for smoking. Make a plan for how you will deal with each situation.
• Change your daily routine. Take a different route to work or eat a meal in a different place. Every day, do something that you enjoy.
• Cut down on stress. Calm yourself or release tension by reading a book, taking a hot bath, or digging in your garden. See the topic Stress Management for ways to reduce stress in your life.
• Hang around ex smokers and nonsmokers.

4. Get and use medication

The U.S. Food and Drug Administration (FDA) has approved several medications to help people quit smoking. You will double your chances of quitting even if medication is the only treatment you use to quit, but your odds get even better when you combine medication and counseling.

These medications also may help you if you use spit tobacco (chewing tobacco and snuff), pipes, or cigars every day.

5. Be prepared for relapse

Most people are not successful the first few times they try to quit smoking. Don’t beat yourself up. Make a list of things you learned, and think about when you want to try again, such as next week, next month, or next spring.

You might try something new next time, such as a new medication, or program. You might try combining tools, such as counseling and medication. Keep trying and don’t be fooled by light cigarettes, or reducing your smoking. Neither one appears to make smoking safer.

Quitting tobacco use when you have other medical conditions

If you have depression, anxiety, or a similar problem, or if you have had an alcohol or drug use problem, try to care for the problem before you try to stop smoking.

Some people who have had one of these medical problems find that the problem returns when they try to quit smoking. If you have any of these problems, talk to your doctor before you quit. Once you quit, seek help right away if you see signs that the problem is returning.

Smoking can also affect the level of several medications in your blood. If you take medications for a health problem, talk with your doctor before you quit smoking to see whether you should alter the dose.

Remember though that you are not alone. Smoke Away  knows this as well as anyone else who has gone down this rocky path to a smoke free existence. Just remember, you are not alone by any stretch of the imagination!

If you need more incentive to quit smoking, here are some reasons that you may not know about. From WebMD.

You know smoking causes lung cancer, emphysema, and heart disease, but you’re still lighting up. To help you get on the wagon, we’ve compiled a list of little known ways your life can go up in smoke if you don’t kick the habit.

From an increased risk of blindness to a faster decline in mental function, here are 10 compelling — and often surprising — reasons to stick to your commitment.

Alzheimer’s Disease: Smoking Speeds Up Mental Decline

In the elderly years, the rate of mental decline is up to five times faster in smokers than in nonsmokers, according to a study of 9,200 men and women over age 65.

Participants took standardized tests used to detect mental impairment when they entered the study and again two years later. Higher rates of mental decline were found in men and women — and in persons with or without a family history of dementia or Alzheimer’s disease, the researchers reported in the March issue of the journal Neurology.

Smoking likely puts into effect a vicious cycle of artery damage, clotting and increased risk of stroke, causing mental decline, writes researcher A. Ott, MD, a medical microbiologist with Erasmus University Medical Centre in the Netherlands.

The bottom line: The study provides substantial evidence that chronic tobacco use is harmful to the brain and speeds up onset of Alzheimer’s disease, Ott says.

Lupus: Smoking Raises Risk of Autoimmune Disease

Smoking cigarettes raises the risk of developing lupus — but quitting cuts that risk, an analysis of nine studies shows.

Systemic lupus erythematosus — known as lupus — is a chronic autoimmune disease that can cause inflammation, pain, and tissue damage throughout the body. Although some people with lupus have mild symptoms, it can become quite severe.

For the analysis, Harvard researchers reviewed studies that examined the relationship between cigarette smoking and lupus. Among current smokers, there was “a small but significant increased risk” for the development of lupus, they report. Former smokers did not have this increased risk, according to the study, which appeared in the March issue of Arthritis & Rheumatism.

SIDS: Maternal Smoking Doubles Risk

Smoking increases the risk of sudden infant death syndrome, or SIDS, a European analysis shows.

The researchers compared 745 SIDS cases with more than 2,400 live babies for comparison and concluded that just under half of all deaths were attributable to infants sleeping on their stomachs or sides. Roughly 16% of SIDS deaths were linked to bed sharing, but for unknown reasons, bed sharing was particularly risky when the mother smoked. The risk was very small when mothers did not smoke during pregnancy, the researchers say.

Maternal smoking alone was associated with a doubling in SIDS risk. The risk was 17 times greater, however, for babies who bed shared and had mothers who smoked. The findings are reported in the Jan. 17 issue of The Lancet.

The safest thing to do is to put the baby to bed on his back with no bedcovers in the same room with parents who don’t smoke,” London School of Hygiene and Tropical Medicine epidemiologist Robert G. Carpenter, PhD, tells WebMD.

Colic: Smoking Makes Babies Irritable, Too

Exposure to tobacco smoke may increase babies’ risk of colic, according to a review of more than 30 studies on the topic.

Colic often starts a few weeks after birth, peaking at about 5 to 8 weeks of age. It usually goes away by 4 months of age. Babies’ symptoms include irritability, inconsolable crying, red face, clenched fists, drawn-up legs, and screaming.

Colic affects an estimated 5%-28% of babies born in Western countries. Its causes have been attributed to everything from exposure to cow’s milk proteins to feeding difficulties to maternal depression or anxiety.

Tobacco smoke appears to raise levels of a gut hormone called motilin in the blood and intestines. Motilin increases the contractions of the stomach and intestines, increasing the movement of food through the gut. “Higher-than-average motilin levels are linked to elevated risks of infantile colic,” the researchers write in the October issue of the journal Pediatrics.

An Increased Risk of Impotence

Guys concerned about their performance in the bedroom should stop lighting up, suggests a study that linked smoking to a man’s ability to get an erection. The study of nearly 5,000 Chinese men showed that men who smoked more than a pack a day were 60% more likely to suffer erectile dysfunction, compared with men who never smoked cigarettes.

Overall, 15% of past and present smokers had experienced erectile dysfunction, more commonly known as impotence. Among men who had never smoked, 12% had erection problems, according to the study, presented last year at the American Heart Association’s annual Conference on Cardiovascular Disease Epidemiology and Prevention in Miami.

Blindness: Smoking Raises Risk of Age-Related Macular Degeneration

Smokers are four times more likely to become blind because of age-related macular degeneration than those who have never smoked. But quitting can lower that risk, other research shows.

Age-related macular degeneration is a severe and progressive condition that results in loss of central vision. It results in blindness because of the inability to use the part of the retina that allows for ’straight-ahead’ activities such as reading, sewing, and even driving a vehicle. While all the risk factors are not fully understood, research has pointed to smoking as one major and modifiable cause.

“More than a quarter of all cases of age-related macular degeneration with blindness or visual impairment are attributable to current or past exposure to smoking,” Simon P. Kelly, MD, an ophthalmic surgeon with Bolton Hospitals in the U.K, wrote in the March 4, 2004 issue of the BMJ. He came to his conclusion after reviewing three studies involving 12,470 patients.

But other studies show that former smokers have an only slightly increased risk of age-related macular degeneration, compared with never smokers, he writes.

Rheumatoid Arthritis: Genetically Vulnerable Smokers Increase Their Risk Even More

People whose genes make them more susceptible to developing rheumatoid arthritis are even more likely to get the disease if they smoke, say Swedish researchers.

In fact, certain genetically vulnerable smokers can be nearly 16 times more likely to develop the disease than nonsmokers without the same genetic profile, according to the study in the October issue of the journal Arthritis & Rheumatism.

Swedish researchers asked participants about their smoking habits and screened their blood for a gene-encoding protein sequence called the shared epitope (SE), which is the major genetic risk factor currently linked to rheumatoid arthritis. Compared with people who had never smoked and lacked SE genes, current smokers with SE genes were 7.5 times more likely to have rheumatoid arthritis.

Smokers with double SE genes were almost 16 times more likely to have rheumatoid arthritis, while smokers without SE genes were only 2.4 times more likely to be affected.

Snoring: Even Living With a Smoker Raises Risk

Smoking - or living with a smoker — can cause snoring, according to a study of more than 15,000 men and women.

Habitual snoring, defined as loud and disturbing snoring at least three nights per week, affected 24% of smokers, 20% of ex-smokers, and almost 14% of people who had never smoked. The more people smoked, the more frequently they snored, the researchers reported in the October issue of the American Journal of Respiratory and Critical Care Medicine.

Even nonsmokers were more likely to snore if they were exposed to secondhand smoke in their homes. Almost 20% of these nonsmokers snored, compared with nearly 13% who had never been exposed to secondhand smoke at home.

Acid Reflux: Heavy Smoking Linked to Heartburn

People who smoke for more than 20 years are 70% more likely to have acid reflux disease than nonsmokers, researchers reported in the November issue of the journal Gut.

Roughly one in five people suffer from heartburn or acid reflux, known medically as gastroesophageal reflux disease or GERD.

The researchers based their findings on two major public health surveys conducted in Norway in the 1980s and 1990s. Just more than 3,100 people who complained of having heartburn and 40,000 people without reflux symptoms answered questions about lifestyle factors including diet, exercise, alcohol consumption, and tobacco use.

Breast Cancer: Active Smoking Plays Bigger Role Than Thought

Other research out in 2004 shows that active smoking may play a much larger role in increasing breast cancer risk than previously thought.

In the study, published in the Jan. 7 issue of the Journal of the National Cancer Institute, researchers looked at breast cancer risk among 116,544 women in the California Teachers Study who reported their smoking status. Between 1996 and 2000, 2,000 of the women developed breast cancer.

The prevalence of breast cancer among current smokers was 30% higher than the women who had never smoked — regardless of whether the nonsmokers had been exposed to secondhand or passive smoke.

Those at greatest risk: Women who started smoking before age 20, who began smoking at least five years before their first full-term pregnancy, and who had smoked for longer periods of time or smoked 20 or more cigarettes per day.

And There’s More …

If those top 10 reasons weren’t enough to motivate you to quit smoking, keep this in mind:

• Smoking is linked to certain colon cancers.
• Smoking may increase the risk of depression in young people,
• Some studies have linked smoking to thyroid disease.

Lastly, the makers of Smoke Away would like to know what reasons not mentioned here would you have our readers know about before stupidly wondering why they should quit smoking. Want to find out other reasons? log onto Smoke Away Support and talk to people who know first hand!

1-800-Quit-Now is a national router number which accepts callers from throughout the nation, seamlessly directing them to the appropriate state quitline. In an effort to promote this valuable resource, the Smoking Cessation Leadership Center has developed a small, plastic card the size of a credit card to help promote the new national quitline, 1-800-Quit-Now. If there is no state-run quitline, the call goes to the National Cancer Institute (NCI) quitline. By the end of the year, every state will be able to offer smokers this valuable service.Quitlines are toll-free telephone centers staffed by trained smoking cessation experts. For clinicians, they can provide an easy, fast, and effective way to help smokers quit. By simply identifying smokers, advising them to quit, and sending them to a free telephone service, clinicians can save thousands of lives.In an effort to try and help people stop smoking regardless of the mechanism, Smoke Away applauds the efforts mentioned above. We also urge people to take part in either this free service, or if they need to, they can certainly log onto Smoke Away Support and talk to actual people who are currently in the midst of their “quit”, or better yet have been successful and are now helping others!

Building on local momentum, Chicago convened a local summit on September 25, 2007, titled Chicago Second Wind Summit: A Chicagoland Smoking Cessation Initiative .  Under the leadership of Carol Southard (who also leads the SCLC ADHA partnership), Stacy Ignoffo from the Respiratory Health Association of Metropolitan Chicago (RHAMC), and Donna Scrutchins from Chicago Department of Public Health , 45 local tobacco advocates convened at RHAMC headquarters and set the following goals and strategies:

Primary Measure

• Reduce 19.1% adult smoking prevalence to 14% by year 2010. 
• Reduce 21.7% teen smoking prevalence to 16% by year 2010.
• Increase quit attempts from 60% to 80% by year 2010.

Secondary Measure

• Double call utilization of quitlines (currently at 0.50%) each year for next three years.

Beginning strategies were developed in the following areas:

•   Targeted public cessation awareness campaign
•   Recruiting community organizations to be smoking cessation resources
•   Smoking cessation intervention education for health care providers
•   Fundraising for smoking cessation strategies
•   Policy issues related to smoking cessation

Committees have already begun to arrange follow-up calls as a way of moving forward on the strategies they have identified.  This event is timed to pave the way as Illinois becomes officially smoke - free on January 1, 2008. 

If you would like more information or would like to be involved in the Chicagoland Smoking Cessation Initiative, contact Reason Reyes at reason.reyes@ucsf.edu or Carol Southard at csouthar@nmh.org .

In the United States, an estimated 25.1 million men (23.4 percent) and 20.9 million women (18.5 percent) are smokers. These people are at higher risk of heart attack and stroke. The latest estimates for persons age 18 and older show…*

• Among non-Hispanic whites, 24.1 percent of men and 20.4 percent of women smoke (2004). 
• Among non-Hispanic blacks, 23.9 percent of men and 17.2 percent of women smoke.
• Among Hispanics, 18.9 percent of men and 10.9 percent of women smoke.
• Among Asians (only), 17.8 percent of men and 4.8 percent of women smoke.
• Among American Indians/Alaska Natives, 37.3 percent of men and 28.5 percent of women smoke.
• Studies show that smoking prevalence is higher among those who had earned a GED diploma (39.6 percent) and among those with 9-11 years of education (34.0 percent) compared with those with more than 16 years of education (8.0 percent). It’s highest among persons living below the poverty level (29.1 percent).

* National Health Interview Survey (NHIS), 2004, National Center for Health Statistics and NHLBI