HOW TO QUIT SMOKING

Quick, what's the greatest threat to a smoker's health? Lung cancer is a good guess, and a wrong answer. Cigarettes cause 124,000 lung-cancer deaths in America each year, but they kill even more people (138,000) via heart disease. Smokers suffer heart attacks at twice the rate of nonsmokers--and they're less likely to survive them. Fortunately, these effects are reversible. Quit smoking, and your risk of a heart attack drops almost immediately, returning to that of a never-smoker within five to 15 years. Breaking the addiction isn't easy--some 40 percent of smokers try each year, and most of them fail. But a failed attempt is not a final defeat. What distinguishes successful quitters is their willingness to keep trying. Smoking cessation is a marathon, not a 50-yard dash, and winning takes practice. Here are some strategies for reaching the finish line.

Think ahead. It often helps to set a date to quit and to spend some time preparing yourself for the challenges you'll encounter. The first ones are physiological. Tobacco smoke delivers nicotine, a powerful psychoactive drug, to the nervous system. Most smokers become irritable, restless, anxious or depressed when they try to go without it, and many have trouble concentrating and sleeping. Fortunately, these withdrawal symptoms are transient. They usually peak within two to three days and then wane steadily. So think beyond the discomfort of the moment. If you can make it to day four, life will get easier.

Use crutches. Medical treatment makes the transition easier. Nicotine administered through patches, gums, lozenges, inhalers or nasal sprays can alleviate withdrawal symptoms, and the prescription drug Zyban (bupropion) can help reduce craving. Studies suggest that quitters who use any of these aids double the chances of success. For best results, you should continue using them for two to three months.

Change your routine. Nicotine isn't the only reason quitting smoking is hard. Cigarettes become a part of a smoker's everyday routine. If you're accustomed to lighting up whenever you have a cup of coffee, finish a meal or encounter a stressful situation, you may need to recondition yourself. Simple tricks can help you sidestep temptation. Some people try switching from coffee to tea for a while, or using a toothpick as an after-dinner pacifier. New rituals are easy to adopt, and they quickly become old ones.

Seek support. Quitting is easier if you have people to lean on, so don't go it alone. Friends, co-workers and family members can provide much-needed moral support, especially if they've been through the process themselves. Physicians and psychotherapists can offer valuable counseling. And though smoking-cessation programs can't guarantee results, they can increase your chances of success. Free information and counseling are now available nationwide at 800-QUIT-NOW or through Web sites such as smokefree. gov, cdc.gov/tobacco and quitnet.com.

Smoking is a powerful addiction, but it can be beat. Former smokers now outnumber current ones in this country, and indoor-smoking bans are giving people new incentives to quit. Medicines now in development could soon make smoking cessation easier, but no one should wait for them. Today's treatments are effective, and too few smokers are benefiting from them.

RIGOTTI, AN ASSOCIATE PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL, DIRECTS THE TOBACCO RESEARCH AND TREATMENT CENTER AT MASSACHUSETTS GENERAL HOSPITAL. FOR MORE INFORMATION ON SMOKING CESSATION, GO TO HEALTH.HARVARD.EDU/NEWSWEEK.