Technology is helping to make winners of quitters.
The internet has long been rife with self-help sites for those who wish to give up smoking, but new technologies are emerging to give smokers a leg up in their struggle.
There are websites that offer interactive resources to motivate quitters and keep them on track, mini-computers that can help you track your progress, and software for hand-helds that makes it easier for doctors to pitch in.
"These technologies offer a lot of promise -- they are very intriguing," said Scott Strayer, a physician who developed software called the Handheld Computer Smoking Intervention Tool for the National Cancer Institute.
The software allows clinicians to access data about smoking cessation, drug interactions, addiction evaluations and other information to use in interviews as people begin the effort to quit.
The role of computers is evolving, said Strayer, a family practice physician who teaches at the University of Virginia. He hopes the next generation of hand-held medical devices will be able to track smokers' progress and link their quitting regime with their health records, to give doctors a portable and unobtrusive profile of their patients' efforts.
Though there has been little clinical research, Strayer said websites with interactive capabilities like social networking also can improve the chances of kicking the habit for good.
A study published last month in the New England Journal of Medicine found smokers tend to quit in groups and that real-life social networks add to the pressure to quit.
Researchers at the University of California-San Diego said they looked at 12,000 socially interconnected people over 32 years. They did not examine online communities, but some researchers believe that what works in the real world also would work online.
One of the best online communities is at a site run by a suburban Boston woman, Terry Miller (quitsmoking.about.com). It offers an environment of mutual encouragement and support among its thousands of members, who gather dots, stars, keys and wings as they progress.
Miller, a 51-year-old mother of two, logged on to the site after smoking for 26 years. That was six years ago and Miller now operates the site, which she says has helped thousands of people quit.
Miller says the online community actually may work better than a real-life social circle at helping people. For example, the support community online is far bigger, it's made up entirely of individuals on a shared journey, and it's available to quitters round-the-clock.
"In all of the years I've been participating at the ... forum, the idea of stepping outside of oneself to help another has been the foundation of the community. It's contagious and self-sustaining," Miller said. Though she has no firm evidence, Miller believes the success rate for people who join the site is much higher than the 7 percent who succeed in the general population.
Beth Bock, a professor in the Department of Psychiatry and Human Behavior at Brown University Medical School, has been studying online resources for aspiring quitters for years. Her latest research, due to be published shortly in the Journal of Medical Internet Research, found that while web-based resources are plentiful, it may be difficult to locate the best sites.
An analysis of the top results for search terms like "quit smoking" or "smoking cessation" found three of every four sites offering little or no quality resources; many merely sold smoking-cessation products or listing articles.
The best sites followed U.S. Public Health Service guidelines, which include assessing how ready smokers are to quit, assisting them with plans, providing practical counseling tips and suggestions, offering social support, recommending mediation and arranging follow-up.
Interaction is crucial, Bock said, and while some sites provide ways for smokers to interact with each other, they could be doing much more.
PRESSING THE BUTTON
The QuitKey mini computer helps quitters keep track of their progress.
Then there are devices like the QuitKey, a computer small enough to carry on your key chain, and which can prod you, step by step, along the path to nicotine freedom.
In step one, you smoke normally but press a button, to allow the device to track your tobacco habits. The little computer creates a profile of your addiction. Then, in stage two, it prompts you when to smoke, gradually reducing the number of cigarettes per day until it reaches zero.
If all else fails, there is a South American website called Build Your Own Death Project (irreal.cl/byodp) that offers a novel way of reminding smokers of the deadly consequences their habits can have.
The site allows smokers to download, print and assemble cigarette packaging with skeletons, ghosts and other ghoulish graphics on them and names like "Cancers," "Muerte" and "Suicide."