Every January smokers across America pledge to quit smoking. But by February, many have given up the effort and are back in the habit, saving that New Year's resolution for next year. How can people really make 2004 the year they quit smoking?

According to Frederic Grannis, M.D., a lung cancer specialist at City of Hope Cancer Center in Los Ange-les, "The most important ingredient in successful smoking cessation is for the individual smoker to make a personal decision to stop smoking in order to avoid the risks to future health. Having said that, it must be understood that it is very hard to stop smoking. The smoker is addicted to nicotine and also has a complex behavior pattern and habit of smoking. Although some people can quit 'cold turkey', without any help, most people fail on their own and need help." When people quit smoking the body reacts to the absence of nicotine, resulting in withdrawal symptoms that can include depression, feelings of frustration or anger, irritability, difficulty sleeping, restlessness, headaches, tiredness and increased appetite. Nicotine substitutes and prescription oral medicines, such as bupropion, can help ease withdrawal symptoms. There are many types of nicotine replacements including nicotine patches, nicotine gum, nicotine nasal spray, nicotine inhalers and nicotine lozenges. Once the physical symptoms of quitting are under control, it is time to focus on the psychological challenges. For many people, smoking is strongly linked to daily activities such as waking up, eating a meal, watching TV or drinking coffee. To cope with cravings that come at these moments, it is necessary alter your behavior. "For example, if you usually have a cigarette when you drink coffee, try taking a brisk walk instead of a coffee break, or consider drinking water or juice instead of coffee," suggests Dr. Grannis. Other tips: * Get rid of smoking related items such as lighters and ashtrays. * Let your friends and family know you are quitting so that you have a strong support system, or consider attending a smoking cessation class. * Avoid people and places where you are tempted to smoke until you are more confident about your ability to avoid the temptation. * Alter habits to perform activities that you don't associate with smoking. * Try alternatives such as chewing gum, hard candy or sunflower seeds. * Find ways to keep your hands busy to distract you from the urge to smoke. Quitting smoking is difficult, but 46 million Americans have successfully quit and therefore reduced their risk of lung cancer.

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