Like most people, you're probably waiting until Jan. 1 before you commit to your list of New Year's resolutions. But, if quitting smoking is on that list, you shouldn't wait to start preparing for the big event. Developing a clear plan makes it easier to

Start by setting a firm "quit date" far enough in the future to allow time to lay your groundwork. If Jan. 1 seems too soon, push your quit date back a week or two. Once you've set a date, stick to it. Prepare yourself physically. Purchase nicotine replacement therapy ahead of time, and keep it on hand from the very first day. If you've been smoking more than a few cigarettes each day, you are probably addicted to nicotine and will develop troublesome withdrawal symptoms as soon as you stop smoking. In some individuals, the symptoms are mild and easily overcome. Others, however, have enormous difficulty because of the severe physical symptoms and psychological cravings they experience. Nicotine replacement helps control these symptoms and cravings by delivering small doses of nicotine to the body (much smaller than you get when you smoke a cigarette, and without the associated cancer-causing compounds). Studies show that nicotine replacement therapy can double your chances of quitting successfully. It is available in several forms, including gum, patches, inhalers and nasal sprays. (Gum and patches can be purchased over the counter; inhalers and nasal sprays require a prescription from your physician.) An alternative to nicotine replacement is the drug bupropion (brand name, Zyban). This prescription drug, originally used as an antidepressant, has been found just as effective as nicotine replacement therapy in numerous studies. Other prescription medications, such as clonidine and nortriptyline, are also useful but are generally only used when nicotine replacement and bupropion fail. Medications alone, however, are not enough. Although they may help you manage the physical symptoms and cravings caused by nicotine withdrawal, many problems can arise because of the habitual patterns and psychological issues surrounding your smoking. Prepare yourself emotionally. Before you attempt to quit smoking, identify the reasons you want to stop. Are you doing it for your health? Do you want to set a nonsmoking example for your children? Are you spending too much money on cigarettes? Write your reasons for quitting on an index card or small piece of paper that you can carry with you, and review them every time you get an urge to smoke. These constant reminders will help you stick to your commitment to quit. Identify the places and things that trigger your urge to smoke. Sometimes they're as simple as getting in the car or sitting down to eat; or they may be related to emotional stress or fatigue. If you have made a previous attempt to quit, think about the situations that caused you to relapse. Avoid social situations that trigger an urge to smoke. Try to stay away from places where people are likely to be smoking. If you must be around smokers, let them know you are trying to quit and ask them not to smoke around you. Alcohol is another common trigger and should be avoided entirely during the first few weeks after you stop smoking. It may be possible to avoid some triggers, but it's not realistic to expect you can avoid all of them, so plan ahead for how you will handle these situations. For example, if you crave a cigarette immediately after meals, plan to leave the table early and go for a short walk after each meal. If parties are difficult for you, plan to keep a nonsmoking friend at your side. By planning ahead for these kinds of situations, you reduce your risk of giving in to these triggers and starting to smoke again. Enlist the support of family and friends before you actually try to stop smoking. Tell people why you want to stop, let them know how important it is that you succeed, and tell them specifically what they can do to help. Even your friends who continue to smoke can help by not smoking in your presence and not offering you anything to smoke. Consider seeking additional support as well. Individual or group counseling can be of significant benefit, as can regular contact with a physician. Schedule an appointment to talk with your doctor (even if it is only over the telephone) or attend a counseling session before your quit date. Putting these support systems in place before you quit makes it easier to use them if you need them. Prepare your environment. Before your quit date arrives, search your home, office and car for unsmoked cigarettes and throw them all away. Leave no stone unturned: Search every drawer and closet, and check all the pockets of your clothing. While you're at it, toss out all of your ashtrays and matches as well. If losing weight is also on your list of New Year's resolutions, cross it off. Dieting at the same time you are trying to quit smoking will only make it more difficult to succeed. In fact, the majority of smokers who quit actually gain weight, but it is typically less than 10 pounds. As far as your health is concerned, quitting smoking is much more important than losing a few pounds, so get rid of the cigarettes now, and worry about the weight later. Dr. Jonathan Fielding is the director of public health and the health officer for the Los Angeles County Department of Health Services. Dr. Valerie Ulene is a board-certified specialist in preventive medicine practicing in Los Angeles. They can be reached by e-mail at [email protected] Their column appears the second and fourth Mondays of the month.

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