by Cliff Mehrtens

Quitting smoking is one of the most difficult health-improvement tasks a person will tackle. It often involves multiple attempts and a variety of strategies.

“It is very hard,” said Dr. Devina Talwar of Harbor Internal Medicine in Mooresville, which is part of Lake Norman Regional Medical Center. “Willpower is the key, but it is definitely hard.”

About 7 percent of smokers will succeed at quitting on their first try, according to the American Cancer Society. Only about half of those are able to quit “cold turkey,” which means stopping without weaning themselves from the addictive nicotine contained in cigarettes.

An estimated 45 million adults – about one in five – in the United States smoke cigarettes, according the Centers for Disease Control and Prevention. Seventy percent of smokers say they’d like to quit, and 40 percent will try to quit this year, according to American Cancer Society statistics.

“The biggest factor is they have to want it for themselves,” said Dr. S. Jacob Nadakav of Mooresville’s Harbor Internal Medicine. “Once they come to understand that smoking is not good for their health, and looking at the cost point-of-view, it can help with their decision.”

The most common medical methods to help patients quit (all approved by the U.S. Food and Drug Administration) are:

• Nicotine patches – The patches release a measured dose of nicotine through the skin. A person is weaned off nicotine by switching to lower-dose patches over several weeks. Different types and strengths of patches are available, with and without a prescription. The 16-hour patch is designed for light-to-average smokers, and is less likely to cause side effects. It doesn’t deliver nicotine during the night, so it may not be right for those with early-morning withdrawal symptoms.

The 24-hour patch provides a steady dose of nicotine, which helps avoid peaks and valleys. It helps with early-morning withdrawal. But there could be side effects like disrupted sleep patterns and skin irritation.

• Nicotine gum – The gum is fast-acting because the nicotine is absorbed through mucous membrane in the mouth. It can be bought over the counter and comes in various strengths. One advantage is that a smoker can control the nicotine dosages by using gum.

• Nicotine nasal spray – The spray, which requires a doctor’s prescription, delivers nicotine quickly into the bloodstream because it’s absorbed through the nose. It relieves withdrawal symptoms quickly and allows a smoker to control nicotine cravings.

• Nicotine inhaler – An inhaler, available only by prescription, is a thin plastic tube with a nicotine cartridge inside. It looks like a fat cigarette. The inhaler delivers nicotine vapor to the mouth, where it is absorbed into the bloodstream.

• Nicotine lozenges – Lozenges, which can be bought without a prescription, are similar to nicotine gum. They are available in different strengths.

Hypnosis also has been used to help smokers quit, but like all methods, results vary depending on the person.

“The methods change from individual to individual,” Nadakav said. “The best advice I can give (to smokers) is that quitting is the most important thing they can do for their health. We don’t mean to use scare tactics, but if they can think about enjoying their family, and the length and quality of life, those are important issues.”

Nadakav also asks smokers to consider the cost involved with smoking. A pack of 20 cigarettes costs between $5 and $6; a carton can cost as much as $70.

“I suggest they put what they spend on smoking into a jar,” he said. “At the end of the year, instead of spending that on cigarettes, you’d have enough money for a very nice vacation.”