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How to Quit Smoking Like a Man

They say you have to want to quit smoking. But what smoker doesn’t want to quit?

Who is most likely to quit smoking?

So I guess it’s a matter of willpower — except that psychological predispositions matter too. Smokers are much more likely to be depressed than non-smokers, and among schizophrenics, the rate of smoking is close to 90%. Is it because smoking eases their pain, or is smoking a symptom of someone who, at some level, doesn’t think life is really worth living? Although I’m not particularly nuts, I do approach the question with a degree of fatalism. I’ve smoked about 75,000 cigarettes. Each one has left a poisonous black slick on my lungs. It’s hard not to feel that the damage is already done.

And “willpower,” as measured by the stated decision not to smoke, isn’t a deciding factor in how successful you’ll be at quitting smoking. “You absolutely have to decide to quit,” says Jonathan Foulds, director of the Tobacco Dependence Program at the University of Medicine and Dentistry of New Jersey. “But if you ask people when they start a program, ‘How much do you want to quit?’ usually their answer doesn’t predict success nearly as well as how addicted they are.”

The best indicator of whether you will be able to quit smoking, it turns out, is how long it takes before you fire up the first coffin nail in the morning. At Foulds’s clinic, which sees 500 to 600 prospective quitters a year, patients who light up within five minutes of waking have only a one-in-five chance of kicking the habit. People who can wait half an hour or more quit smoking a third of the time.

Another key question is the smoker’s ability to withstand discomfort. One scientist found that the longer a smoker could hold his breath, the more likely he was to be able to quit smoking. “Nicotine withdrawal is uncomfortable,” says Foulds. “People need to prepare themselves that, come hell or high water, nothing is going to get them to smoke.”

Number one tip: Don’t try to quit smoking alone

And of course, there are chemicals that make it less uncomfortable to stop. When smokers enter cessation programs, they generally get drugs or nicotine replacement therapy along with counseling. People who try to quit smoking without either have a 7% success rate. The rate doubles with pharmaceutical help and triples with pharmaceutical help and counseling, says Foulds.

“In our clinic, we use Zyban [an antidepressant shown to help people quit smoking] plus the patch plus one of the other replacement therapies,” says Foulds. “We figure it’s a lifesaving intervention, so why do it halfheartedly? These medicines are not very dangerous in themselves, so there’s no reason to hold back.”

It’s perfectly all right to be on nicotine replacement for as long as necessary to quit smoking. Nicotine has some obvious benefits — it makes you more alert and seems to decrease the risk of Parkinson’s and Alzheimer’s disease. And although it may increase blood pressure, its negative effects are trivial compared to the thousands of other poisons in cigarette “tar,” which is responsible for cancer, heart disease, and most other ill effects of smoking. “If it’s a question of smoking or spending your life on nicotine replacement, I choose the latter,” says Klesges.

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