Some Q&A on how to kick the cigarette habit

Remember that movie Casablanca? Everybody smoked. In every scene, Bogart was putting a cigarette in his mouth, and those were the real kind - non-filtered - as if that makes any difference.

I come from a family of smokers. My dad ran through a pack of Lucky Strikes in two days. One if restaurant customers gave him a bad time. He lived to the age of 78. Second hand smoke in the house? Yep! But I never thought about it. I started smoking at 17 when I got a summer job working at the Bremerton Naval Shipyard and continued to smoke - off and on - until 1989. I quit when I got a bad bronchial infection and haven't smoked since. I also remember those famous words from the comedian Joe E. Louis, who said: "if I'd known I was going to live this long, I would have taken better care of myself." A pat on the back for me quitting for 18 years is welcome, thank you. Now it's your turn. Maybe I was lucky being able to quit so easily, but here are some questions and answers about you quitting this nasty habit.

The American Lung Association says 34 percent of the 50 million who smoke try, but only 5 percent are successful. There are many new ways of breaking the habit but the reality is, the human psyche may never allow us to become completely smoke-free.

Q: What are the most effective ways to quit smoking?

A: Other than you really wanting to stop, the best possible outcome will require both medication - nicotine patches, Zyban and so forth - as well as "psychosocial" intervention. That $500 word means intervention between social and psychological help. All these things can help your chance of quitting successfully.

Q: Do smokers need therapy?

A: About 70 percent of smokers want to quit, but smokers have a much higher rate of depression and anxiety than those who don't smoke. Simply put, the longer you smoke, the more chance you will have of developing some negative emotional issues.

Q: Why might a person quit, then, start again?

A: A relapse is caused, for the most part, by stress, an argument, anger or anxiety. Your brain tells you that lighting-up will soothe your aching heart, and your mood.

Q: Is there a contrast between feeling lousy from withdrawal and feeling good from the cigarette?

A: Smokers are in withdrawal virtually all the time. As soon as the body's nicotine level starts to drop, they start to go through withdrawal, so smokers are always getting some reward from smoking.

Q: Is there a link between smoking a cigarette and feeling better?

A: Addiction is a vicious cycle. The best predictor of success is how much negative mood a person experiences in the first few days of quitting. Many smokers don't experience a decline in withdrawal symptoms after they quit, but rather, their withdrawal symptoms can be higher one or two months down the road.

Q: Is withdrawing from smoking the reason why people continue to feel rotten?

A: Yes! When people have long-term withdrawal syndromes, they are prone to failure.

Q: Can medication and psychotherapy get you through all this?

A: On your own, the success rate is around 5 percent. But with intensive treatment, it can be five times higher. When you quit smoking, in some sense it's like mourning. Nicotine stimulates some of the same brain regions stimulated by interaction with a loved one. So when smokers say, "you know, I feel like I lost my best friend," neurologically, they have.

Q: So what's the bottom line in terms of advice?

A: Don't be too optimistic about what quitting is going to be like: that will make you better prepared. As opposed to mourning a loved one who is gone forever, here the loved one is available at the nearest smoke shop or convenience store. Once a person has a single puff, the train has left the station and the odds are 80 to 85 percent they will go back to full-time smoking

Q: So should they keep trying?

A: Smokers are most likely to quit in their third, fourth or fifth attempt. Nothing predicts success like failure.

Personal note: I still think about lighting up once in a while but then I remember how my clothes, car, and house smelled back in those years when friends and associates who didn't smoke never bothered to tell me about how putrid it was. Stop smoking for 3 or 4 months, then go into someone's apartment or house or to a Laughlin casino poker room where smokers light up constantly and take a whiff. Yuck! Now you know what people thought about you.