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    Mayo Clinic Q and A: Quitting smoking — what works?

an ashtray full of cigarette butts in front of a no-smoking sign, with a hand shoving another butt into the pileDEAR MAYO CLINIC: I am finally ready to quit smoking for good. Is it better to quit smoking abruptly or gradually taper off tobacco use?

ANSWER: Congratulations on taking that first step: deciding to quit smoking. Smokers and tobacco users are more likely to develop disease and die earlier than people who don't use tobacco. Because nicotine is highly addictive, it may take more than one try to quit. But it is possible. Thinking about how to go about quitting is important, and there are a number of resources available to help you quit.

While quitting either abruptly or gradually can work, quitting abruptly may work better, according to a recent study published in the Annals of Internal Medicine.

The study involved about 700 smokers randomly assigned to either quit tobacco use abruptly with the aid of nicotine replacement patches or gradually reduce tobacco use with the aid of nicotine patches and a two-week structured cigarette reduction program. Behavioral counseling was provided leading up to the quit day for both groups.

After four weeks, 49 percent of the abrupt quit group and 39 percent of the gradual reduction group remained tobacco-free. At six months, 22 percent of the abrupt quit group and 15.5 percent of the gradual reduction group remained tobacco-free.

It’s not entirely clear why this gap exists. It may be that the taper for the gradual reduction group was too sudden or the tapering schedule may have made it more difficult to initiate the quit date.

One thing is known: The best way to quit smoking is with the aid of one of several nicotine replacement products and behavioral counseling. Stopping smoking with no help — gradually or suddenly — isn’t as likely to help you quit.

In addition, each time a person tries to stop, the likelihood for success increases. If you’ve tried to stop smoking but failed, don’t give up. You’re more likely to succeed with repeated attempts, and behavioral counseling and medications to help.

Every state has a telephone quit line that you can access by calling 1-800-QUIT-NOW (800-784-8669 toll-free). Or go online to becomeanex.org or smokefree.gov, where you'll find more information and support to help you stop smoking for good. (adapted from Mayo Clinic Health Letter) Dr. Jon Ebbert, Nicotine Dependence Center, Mayo Clinic, Rochester, Minnesota