"Tobacco cessation is no longer a one-size-fits-all approach," says Paul
M. Cinciripini, a professor at the University of Texas' M.D. Anderson
Cancer Center in Houston. "We now know various groups have specific
concerns and may be motivated to respond by different tobacco cessation
programs and treatments."

Cinciripini gives examples of groups as diverse as pregnant women,
teenagers, Spanish-speaking individuals and college students, all of
which are targeted for different programs by the cancer center.

For example, Project SUCCESS includes offering health information about
an individual's respiratory symptoms, lung function and carbon monoxide
level to help college students quit smoking. Currently under way at the
University of Houston, the project uses nicotine-replacement therapy
along with both face-to-face and Internet-based counseling sessions to
help students break their tobacco addiction.

Project ASPIRE, by contrast, is aimed at urban, minority high school
students and uses much more state-of-the-art technology, primarily
because its subjects aren't always as readily available for counseling
as college students, researchers say. ASPIRE's material is available as
a computer-based interactive, multimedia as well as a Web-based CD-ROM.

Women who quit smoking during pregnancy but take it up again after the
birth of their child present a special challenge. Smoking relapse rates
for postpartum women are high, with about 80 percent of women resuming
smoking by the time their babies reach their first birthday. The
treatment for this group involves a lot of telephone-based counseling
that allows back-and-forth discussions about issues such as mood
changes, stress, support by friends and family and weight concerns. It
focuses principally on strengthening a woman's motivation to remain a
nonsmoker not only for her own health, but also for the health of the baby.

Another M.D. Anderson smoking cessation program, Adios al Fumar, is
directed toward the Spanish-speaking population. Its objective is to
increase the reach and effectiveness of smoking cessation services
offered in Spanish by the National Cancer Institute (news - web sites)'s
Cancer Information Service (1-800-4-CANCER).

Adios al Fumar has two principal approaches. The first uses a wide range
of media sources, including print and broadcast advertising in
Spanish-language media outlets and targeted direct mail, to reach
Hispanics who smoke; the second uses follow-up individualized telephone
counseling.

M.D. Anderson isn't the only medical facility pursuing specialized
programming aimed at stopping smoking. There are hundreds of them.

For example, pediatricians at Children's Hospital of Pittsburgh recently
rolled out a program called Clean Air Plus for smoking parents of very
young children. In addition to helping the adults achieve improved
health by avoiding tobacco products, the program motivates them by
emphasizing the benefits of protecting their children from secondhand
smoke, which is linked to a wide range of health problems in youngsters,
including ear and respiratory infections.

One of the advantages of the Clear Air Plus program is that most parents
see their child's pediatrician much more often than they see their own
internist or family doctor. In fact, pediatricians typically see an
infant seven times in the first year of life, and 20 times by the time a
child is 5. That gives doctors many opportunities to offer a parent
assistance in quitting smoking.

While it's obvious there isn't a single "stop smoking" formula that
works for everyone, Edwin B. Fisher, a professor of psychology at
Washington University in St. Louis and director of the division for
health behavior research at the university's School of Medicine, offers
the following advice:

Set a clear "quit date" that makes sense for you personally, such as a
birthday or some other personal milestone. Choose a Monday morning if
you smoke most on the weekends, or a Friday afternoon if you're tempted
most at the office.

Anticipate the situations in which you're going to be tempted to
relapse, and have a realistic plan -- not a wish and a prayer -- for how
you're going to cope with those temptations.

Consider using a nicotine-replacement device, like gum, a patch,
lozenge, inhaler, nasal spray or other medications, for smoking
cessation as a way of helping you get used to life without your favorite
tobacco product before you have to give it up altogether.

Recruit the help of other people. No one else can do it for you, but the
cooperation and encouragement of those around you can really help you
get a hard job done much better.

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