The Surgeon General's warning is printed on every pack. Statistics suggest using the pack's contents takes the lives of more than 1,200 people every day, or an estimated 440,000-plus every year in the United States. Moreover, the product consumption is billed as the leading preventable cause of death in our country. And still, millions of otherwise intelligent people ignore the risks and continue smoking cigarettes.
Why? Because, as researchers have come to realize, the nicotine that smokers draw from every cigarette has them in an addictive choke hold no less powerful than that of cocaine or heroin. And with that, for the estimated 46 million adult smokers in America, cigarette smoking isn't simply a bad habit to be broken, but rather a drug addiction to battle.
The National Institute on Drug Abuse reports that most smokers recognize tobacco as harmful, and at least 35 million of them make a serious attempt to quit each year. But of those who tried to quit on their own, only 7 percent were successful at quitting for a full year, and most of them relapsed within a few days.
Diane (last name withheld at her request) is in her 40s. She quit smoking seven weeks ago, after smoking for more than 30 years. Most people would say she hasn't had a cigarette in almost two months. She would say it's been 49 days, 22 hours and 15 minutes.
Diane is a professional woman and a caring mother. But cigarettes have run the course of her life; knowing better has never helped her overcome the addiction. She attests to the power cigarettes hold over their victims as she shares a story about her father's death from lung cancer.
"I watched my father die, and I knew smoking is what did it. But I'd be there in the hospital, watching him gasping for air, and I'd still go outside to smoke. I'd think while I was out there how sick it was. But I couldn't help it. One day when I came back in, he asked if I had gone out for a smoke. I said yes, and he just shook his head -- knowing it was bad, but at the same time saying he wished he could have gone out to have one with me. I know how sick all of that sounds, but that's how much they control you."
The Great American Smokeout
These kinds of testimonials are what fuel stop-smoking efforts such as the American Cancer Society's Great American Smokeout. This year's event -- which spans the nation -- will be held Thursday. Organizers sponsor this event to encourage smokers to put down their cigarettes for at least that one day or to use the day as their planned "quit date."
According to Paul McGee, spokesman for the local chapter of the American Cancer Society, the Great American Smokeout ranks No. 2 -- second only to New Year's Day -- as the leading day of the year for people to snuff out their last cigarette. McGee said his office will be marking the occasion with an awards ceremony to honor people who have helped others to put down their cigarettes for good and start a new, smoke-free life.
The highlight of this year's event is the newly launched Livefree.Smokefree. campaign, featuring seven Great American Quitters who will share their stop-smoking journey online at www.cancer.org/live freesmokefree. At this Web site, the quitters will keep online diaries, and people visiting the site have the opportunity to cheer them on. Also, those who visit the site and participate will receive a free Live-free.Smokefree wristband -- a token organizers hope might prompt conversation and support.
McGee notes that the annual smokeout has taken on a life of its own, with many schools sponsoring a day of awareness and education. That is key to creating a nation absent from tobacco use -- educating young people about the danger of tobacco.
4,000 youths a day try cigarettes
Of all the statistics related to cigarette smoking, those involving young people are perhaps the most sobering. According to the Centers for Disease Control and Prevention, each day in the United States, an estimated 4,000 youths between the ages of 12 and 17 try their first cigarette. And, if current smoking behaviors continue, some 6.4 million of today's children are expected to die -- ahead of their time -- from some smoke-related disease.
The National Center for Tobacco-Free Kids reports 4.5 million kids under age 18 in the United States are regular smokers. And although the numbers are declining, more than a fifth of all high school students and 10 percent of eighth graders currently smoke.
Not exactly music to the ears of those trying desperately to orchestrate a smoke-free America. That so many people in our country took up smoking, breeding generations afflicted by tobacco, is not surprising. Nor is the whimsical nature in which people decades ago lit their first smoke. As with so many things in life, the idea that it was socially acceptable laid the groundwork for the notion that it couldn't be bad.
And smoking was more than just acceptable. It was viewed as glamorous and exciting in early years. Advertisements depicted people having the time of their lives: beautiful scenic location, a cigarette in hand, laughter and sexual innuendo. Movie stars smoked, on and off screen, and many of them appeared in ads promoting cigarettes.
Doctors endorsed cigarettes as a way for men to relax after a hard day's work, and as an aid for women to stay thin. Cigarette manufacturers even jumped on the bandwagon for the women's rights movement, producing a long, thin smoke just for women and congratulating their efforts with the slogan, "You've come a long way, baby."
Today the efforts focus on reversing the joys-of-smoking attitudes born from generations when tobacco dangers were never talked about. Delivering the message to youth is all-important, given statistics suggest that nearly 90 percent of smokers start before they turn 18.
Diane fits that category, lighting her first cigarette before she reached high school. "I started when I was 13. I guess it was to be cool. I had a friend that came over one weekend, and she had taken one of her mom's, and we went outside and smoked it. Funny thing is, I didn't even like it at first. But it kind of became a weekend thing I did with her.
"I remember a time when I was in high school, thinking, 'I guess I'll just quit.' But then I started worrying about gaining weight -- and I just kept smoking."
A lifetime of smoking
And so her journey down the path toward a lifetime of smoking began.
By the time she was married and started contemplating having a child, she was a pack-a-day smoker. That was more than 20 years ago, and while smoking then was far more socially acceptable than it is today, the dangers of the habit were public knowledge. When she became pregnant, she knew cigarettes shouldn't be part of the experience.
"When I got pregnant, I planned to quit. But even then, I just couldn't do it. I did cut back -- I'd ration out some for each day. But I couldn't quit altogether. I'm embarrassed to admit that."
She carried her baby nine months, delivering a full-term, healthy girl. But she'll carry the guilt of smoking during her pregnancy for a lifetime.
That fact is, in part, what prompted her to quit smoking seven weeks ago. Her daughter announced that she was pregnant. She, too, was a smoker. "I felt responsible for that. And I didn't want her to smoke while she was pregnant, so I told her we'd quit together."
That was a welcome motivator for her daughter, not just because of her pregnancy, but also because Diane had recently been put on blood pressure medication by her doctor. That was another wake-up call for Diane -- her mother had a stroke at a young age.
This two-fold motivation prompted Diane to take the necessary steps toward abstinence from tobacco for the first time since she was a teen. The first step was to purchase a supply of nicotine patches.
"I've tried to quit many times. I knew I needed something," she said, noting several failed attempts using various methods -- cold turkey, cutting back, and hypnosis.
Taking advantage of the stop-smoking tools available today -- nicotine replacement therapy, quit lines, cessation classes and online resources -- are crucial to success, according to Pat Bax, coordinator of the Tobacco Cessation Center of Western New York, based at Roswell Park Cancer Institute. "I think it's so important for people to know they do not have to do this alone."
In terms of the population afflicted by nicotine addiction, the situation is not all doom and gloom. For each adult still smoking, there are similar numbers who have quit. In all, in the four decades since the first Surgeon General's Report on smoking was issued in 1965,adult smoking rates have dropped nearly in half -- from 42.4 percent to 22.8 percent.
"We are inspired by the number of people who are successful," Bax said, noting that for some it may take more than one attempt. All is not lost with a failed attempt, she explained, because each attempt makes people a little more educated about what quitting entails, and makes more clear the reasons why they want to quit. In the process, each attempt to quit "decreases the pleasure."
The most important thing to remember, no matter how many failed quit attempts: "Just don't give up," Bax said.
As for Diane, "I think I've done it this time," she said. "You know, the other day, I thought I'd really like to have just one. But I knew if I had one, I'd smoke the whole pack. And then I thought, what's the point -- there isn't one.
"You used to be able to go into a bar with friends and have a drink and smoke, but you can't do that any more. You can't go into a restaurant and have dinner and then relax after the meal with coffee and a cigarette. It's really gotten to be just a pain, no matter where you go. It's not socially acceptable anymore. It's embarrassing to be a smoker."
Now that she seems on her way to beating her cigarette habit, she'd like to send a message to kids: If you start smoking, cigarettes will take over your life.
Terry Zayac is freelance writer who lives in Holland.
WANT TO QUIT SMOKING? HERE'S WHERE TO FIND HELP
The New York State Smoker's Quitline is a resource to help smokers begin the process of breaking the tobacco habit, says Pat Bax, coordinator of the Tobacco Cessation Center of Western New York. There, smokers who want to quit have the opportunity to speak with counselors and find a host of valuable resources (1-866-NYQUITS).
Two inspirational Web sites recently developed, BobQuits.com and MaryQuits.com, provide a peek into the lives of two smokers who have made the decision to quit. Created by the American Legacy Foundation, these sites introduce the smokers and provide a daily video -- a sort of reality show online -- of the quitting experience.