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EXCERPTS FROM: Smokers Quit Buying Aids to Stop Smoking

 HAVE THE NATION'S SMOKERS given up their battle to quit?

Wall Stree Journal [06/09/00]

 Over the past year, sales of prescription stop-smoking aids have fallen 18%, according to IMS
 Health.

 The drop in sales of stop-smoking aids is another indication of how difficult it is to get Americans to
 kick the habit. No one knows exactly why sales of these products are down, but doctors and
 researchers blame insurance companies that don't pay for cessation drugs and doctors who don't
 actively help their patients quit smoking.

In addition, many smokers have unrealistic expectations of the stop-smoking aids, giving up after one
 failed attempt when it takes the average quitter at least six to eight tries before success.

 THE SURGEON GENERAL later this month is expected to issue broad new guidelines for
 doctors and clinics to use in helping the nation's 50 million smokers kick the habit. The message will
 be that insurance companies, doctors and smokers need to start viewing tobacco addiction as a
 chronic disease that may require several attempts to put in remission, says Michael Fiore, who
 chairs the federal panel writing the guidelines.

Another obstacle to quitting may be cost. Only about half of U.S.
 insurance companies reimburse patients for stop-smoking drugs and
 related counseling programs.

Doctors don't do enough,
 either. Although 70% of smokers visit a primary-care physician each year,
 only about half are urged during the visit to quit smoking, says Thomas
 Brandon, director of tobacco research at the H. Lee Moffitt Cancer
 Center in Tampa.

 These trends are particularly troubling given that smokers have a far better
 chance of quitting when they have help of some kind. A May report in the
 American Journal of Preventive Medicine found that 80% of would-be
 quitters in California opted for the "cold turkey" approach. But only 7% of
 those smokers were able to quit for 12 months, while 15% of those who used counseling or
 nicotine-replacement therapies succeeded.

 Some researchers believe the current crop of smokers are "hard-core" -- highly addicted and
 difficult to treat. The theory is that with the health hazards related to smoking widely understood,
 the easiest cases have already quit. In the March issue of Nicotine and Tobacco Research, a
 review of smoking-cessation counseling programs showed success rates were 30% lower in the
 late 1990s than in the late 1970s, suggesting today's smokers are tougher cases, says co-author Dr.
 Brandon.

  The new surgeon-general report is expected to offer new guidelines for having doctors and clinics
 provide every smoker with effective treatment, including using a combination of nicotine patches,
 gums, nasal sprays and inhalers, as well as Zyban. The report is also expected to urge a
 "population-wide" approach to help people stop smoking. A widespread antismoking campaign
 in California, for example, has helped reduce smoking rates there to 18%, compared with 25%
 across the U.S.

 For smokers who want to quit, seeking help from a doctor or a counseling program offers the best
 chance of success. They advise smokers to consider using a stop-smoking aid even if it didn't work
 the first time. Set a definite quit date; don't just try to smoke less. And learn from past attempts
 what hurt and helped. Also, avoid alcohol.

 Finally, while medications help, nothing on the market entirely eliminates tobacco cravings.