Smoking is a hard habit to break. Many people who try to quit try several times before they're successful.
"I smoked for about 10 years prior to quitting, although I tried quitting maybe five times during that time frame," says Robert Anderson, 28, of San Diego.
Anderson, who smoked up to 15 cigarettes a day, says he decided to quit for several reasons.
"Health reasons is a big one," he says. "The drain on the pocketbook was another. Although, the biggest reason I had that really did it for me was the fact that my wife and I were trying to get pregnant. Now that we have a little one on the way, the perspective I have is: I don't have the right to die anymore."
According to the American Cancer Society, each year about 443,600 people in the United States die from illnesses related to tobacco use. Smoking cigarettes kills more Americans than alcohol, car accidents, suicide, AIDS, homicide and illegal drugs combined.
Peer pressure is a big reason that people begin smoking, says Dr. Norman Edelman, chief medical officer of the American Lung Association.
"Smoking is a very social thing," Edelman says. "Most people who get hooked on cigarettes get hooked as teenagers or even earlier."
Edelman says that along with peer pressure, heavy advertising by tobacco companies and the addictive power of nicotine also play big roles.
"Nicotine is a very, very powerfully addictive substance," Edelman explains. "It's just as addictive as narcotics. It's hard to quit smoking for two reasons: Nicotine is a chemical addiction, and smoking is a habit that people have gotten used to."
For people who want to quit smoking, there are many available options. The ALA believes the most effective way is by combining its support program, called Freedom From Smoking, with a pharmaceutical -- either a nicotine replacement product or pills.
Anderson says he quit partly by using a nicotine patch, but before that, he started weaning himself off smoking by systematically breaking down his triggers.
"Triggers were and are the biggest problems for me," he says, citing driving, after meals, and drinking as the main triggers. "So I would skip my morning cigarettes and wait until after lunch to have my first one of the day. The next day, I would skip my afternoon and evening ones and wait until the next day to have another. After some weeks of doing that consistently, I decided to try the patch, and it helped a lot."
Anderson says it's been a difficult process for him, but he is determined to stick with it.
"I have had a few setbacks," he says, "but the difference this time is that I am getting right back on the horse after I give in to the craving and not just giving up, as I did so many times before."
The ACS says that within 20 minutes of your quitting smoking, your heart rate and blood pressure drop. Twelve hours after you quit, the carbon monoxide level in your blood drops to normal. Two weeks to three months after you quit, your circulation improves, and your lung function increases. One to nine months after you quit, coughing and shortness of breath decrease; cilia (tiny hairlike structures that move mucus out of the lungs) regain normal function in the lungs, increasing the ability to handle mucus and clean the lungs, which reduces the risk of infection.
Furthermore, the ACS says, one year after you quit, your excess risk of coronary heart disease is half that of a smoker's. Your stroke risk is reduced to that of a nonsmoker's five to 15 years after you quit. After 10 years, your risk of dying from lung cancer is about half of what it would have been had you continued smoking. The risk of cancers of the mouth, throat, esophagus, bladder, cervix and pancreas decrease, too. And 15 years after you quit, your risk of coronary heart disease is the same as a nonsmoker's.
Anderson says quitting smoking is something you have to want to do, and it's important not to give up.
"The only difference between a quitter and a person who didn't quit is the fact that the quitter didn't give up," he says. "It is one of the hardest things that I personally have done, and it feels as if I will always have an inclination to start again, but I know that I can't. I can't give up."