I doubt there is a single adult smoker who doesn't wish to stop. Lung cancer remains the leading cause of cancer deaths in the United States and is climbing in incidence worldwide, as aggressive marketing has led to a greater prevalence of smoking in developing countries. Smoking leads to lung cancer and chronic obstructive pulmonary disease, a major cause of crippling breathlessness, heart failure and frequent infections. Smoking also leads to a higher risk of heart attacks and strokes, which are likely more serious and frequently fatal.

According to the Centers for Disease Control and Prevention, approximately 46 million — 19 percent — of all adults smoke. With age, smoking prevalence decreases but still remains high, with approximately 10 percent, or 3.5 million individuals, over the age of 65 continuing to smoke.

Currently, the only hope of curing lung cancer is to detect it before it has spread or the tumor has grown too large. Chest X-rays are not sensitive enough to detect early disease. This has led to a large research effort to determine if very low-dose CT scans could be valuable.

Numerous publications have shown they can be, especially in identifying curable cancers. And now the United States Preventative Services Task Force recommends this scan be conducted annually in current or former smokers between the ages of 55 and 80, who must either continue to smoke, have quit in the past 15 years or have been heavy smokers. They also must be healthy enough to tolerate therapy. Experts define smoking severity in terms of pack-years smoked. This is calculated by multiplying the number of packs smoked daily by the number of years smoked. Anyone who has smoked more than 15 pack-years is a candidate for screening.

The task force maintains that this CT scan provides no more irradiation than a mammogram and would prevent 20,000 deaths annually. However, there are some downsides that could take many years to answer, most important of which is the presence of many suspicious lesions in a lung damaged by smoking. To assure it is not cancer, unnecessary biopsies will be performed that are risky and could lead to many serious complications.

While screening to identify early cancers is an important breakthrough, it is far more important to never have smoked or to quit at the earliest age possible. This approach has been remarkably successful. In 1965, 43 percent of adults smoked. This percentage had decreased to 19 percent in 2011 largely because of education aimed at both children and adults about the dangers of smoking and benefits of quitting.

Another important approach to prevent smoking is to increase the cost. In an article published in The New England Journal of Medicine, it is proposed that tax on tobacco be tripled globally. The authors suggest poorer countries would benefit most from this tax, which has the potential of saving 200 million lives over a century. In the United States and Canada, doubling the price of cigarettes would prevent 70,000 to 200,000 deaths annually.

Physicians should inform their smoking patients about approaches to help them stop. Nicotine patches and gum are somewhat successful, as is the prescription drug Chantix. And many smokers are trying out electronic, or e-cigarettes, which look and feel like actual cigarettes but produce a flavored vapor, as opposed to smoke, that contains varying concentrations of nicotine. Research published in The Lancet indicates that e-cigarettes are about as successful as nicotine patches in helping smokers to stop.

The development of these nicotine-replacement approaches to smoking cessation has led fewer and fewer people to attend tobacco cessation programs. A paper published in the journal Addiction reports that smokers working with trained counselors who use multiple approaches to help them quit are three times more likely to be successful than those attempting to go it alone.

Hopefully, in the coming years, we will develop new approaches to identify and treat tobacco-related illnesses at an early stage when success is more likely. But the most important goal is preventing children and young adults from starting and helping them quit as early as possible if they already have.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at: DrDavidHealth.com