Tobacco smoke, including second hand smoke, poses a serious health hazard for which there is no risk-free level of exposure.

Cigarette smoking accounts for as many as 440,000 preventable deaths a year, according to the American Heart Association, with as many as 69,000 from secondhand smoke exposure.

It's never too late to stop. Quitting can reduce smoking-related heart disease by half in just one year, for instance, and reduce stroke and lung cancer risk significantly as time goes on. New treatments and strategies make the process easier by helping to control urges, reduce stress and prevent related weight gain.

"People do it on their own, but the highest success rate comes with being in a program," says Cari Shulkin (above, right), a registered nurse and tobacco treatment specialist with UC Davis Health System.

She offers this progression of steps as a path to success:

  • Talk with your personal doctor about quitting and the medications available to help. UC Davis programs typically advise a three-month regimen of one of two medicines. Wellbutrin is an antidepressant that's successful in smoking cessation. Chantix encourages release of dopamine, a brain chemical that helps reduce cravings and withdrawals. Chantix also blocks the rewarding effects of nicotine.
  • Get the prescriptions filled, and set a quit date that's one to two weeks after you start taking them.
  • Begin changing behaviors you associate with smoking. Change your "smoking place," if you have one, to a place that's less enjoyable. This could mean moving from that quiet, comfy backyard chair to a standing position in public view on the front porch, for instance. The idea is to disassociate cigarettes with pleasurable activities.
  • Keep a "smoking journal" with your pack of cigarettes. Record the conditions and emotions associated with each cigarette, such as mood, activity and craving. Doing so helps identify patterns of heavy smoking and increases awareness about every cigarette.
  • Stop smoking in your car, a common trigger point.
  • Stop smoking cigarettes and drinking coffee together. Insert another activity in between, such as walking the dog.
  • Wait 30 minutes after each meal before a having a cigarette. You build a sense of empowerment when you gradually decide for yourself when to smoke, rather than letting the addiction tell you.
  • Three days before quit date, change your brand to a "bad" tasting cigarette. Start an exercise program. Exercise helps to relieve stress naturally and benefits the body, rather than harming it. It's a great outlet for lingering frustrations and cravings.
  • Celebrate success on your quit date (and anniversaries)!

UC Davis Health System offers stop-smoking programs throughout the year, usually in five-week increments with two-to-three classes per week. Classes feature a range of speakers and focus on techniques to modify behavior, control weight gain, use nicotine replacement effectively and prevent relapses. A monthly support group is also available for those who complete the program. For more information, contact Shulkin at (916) 734-8493 or

To try quitting on your own, other programs are available by calling the California Smokers' Helpline at (800) NO-BUTTS or visiting community stop-smoking resources online.