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CNN Sunday Morning

Weekend House Call: Kicking Smoking Habit

Aired August 03, 2003 - 08:29   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Today on WEEKEND HOUSE CALL, we're talking about kicking the smoking habit. Now, we all know someone who's tried over and over again to quit smoking. It's probably one of the hardest things a person can do. On average it takes most people four or five attempts before they quit successfully. Today we're going to give you great tips for ending your love affair with nicotine and we'll look at the positive things that can happen to your body the very second you quit smoking for good.
(BEGIN VIDEOTAPE)

COHEN: (voice-over): The minute you stop smoking, the air around you is no longer dangerous yourself or others. 20 minutes after your last cigarette your blood pressure and pulse rate drop to normal and temperature in your hands and feet increase to normal. Eight hours later the carbon monoxide level in your blood drops to normal and the oxygen level in your blood increases to normal. In just 24 hours your chance of a heart attack decreases.

In 48 hours your sense of smell and taste improve. In two to 12 weeks circulation and breathing improve, walking becomes easier. In one to nine months coughing, sinus congestion, and shortness of breathe all decrease. Your overall energy level will increase. The lung's ability to self-clean and reduce infection also increases. In just one year, the risk of premature heart disease is half the risk of a smoker. In five years, the risk of a stroke is comparable to that of someone who never smoked. In ten years your life expectancy is comparable to someone who never smoked. Your lung cancer death rate is about half the rate of a smoker and your risk of getting cancer of the mouth, throat, esophagus, bladder, kidney, or pancreas all decrease. In 15 years your risk of getting heart disease is equal to that of someone who never smoked.

(END VIDEOTAPE)

COHEN: Some other benefits, you'll save money and have more energy; your car, house and clothing will smell much better and food will actually taste better and you'll age less rapidly and have fewer wrinkles. That's probably one of the main reasons why many people want to smoke. We want to answer your questions about stamping out the smoking habit. Call us at 1-800-807-2620 or e-mail us at housecall@CNN.com. We have with us Dr. Lowell Dale from the Mayo Clinic to answer our questions.

Good morning, Dr. Dale. DR. LOWELL DALE, MAYO CLINIC: Good morning.

COHEN: Dr. Dale is the associate director of the Mayo Nicotine Dependent Center.

Thanks for joining us.

We've received hundreds of e-mails on this topic, so let's jump right in with one from Molly in Colorado.

She writes, "I'd like to know the best strategies to quit smoking. I've been smoking for 32 years and would like to quit, but all previous attempts have failed. How can I get my mind ready for this?" -- Dr. Dale.

DALE: That's a question we get all the time in our treatment program and there are several aspects to looking at this. You know, I think the first thing that Molly needs to do is reframe her previous attempts. The tendency is for people to look on previous attempts as failures and I'd really like to have people think of it more as a learning experience, so the first thing Molly should do is carefully look at what worked for her and what didn't and then try and make those changes.

The next thing is -- that I think for people like Molly and for physicians and for society in general, is to try and look more at smoking as a condition, a medical condition, rather than just a bad habit. And, if we can look at it as a condition, then we can take it more -- excuse me -- more seriously and that means -- that means looking toward some counseling, getting some outside support to help us, and then using medications, as well.

COHEN: We have a phone call now from Miriam in Arkansas.

Miriam, go ahead.

MIRIAM, ARKANSAS CALLER: Yes, my husband has been smoking for over 41 years. He has lost 61 pounds, his doctor is concerned, he has tried everything known to man to try and stop smoking. He can stop for a very short period of time. Now, he's under a lot of stress, his job is very demanding. He's a superintendent in a construction company, and the minute he's under any kind of a major project, the thing that starts right back up is the smoking and it is definitely affecting his health, and as you already mentioned, it's affecting his -- his age, the way he -- he looks like he's 70 and he's not. His breathing is now...

COHEN: Dr. Dale, are there people who just can't quit, like this caller's husband, who've tried so many times and just can't do it?

DALE: Well, you know, I know it's extremely frustrating, especially when you're faced with all these health issues, but people shouldn't give up and there are treatment options available that, even though people say they've looked at everything, I think it's important that they understand that there are a lot of aggressive treatment programs available. They should look for -- if their physician hasn't been able to help them, then they should look for people that specialize in tobacco treatment. And, here at Mayo, we actually offer a program -- what's an inpatient program, a residential program, where people come and spend eight days with us to learn how to deal with this very serious addiction. And, what we do during that time is intensive counseling a lot of education, we're very aggressive about using medical management and many of those things people have not used, even when they talk about using -- you know, having tried everything.

COHEN: We have an e-mail now, from John in Washington.

John asks, "What worked most often statistically speaking -- quitting cold turkey, or cutting down in a methodological way?"

You hear this question all the time, doctor. Should you just say -- OK, Monday I'm quitting and that's it or should you sort of scale down over time?

DALE: Everybody's a little different in how they're successful in doing that. In general, most people who have stopped successfully have quit cold turkey, but that means they've stopped suddenly -- just stopped using tobacco, but the important thing, I think, is that when they do that, they combine that with medications to help them deal with their with draw symptoms and also really consider some counseling, external support to help them deal with the real habit part of smoking, as well as, dealing with the -- with the withdrawal symptoms.

COHEN: We have on the phone now, Mary, from New York. Mary tried to quit cold turkey.

Mary, how did it work?

MARY, NEW YORK, CALLER: Well, it didn't work too well, because the seventh day, I just -- the desire was so strong I wound up getting cigarettes. I bought a pack. And I started smoking, but I cut back, but I can't let go. I even tried like, maybe four cigarettes a day, and that didn't work either. So, you have any suggestions?

DALE: Sure, Mary. Again, I think when people try and stop cold turkey, they really are faced with having to deal with withdrawal symptoms. We know that nicotine is physically addicting, and many people do fail because they don't know how deal with the irritability and the frustration and anger and loss of concentration and the intense cravings that go with withdrawal and that's where medications can be very, very beneficial. We know that the medicines like nicotine replacement: the patch, the gum, the inhaler and now the new lozenge; or the medicine Zyban can really help control those withdraw symptoms so you can really focus on some of the behavioral issues related to your smoking.

COHEN: We have an e-mail now, from Deborah in San Diego who wants to know, "My husband has tried to quit smoking many times. Are there any very light tranquilizers available to help him stay calm for the first couple of weeks? He owns his own business and gets stressed-out and then he starts smoking." DALE: The studies that have been done that have looked at the use of tranquilizers have not shown them to be very effective. I think what she's describing with her husband's trying to stop is that -- again, these are withdrawal symptoms, again the irritability and the anxiousness that are very typical of what we see when people are trying to stop. And the best treatment, again, is using the medications like nicotine replacement therapy or the Zyban to help control those. If stress is a major problem, then that's where counseling can come in to get some non-medical means of learning how to deal with stresses. For example, deep breathing techniques, visual imagery, those sorts of things.

COHEN: Thank you, Dr. Dale. We have to take a break, now, and when we come back, a look at hypnosis. Does it work? Keep watching and you'll find out. Call us with your questions. Our number is 1- 800-807-2620 or e-mail us at housecall@CNN.com. Stay with us.

(COMMERCIAL BREAK)

COHEN: Did you know that about 25 percent of American adults smoke and 3,000 people under the age of 18 become smokers every day? Smoking is the number one cause of cancer deaths and it's totally preventable. If you want to stop smoking choose a stop day. You may want to take a day off work or use a weekend or vacation day, or if you need to stay busy, choose a day that will keep your mind and hands occupied. Make sure to tell your friends and coworkers the day you've selected, because you'll need their support.

This is WEEKEND HOUSE CALL we're talking about kicking the smoking habit. If you have a question, call us at 1-800-807-2620 or send us an e-mail at housecall@CNN.com.

While we get those calls lined up, let's check out our health quiz. If you a pack a day and quit right now, how much money would have save in a year?

We'll have that answer in 30 seconds. So stay with us.

(COMMERCIAL BREAK)

COHEN: Checking our health quiz, we asked: If you smoke a pack of cigarettes as day and quit today, how much money would you save in the next year? The answer: the average price of a pack of cigarette in the U.S. is $3.85. That's a yearly savings of $1405.25 for the year. Think of what you could do with that money.

Now, once you've chose an day in the future to quit smoking, here's a list of tips to help change your routine in the meantime to prepare you for the big day. Buy cigarettes at different store each time you buy them. Only buy a single pack at a time. Never have more than one pack at any time. Smoke a different brand of cigarettes, one you don't like as much. Choose one location to smoke and don't smoke anywhere else. Don't carry cigarettes with you, and switch to matches if you usually use a lighter. Keep one ashtray in the one location you've chosen.

We have with us Dr. Lowell Dale from the Mayo Clinic who's joining us from Minnesota to answer your questions.

We have an e-mail from Richard in Florida who asks, "Is an inhaler a better choice over gum or patches?"

What do you think, Dr. Dale?

DALE: Everyone has a different means of stopping, and I'm not sure that one medication is any better than the others. I think what's important is that people find the medicine that works best for them, and then that they use that medicine, enough of it, in order to control their withdraw symptoms.

COHEN: We have a phone call now from Stephanie in -- Stephanie, I'm sorry. I've forgotten where you're from -- Virginia.

STEPHANIE, MANASSAS, VIRGINIA, CALLER: I'm from Manassas.

COHEN: Oh, in Manassas. OK Stephanie, go ahead with your question.

STEPHANIE: I'm interested in quitting smoking, is it OK to use the NicoDerm patch in conjunction with the Zyban?

DALE: That's a very good question, Stephanie. There's been one study that's been done that has used the combination of patch and Zyban and it was found to be very helpful compared to using just one or the other by itself, and it was very safe. In our treatment program, it's more the rule that we use combination therapy, like that, rather than the exception, so I think that's a real reasonable way to go.

COHEN: Dr. Dale, why is it that some people have a relatively easy time quitting while other people have a harder time? Is it difference in brain chemistry?

DALE: That's right, Elizabeth. It really is a difference. Everybody is different and there is a wide spectrum of the severity of the dependence and it gets back to the idea that -- you know, that this really is a medical condition and just like people have differences in severity of their diabetes or high blood pressure, just people have different variability in their dependence on nicotine. And so, while your neighbor may be able to quit fairly easily and you're really struggling with that, it really is related to how hooked or dependent your brain has become on that nicotine.

COHEN: We have an e-mail now, from Chris in Arkansas who asks, "What's your opinion of using hypnosis as a method to stop smoking?"

Dr. Dale, does it really work?

DALE: Well, I think we all know people who have been able to stop with hypnosis, but in our treatment program, we try to use interventions that have been scientifically proven to work, and hypnosis has not been. So, we don't advocate that as the only way to look to look at stopping smoking. We really advocate -- you know, getting some counseling support, using medications, and really the proven therapies.

COHEN: Mark from Texas has a question, "I've been dipping smokeless tobacco for 23 years and would like to quit -- any suggestions?"

DALE: Smokeless tobacco is not harmless and it's good to hear that this person is really seriously thinking about trying to stop that. We've done quite a bit of work here, now, with smokeless tobacco users and we have found that many of the issues are the same with smokeless tobacco users, as with smokers, and that many of the medicines that are available for smokers appear to work, as well. It's just that you have to be very aggressive. We know that smokeless tobacco users are exposed to levels of nicotine that are comparable to smokers and sometimes higher, so they have to be very aggressive. So, nicotine replacement, again, and Zyban have been shown to work.

COHEN: Molly from Florida is no the phone.

Molly, go ahead with your question for Dr. Dale.

MOLLY, FLORIDA CALLER: Hi, Dr. Dale. I have read and heard it is harder for women to quit smoking than men. Is there is any truth to that?

DALE: There are -- there are some -- there is some evidence to suggest that women do have a more difficult time, and we aren't quite sure why that is. That doesn't mean that women -- you know, can't stop. It just means that we need to probably look beyond traditional behavior modification techniques and begin to explore some of the other issues for why women really find the need to smoke. We know that women who smoke tend to have higher rates of depression than others, and being aware of that and addressing that issue, for example, can often help that person stop.

COHEN: Thank you, Dr. Dale. We have to take a break, now. When we come back, get a paper and pen ready. We'll give you some Web sites where you can find information about smoking cessation clinics in your air area. Some of the help lines are free, no cost and some states subsidize smoking cessation programs.

WEEKEND HOUSE CALL will be right back.

(COMMERCIAL BREAK)

(NEWSBREAK)

(COMMERCIAL BREAK)

COHEN: We're answering your questions about breaking the smoking habit. We have an e-mail from Darlene in Alabama who writes, "Getting medical help is impossible for some that can't afford it. Why aren't there free "Stop Smoking" clinics to help?"

DALE: Dr. Dale, is it expensive to stop smoking? It can be expensive to stop smoking. Certainly the medications are not -- are not cheap, and seeing a treatment specialist also, obviously, takes money. But, there are programs available to help support people, and we just have to look for them. And one of those -- one program -- and especially since the master settlement agreement where the attorneys general and the tobacco company came to agreement about litigation, that many states got money to help support some of these free programs. Many states have tobacco's "quit lines," and they have been shown to be very effective. These telephone lines provide counseling and many of them, actually, provide free patches or other nicotine replacements. So, there are free programs like that out there.

For people -- but it varies so much from state to state that the -- I think one of the better sources to try to find information about these free programs in your state is to go to the American Lung Association Web site or else call them at 1-800-lung-USA, and they can give you some more information.

Another source would be your county or state health department. Most of them do have some sort of tobacco control office that can line you up with those types of programs.

COHEN: So, there are free programs out there. You just have to look for them.

DALE: Exactly.

COHEN: We have a phone call, now, from Dean in Florida.

Dean, go ahead.

DEAN, TAMPA, FLORIDA CALLER: Yes, good morning, folks. It was recently reported that certain cigarettes have higher rates of nicotine inside their cigarettes. What does that make, far as differences in far as treating who do want to stop smoking when it comes to the differences in nicotine rate?

DALE: Yes, I saw that report, too, that showed that tobacco companies have been able to manipulate the levels of nicotine in cigarettes so that some deliver more, and that tends to make them more addictive. It also, then, as we're looking at treating people that are using these, perhaps higher levels of nicotine, that we probably have to be more aggressive about using our medications. We know nicotine replacement works, but we also know often you have to use enough of it to control your withdraw symptoms. So, probably, they need just more of it.

COHEN: Here's a strange twist on nicotine. A new drink has emerged in South Florida where smoking has been banned in all restaurants; it's called the "Nicotini." Some people are calling it the "liquid cigarette," because the drink comes complete with a nicotine rush and a mental tobacco aftertaste -- yummy.

Dr. Dale, there are all sorts of nicotine replacement therapy out there -- have you ever heard of this one? I mean, would this actually help you quit smoking?

DALE: About a year or so ago, in California, I believe, they tried to market a nicotine water, and the FDA really came down hard on them because it is unregulated, and so I'm surprised that people in Florida are able to -- to be able to purchase this. People should be very careful about this because, again, there -- it's unregulated. You really don't know -- you know, what kind of quantity of nicotine you're getting. The other people thing people should know is that nicotine, when it's ingested, when it's swallowed and get into the stomach, most of it is inactivated. It becomes inactive and so the levels that people are getting are not very high. And, so I'd be very surprised if that can be very helpful for people in stopping.

Dr. Dale, thank you and when we come back we're going to have final thoughts about how you can quit smoking. Stay with us.

(COMMERCIAL BREAK)

COHEN: Another good Web site for information on quitting smoking check out www.cancer.org or check out nicotine-anonymous.org. This Web site is for self-help groups around the U.S. modeled after Alcoholics Anonymous to support those trying to remain tobacco free.

Welcome back to WEEKEND HOUSE CALL where we've been talking about quitting smoking with Dr. Lowell Dale from the Mayo Clinic.

Dr. Dale, what would you say is the single most important thing that people should do when they're trying to quit smoking?

DALE: People shouldn't try and do this by themselves. They really should look for support whether it's their physician, a tobacco treatment specialist, or looking for a national program where they can get more intensive therapy than they can get locally.

COHEN: Thank you, Dr. Dale, for joining us. That's all times we have for today. Make sure to catch us next weekend when we talk about chronic fatigue syndrome. It's plagued the author of the best selling novel and movie "Seabiscuit." We'll tell you the symptoms and some possible treatments of this misunderstood disease.

Also, keep an eye on CNN Medical News all this week. We'll be covering stories on the benefit of soy products, on varicose vein removal treatments, and hormone replacement therapy and heard disease.

Thanks for watching, I'm Elizabeth Cohen. "CNN Sunday Morning" continues now.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired August 3, 2003 - 08:29   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT: Today on WEEKEND HOUSE CALL, we're talking about kicking the smoking habit. Now, we all know someone who's tried over and over again to quit smoking. It's probably one of the hardest things a person can do. On average it takes most people four or five attempts before they quit successfully. Today we're going to give you great tips for ending your love affair with nicotine and we'll look at the positive things that can happen to your body the very second you quit smoking for good.
(BEGIN VIDEOTAPE)

COHEN: (voice-over): The minute you stop smoking, the air around you is no longer dangerous yourself or others. 20 minutes after your last cigarette your blood pressure and pulse rate drop to normal and temperature in your hands and feet increase to normal. Eight hours later the carbon monoxide level in your blood drops to normal and the oxygen level in your blood increases to normal. In just 24 hours your chance of a heart attack decreases.

In 48 hours your sense of smell and taste improve. In two to 12 weeks circulation and breathing improve, walking becomes easier. In one to nine months coughing, sinus congestion, and shortness of breathe all decrease. Your overall energy level will increase. The lung's ability to self-clean and reduce infection also increases. In just one year, the risk of premature heart disease is half the risk of a smoker. In five years, the risk of a stroke is comparable to that of someone who never smoked. In ten years your life expectancy is comparable to someone who never smoked. Your lung cancer death rate is about half the rate of a smoker and your risk of getting cancer of the mouth, throat, esophagus, bladder, kidney, or pancreas all decrease. In 15 years your risk of getting heart disease is equal to that of someone who never smoked.

(END VIDEOTAPE)

COHEN: Some other benefits, you'll save money and have more energy; your car, house and clothing will smell much better and food will actually taste better and you'll age less rapidly and have fewer wrinkles. That's probably one of the main reasons why many people want to smoke. We want to answer your questions about stamping out the smoking habit. Call us at 1-800-807-2620 or e-mail us at housecall@CNN.com. We have with us Dr. Lowell Dale from the Mayo Clinic to answer our questions.

Good morning, Dr. Dale. DR. LOWELL DALE, MAYO CLINIC: Good morning.

COHEN: Dr. Dale is the associate director of the Mayo Nicotine Dependent Center.

Thanks for joining us.

We've received hundreds of e-mails on this topic, so let's jump right in with one from Molly in Colorado.

She writes, "I'd like to know the best strategies to quit smoking. I've been smoking for 32 years and would like to quit, but all previous attempts have failed. How can I get my mind ready for this?" -- Dr. Dale.

DALE: That's a question we get all the time in our treatment program and there are several aspects to looking at this. You know, I think the first thing that Molly needs to do is reframe her previous attempts. The tendency is for people to look on previous attempts as failures and I'd really like to have people think of it more as a learning experience, so the first thing Molly should do is carefully look at what worked for her and what didn't and then try and make those changes.

The next thing is -- that I think for people like Molly and for physicians and for society in general, is to try and look more at smoking as a condition, a medical condition, rather than just a bad habit. And, if we can look at it as a condition, then we can take it more -- excuse me -- more seriously and that means -- that means looking toward some counseling, getting some outside support to help us, and then using medications, as well.

COHEN: We have a phone call now from Miriam in Arkansas.

Miriam, go ahead.

MIRIAM, ARKANSAS CALLER: Yes, my husband has been smoking for over 41 years. He has lost 61 pounds, his doctor is concerned, he has tried everything known to man to try and stop smoking. He can stop for a very short period of time. Now, he's under a lot of stress, his job is very demanding. He's a superintendent in a construction company, and the minute he's under any kind of a major project, the thing that starts right back up is the smoking and it is definitely affecting his health, and as you already mentioned, it's affecting his -- his age, the way he -- he looks like he's 70 and he's not. His breathing is now...

COHEN: Dr. Dale, are there people who just can't quit, like this caller's husband, who've tried so many times and just can't do it?

DALE: Well, you know, I know it's extremely frustrating, especially when you're faced with all these health issues, but people shouldn't give up and there are treatment options available that, even though people say they've looked at everything, I think it's important that they understand that there are a lot of aggressive treatment programs available. They should look for -- if their physician hasn't been able to help them, then they should look for people that specialize in tobacco treatment. And, here at Mayo, we actually offer a program -- what's an inpatient program, a residential program, where people come and spend eight days with us to learn how to deal with this very serious addiction. And, what we do during that time is intensive counseling a lot of education, we're very aggressive about using medical management and many of those things people have not used, even when they talk about using -- you know, having tried everything.

COHEN: We have an e-mail now, from John in Washington.

John asks, "What worked most often statistically speaking -- quitting cold turkey, or cutting down in a methodological way?"

You hear this question all the time, doctor. Should you just say -- OK, Monday I'm quitting and that's it or should you sort of scale down over time?

DALE: Everybody's a little different in how they're successful in doing that. In general, most people who have stopped successfully have quit cold turkey, but that means they've stopped suddenly -- just stopped using tobacco, but the important thing, I think, is that when they do that, they combine that with medications to help them deal with their with draw symptoms and also really consider some counseling, external support to help them deal with the real habit part of smoking, as well as, dealing with the -- with the withdrawal symptoms.

COHEN: We have on the phone now, Mary, from New York. Mary tried to quit cold turkey.

Mary, how did it work?

MARY, NEW YORK, CALLER: Well, it didn't work too well, because the seventh day, I just -- the desire was so strong I wound up getting cigarettes. I bought a pack. And I started smoking, but I cut back, but I can't let go. I even tried like, maybe four cigarettes a day, and that didn't work either. So, you have any suggestions?

DALE: Sure, Mary. Again, I think when people try and stop cold turkey, they really are faced with having to deal with withdrawal symptoms. We know that nicotine is physically addicting, and many people do fail because they don't know how deal with the irritability and the frustration and anger and loss of concentration and the intense cravings that go with withdrawal and that's where medications can be very, very beneficial. We know that the medicines like nicotine replacement: the patch, the gum, the inhaler and now the new lozenge; or the medicine Zyban can really help control those withdraw symptoms so you can really focus on some of the behavioral issues related to your smoking.

COHEN: We have an e-mail now, from Deborah in San Diego who wants to know, "My husband has tried to quit smoking many times. Are there any very light tranquilizers available to help him stay calm for the first couple of weeks? He owns his own business and gets stressed-out and then he starts smoking." DALE: The studies that have been done that have looked at the use of tranquilizers have not shown them to be very effective. I think what she's describing with her husband's trying to stop is that -- again, these are withdrawal symptoms, again the irritability and the anxiousness that are very typical of what we see when people are trying to stop. And the best treatment, again, is using the medications like nicotine replacement therapy or the Zyban to help control those. If stress is a major problem, then that's where counseling can come in to get some non-medical means of learning how to deal with stresses. For example, deep breathing techniques, visual imagery, those sorts of things.

COHEN: Thank you, Dr. Dale. We have to take a break, now, and when we come back, a look at hypnosis. Does it work? Keep watching and you'll find out. Call us with your questions. Our number is 1- 800-807-2620 or e-mail us at housecall@CNN.com. Stay with us.

(COMMERCIAL BREAK)

COHEN: Did you know that about 25 percent of American adults smoke and 3,000 people under the age of 18 become smokers every day? Smoking is the number one cause of cancer deaths and it's totally preventable. If you want to stop smoking choose a stop day. You may want to take a day off work or use a weekend or vacation day, or if you need to stay busy, choose a day that will keep your mind and hands occupied. Make sure to tell your friends and coworkers the day you've selected, because you'll need their support.

This is WEEKEND HOUSE CALL we're talking about kicking the smoking habit. If you have a question, call us at 1-800-807-2620 or send us an e-mail at housecall@CNN.com.

While we get those calls lined up, let's check out our health quiz. If you a pack a day and quit right now, how much money would have save in a year?

We'll have that answer in 30 seconds. So stay with us.

(COMMERCIAL BREAK)

COHEN: Checking our health quiz, we asked: If you smoke a pack of cigarettes as day and quit today, how much money would you save in the next year? The answer: the average price of a pack of cigarette in the U.S. is $3.85. That's a yearly savings of $1405.25 for the year. Think of what you could do with that money.

Now, once you've chose an day in the future to quit smoking, here's a list of tips to help change your routine in the meantime to prepare you for the big day. Buy cigarettes at different store each time you buy them. Only buy a single pack at a time. Never have more than one pack at any time. Smoke a different brand of cigarettes, one you don't like as much. Choose one location to smoke and don't smoke anywhere else. Don't carry cigarettes with you, and switch to matches if you usually use a lighter. Keep one ashtray in the one location you've chosen.

We have with us Dr. Lowell Dale from the Mayo Clinic who's joining us from Minnesota to answer your questions.

We have an e-mail from Richard in Florida who asks, "Is an inhaler a better choice over gum or patches?"

What do you think, Dr. Dale?

DALE: Everyone has a different means of stopping, and I'm not sure that one medication is any better than the others. I think what's important is that people find the medicine that works best for them, and then that they use that medicine, enough of it, in order to control their withdraw symptoms.

COHEN: We have a phone call now from Stephanie in -- Stephanie, I'm sorry. I've forgotten where you're from -- Virginia.

STEPHANIE, MANASSAS, VIRGINIA, CALLER: I'm from Manassas.

COHEN: Oh, in Manassas. OK Stephanie, go ahead with your question.

STEPHANIE: I'm interested in quitting smoking, is it OK to use the NicoDerm patch in conjunction with the Zyban?

DALE: That's a very good question, Stephanie. There's been one study that's been done that has used the combination of patch and Zyban and it was found to be very helpful compared to using just one or the other by itself, and it was very safe. In our treatment program, it's more the rule that we use combination therapy, like that, rather than the exception, so I think that's a real reasonable way to go.

COHEN: Dr. Dale, why is it that some people have a relatively easy time quitting while other people have a harder time? Is it difference in brain chemistry?

DALE: That's right, Elizabeth. It really is a difference. Everybody is different and there is a wide spectrum of the severity of the dependence and it gets back to the idea that -- you know, that this really is a medical condition and just like people have differences in severity of their diabetes or high blood pressure, just people have different variability in their dependence on nicotine. And so, while your neighbor may be able to quit fairly easily and you're really struggling with that, it really is related to how hooked or dependent your brain has become on that nicotine.

COHEN: We have an e-mail now, from Chris in Arkansas who asks, "What's your opinion of using hypnosis as a method to stop smoking?"

Dr. Dale, does it really work?

DALE: Well, I think we all know people who have been able to stop with hypnosis, but in our treatment program, we try to use interventions that have been scientifically proven to work, and hypnosis has not been. So, we don't advocate that as the only way to look to look at stopping smoking. We really advocate -- you know, getting some counseling support, using medications, and really the proven therapies.

COHEN: Mark from Texas has a question, "I've been dipping smokeless tobacco for 23 years and would like to quit -- any suggestions?"

DALE: Smokeless tobacco is not harmless and it's good to hear that this person is really seriously thinking about trying to stop that. We've done quite a bit of work here, now, with smokeless tobacco users and we have found that many of the issues are the same with smokeless tobacco users, as with smokers, and that many of the medicines that are available for smokers appear to work, as well. It's just that you have to be very aggressive. We know that smokeless tobacco users are exposed to levels of nicotine that are comparable to smokers and sometimes higher, so they have to be very aggressive. So, nicotine replacement, again, and Zyban have been shown to work.

COHEN: Molly from Florida is no the phone.

Molly, go ahead with your question for Dr. Dale.

MOLLY, FLORIDA CALLER: Hi, Dr. Dale. I have read and heard it is harder for women to quit smoking than men. Is there is any truth to that?

DALE: There are -- there are some -- there is some evidence to suggest that women do have a more difficult time, and we aren't quite sure why that is. That doesn't mean that women -- you know, can't stop. It just means that we need to probably look beyond traditional behavior modification techniques and begin to explore some of the other issues for why women really find the need to smoke. We know that women who smoke tend to have higher rates of depression than others, and being aware of that and addressing that issue, for example, can often help that person stop.

COHEN: Thank you, Dr. Dale. We have to take a break, now. When we come back, get a paper and pen ready. We'll give you some Web sites where you can find information about smoking cessation clinics in your air area. Some of the help lines are free, no cost and some states subsidize smoking cessation programs.

WEEKEND HOUSE CALL will be right back.

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COHEN: We're answering your questions about breaking the smoking habit. We have an e-mail from Darlene in Alabama who writes, "Getting medical help is impossible for some that can't afford it. Why aren't there free "Stop Smoking" clinics to help?"

DALE: Dr. Dale, is it expensive to stop smoking? It can be expensive to stop smoking. Certainly the medications are not -- are not cheap, and seeing a treatment specialist also, obviously, takes money. But, there are programs available to help support people, and we just have to look for them. And one of those -- one program -- and especially since the master settlement agreement where the attorneys general and the tobacco company came to agreement about litigation, that many states got money to help support some of these free programs. Many states have tobacco's "quit lines," and they have been shown to be very effective. These telephone lines provide counseling and many of them, actually, provide free patches or other nicotine replacements. So, there are free programs like that out there.

For people -- but it varies so much from state to state that the -- I think one of the better sources to try to find information about these free programs in your state is to go to the American Lung Association Web site or else call them at 1-800-lung-USA, and they can give you some more information.

Another source would be your county or state health department. Most of them do have some sort of tobacco control office that can line you up with those types of programs.

COHEN: So, there are free programs out there. You just have to look for them.

DALE: Exactly.

COHEN: We have a phone call, now, from Dean in Florida.

Dean, go ahead.

DEAN, TAMPA, FLORIDA CALLER: Yes, good morning, folks. It was recently reported that certain cigarettes have higher rates of nicotine inside their cigarettes. What does that make, far as differences in far as treating who do want to stop smoking when it comes to the differences in nicotine rate?

DALE: Yes, I saw that report, too, that showed that tobacco companies have been able to manipulate the levels of nicotine in cigarettes so that some deliver more, and that tends to make them more addictive. It also, then, as we're looking at treating people that are using these, perhaps higher levels of nicotine, that we probably have to be more aggressive about using our medications. We know nicotine replacement works, but we also know often you have to use enough of it to control your withdraw symptoms. So, probably, they need just more of it.

COHEN: Here's a strange twist on nicotine. A new drink has emerged in South Florida where smoking has been banned in all restaurants; it's called the "Nicotini." Some people are calling it the "liquid cigarette," because the drink comes complete with a nicotine rush and a mental tobacco aftertaste -- yummy.

Dr. Dale, there are all sorts of nicotine replacement therapy out there -- have you ever heard of this one? I mean, would this actually help you quit smoking?

DALE: About a year or so ago, in California, I believe, they tried to market a nicotine water, and the FDA really came down hard on them because it is unregulated, and so I'm surprised that people in Florida are able to -- to be able to purchase this. People should be very careful about this because, again, there -- it's unregulated. You really don't know -- you know, what kind of quantity of nicotine you're getting. The other people thing people should know is that nicotine, when it's ingested, when it's swallowed and get into the stomach, most of it is inactivated. It becomes inactive and so the levels that people are getting are not very high. And, so I'd be very surprised if that can be very helpful for people in stopping.

Dr. Dale, thank you and when we come back we're going to have final thoughts about how you can quit smoking. Stay with us.

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COHEN: Another good Web site for information on quitting smoking check out www.cancer.org or check out nicotine-anonymous.org. This Web site is for self-help groups around the U.S. modeled after Alcoholics Anonymous to support those trying to remain tobacco free.

Welcome back to WEEKEND HOUSE CALL where we've been talking about quitting smoking with Dr. Lowell Dale from the Mayo Clinic.

Dr. Dale, what would you say is the single most important thing that people should do when they're trying to quit smoking?

DALE: People shouldn't try and do this by themselves. They really should look for support whether it's their physician, a tobacco treatment specialist, or looking for a national program where they can get more intensive therapy than they can get locally.

COHEN: Thank you, Dr. Dale, for joining us. That's all times we have for today. Make sure to catch us next weekend when we talk about chronic fatigue syndrome. It's plagued the author of the best selling novel and movie "Seabiscuit." We'll tell you the symptoms and some possible treatments of this misunderstood disease.

Also, keep an eye on CNN Medical News all this week. We'll be covering stories on the benefit of soy products, on varicose vein removal treatments, and hormone replacement therapy and heard disease.

Thanks for watching, I'm Elizabeth Cohen. "CNN Sunday Morning" continues now.

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