Cigarette smoking is very addictive and can have long-term, adverse health effects. But there is hope for those who want to quit thanks to innovative apps, helplines and proven coping strategies.

In 2019, more than 30.8 million Americans smoked, according to the U.S. Centers for Disease Control and Prevention. That was almost 12.5% of Americans 18 and older.

Smoking is also the No. 1 leading cause of preventable death in the United States, accounting for nearly 1 in 5 deaths.

Cigarettes have chemicals that can make this addiction particularly insidious. When they enter the lungs, they can cause harmful effects like bronchitis, said Jonathan Bricker, professor in the public health sciences division at the Fred Hutchinson Cancer Research Center at the University of Washington in Seattle.

Over time, smoking can eventually lead to lung cancer, which has less than an 18% survival rate within 5 years of diagnosis.

Fortunately, lung cancer can be prevented if you stop smoking and learn to "stay quit," said Dr. Panagis Galiatsatos, director of the Tobacco Treatment Clinic at Johns Hopkins Medicine in Baltimore, Maryland.

Here are six actions you can take to help you or a loved one quit smoking and enjoy a healthier life:

1. Focus on how to 'stay quit'

The goal should not be to quit smoking; rather, it should be on how to "stay quit," Galiatsatos said. He said he's had patients who say they've quit many times, but that they've not been able to permanently stop.

He recommends people break up their larger goal of quitting into smaller goals.

For example, learn your different triggers that could make you want to smoke. That way, you can be mindful and find solutions for those actions.

2. Make each time you quit a learning experience

Most people who smoke quit eight to 12 times, because of the addictiveness of cigarettes, before they successfully quit for good, Bricker said.

Because relapse is so common, Bricker tells his patients to find a lesson they can take from each experience.

"People will say things like, 'I learned how powerful these cravings are, or I learned how seeing my friend smoke was a big trigger for me, or I learned that stress in my life was a big trigger,' " Bricker said.

Patients should approach quitting from the viewpoint that the more things they learn from their relapses, the greater their chance is of quitting permanently, he said.

3. Use phone lines and apps for support

Support groups for people who want to quit smoking are dwindling, so Bricker recommended calling a quitting help line to get outside assistance.

The CDC funds a tobacco cessation hotline, 1-800-QUIT-NOW (784-8669), which is free to US residents in all states, plus the District of Columbia, Guam and Puerto Rico. Your call goes automatically the quit line in your state or territory.

Callers are connected to coaches who help smokers create a plan to quit and give them advice when facing withdrawals and cravings.

Currently, state cessation hotlines only reach about 1% of people who smoke, which the CDC largely attributes to the lack of funding to promote the service.

Bricker's team at Fred Hutch helped to create the app iCanQuit, which was supported by a grant from the US National Institutes of Health.

The app focuses on acceptance and commitment therapy, which encourages people to accept their emotions and thoughts instead of pushing them away. The tool also offers resources for quitting and handling cravings when they arise, Bricker said.

RELATED: Apps that help you acknowledge your smoking triggers work better, study shows

4. Speak to your medical provider

People who want to quit smoking can talk to their medical provider to come up with a treatment plan filled with multiple strategies, Galiatsatos said.

Doctors can prescribe medication to curb cigarette cravings and make them more manageable, he said. It's a short-term solution to help train your brain to not crave cigarettes as strongly, Bricker added.

The medications doctors provide will depend on your specific situation, Bricker said. The prescriptions tend to be minimal at first then escalate depending on the severity of the addiction.

5. Support people addicted to smoking

Galiatsatos said he's never come across a patient who doesn't already know that smoking is bad, so he recommends avoiding that argument when appealing to a love one who smokes.

"If you are really serious about helping your loved one quit, you have to approach it as pro-smoker and anti-smoking," he said.

When trying to help someone who smokes, make it clear that you are approaching the situation with no stigma or judgment, Galiatsatos said.

Once trust is established, he recommends friends and family members offer to help smokers find resources on how to quit smoking.

Medical providers should also be supportive of their patients who smoke, Galiatsatos said.

If patients feel judged by their doctors for smoking, they might just lie about it. And that doesn't help anyone, he said.

Even when patients don't feel motivated to quit smoking that day, it's important to outline the different treatment options so they have the resources later.

6. Address the root cause of the issue

Many times when people smoke, it's to cope with some underlying issue in their lives such as stress or anxiety, Galiatsatos said. When they face those emotions while quitting, it's instinctive for them to turn to cigarettes.

"If you've always relied on cigarettes to be that coping mechanism, and you don't have a replacement, that's all we're going to see," he said.

To combat this challenge, Galiatsatos recommended that people who are trying to quit smoking go to behavioral counseling. They will be able to better identify why they smoked and work to find healthier ways of processing those emotions.

Why is smoking so addictive anyway?

Cigarettes are filled with chemicals such as nicotine, which are chemically enhanced to drive that addiction, said Galiatsatos.

The chemically enhanced nicotine closely resembles the common neurotransmitter acetylcholine, which helps control muscle movement and other brain functions.

When the nicotine fits into the acetylcholine receptors, your body releases dopamine, the "feel-good" brain chemical. When the dopamine goes away, people begin craving another cigarette.

"I always tell people this is the most insidious addictive molecule known to man because it doesn't just overdose you," said Galiatsatos, who is also a volunteer medical spokesperson for the American Lung Association.

It rewires the smoker's brain over years and years, and "by the time someone realizes it's robbing them of their health, it's incredibly hard to break that addiction."

Despite the daunting effort it takes, never forget -- it is possible to overcome this addiction and enjoy better health.

New research shows U.S. teens who use electronic cigarettes prefer ones made by Juul Labs, and mint is the top flavor for many of them. That suggests a shift after Juul's sweeter flavors were removed from retail stores.

The results are in two studies published online Tuesday in the Journal of the American Medical Association. They include a U.S. government report based on a survey indicating that the U.S. teen vaping epidemic shows no signs of slowing down.

An estimated 28% of high school students and 11% of middle schoolers surveyed earlier this year had vaped within the past month. That amounts to over 5 million young users, versus about 3.6 million last year.

The results follow the Trump administration's call in September to ban virtually all vaping flavors.

For the first time in history, the FDA authorized three e-cigarette products: the Vuse Solo device and its pods.

The agency says the company that makes the Vuse Solo gave them data that shows it can be helpful to cigarette smokers.

In an email, the FDA said, "the potential benefit to smokers who switch completely or significantly reduce their cigarette use would outweigh the risk to youth."

Gregory Conley is the American Vaping Association president.

“After years of debate, you now have the FDA, which is our chief regulatory arm for things that we ingest - The FDA is saying that this particular product is appropriate for the protection of public health,” Conley said.

He says electronic cigarettes, which have been sold in the U.S. since 2006, are an essential step in the fight to help smokers quit tobacco cigarettes.

Last year, the FDA also took steps to keep vape products out of kids' hands, sending warning letters to 10 companies telling them to pull their flavored e-cigarette and e-liquid products because they appeal to young people.

Hasmeena Kathuria, MD, is an associate professor of medicine at Boston University and the director of the tobacco treatment center.

“Inhaling anything directly into the lungs is not a good idea,” Kathuria said.

She says she’s glad the FDA is acting on its promise to regulate these products. Nonetheless, the U.S. Surgeon General's office says since 2014, E-cigarettes have been the most commonly used tobacco product by American kids, and Kathuria says that's concerning.

“We think all e-cigarettes should not be allowed on the market because of – one, the youth epidemic of nicotine addiction, two, we know that there's FDA approved medications for smoking cessation that have that are regulated, that we know are safe, that we know that, that there are effective,” Kathuria said.

Knowing e-cigarettes aren't leaving the market anytime soon, the FDA will make these authorizations and marketing decisions on a case-by-case basis.

The agency says it hopes to get to a place where every vape product is “appropriate for the protection of the public health.”

 

TRENTON, N.J. – New Jersey is expanding its list of residents who are eligible to receive a COVID-19 vaccination and the inclusion of one group has led to some pushback – smokers.

In addition to those age 65 years and older, those between 16 and 64 years of age who have certain medical conditions are now eligible to be vaccinated for COVID-19.

Smoking is one of the ten conditions and state health officials say it’s the largest group, with millions of smokers in the state.

“Smoking puts you at significant risk for an adverse result from COVID-19. And there are 2 million smokers in New Jersey that fit into this category,” said the state’s health commissioner, Judith Persichilli at a Wednesday press conference with Gov. Phil Murphy.

The other conditions included are cancer, chronic kidney disease, COPD (chronic obstructive pulmonary disease), Down syndrome, heart conditions (such as heart failure, coronary artery disease, or cardiomyopathies), obesity, severe obesity, and sickle cell disease.

“We know individuals in these categories are at greater risk for severe COVID-19 illness and death,” said Persichilli.

The commissioner says 80% of COVID-19 deaths in New Jersey have been among those 65 years and older, and 67% of all COVID-19 deaths in the state had one or more underlying condition reported.

“However, we know this number is likely higher, because not all cases had data reported on whether those comorbidities or chronic conditions existed,” she said.

Persichilli said expanding vaccinations to these groups, “will help protect the most vulnerable amongst us.”

The decision to include smokers has already led to backlash, because they’ll be able to get vaccinated before some front-line workers, like teachers and public transit employees.

The state’s decision does lineup with guidance from the Centers from Disease Control and Prevention (CDC), though. Smoking is listed as medical condition that could lead to severe illness from COVID-19.

If you’re a smoker, the CDC says to quit.

“If you used to smoke, don’t start again. If you’ve never smoked, don’t start,” the agency wrote on its website.

Click here for resources that can help you kick the habit.