Practical tips about medicine use are one reason that free telephone quitlines are emerging as a better way to stop smoking. They give smokers twice the chance of kicking the habit.

Trained counselors answer the calls and help each person plan a unique quitting strategy around his or her smoking habits and personal concerns. The counselors send printed materials that fit the smoker's stage in the process. More counseling sessions are scheduled for key days after a smoker quits. Unlike many cessation programs, a quitline is not one-size-fits-all—its' more like having your own dressmaker.

"Quitting is a really hard thing to do. We give people the tools to stay smoke-free," explained Angela Geiger, who helped develop the American Cancer Society's quitline services. Many states run free quitlines for residents, and smokers can get help finding one in their area by calling ACS at 1-800-ACS-2345.

Quitlines offer exceptional convenience and flexibility. Smokers don't have to leave home, find transportation, or arrange childcare. They can schedule counseling sessions at night and on weekends and the services are free. Some states may provide stop-smoking medicine at reduced prices.

A combination of stop-smoking medicine, changing daily habits, and emotional support is recommended for many quitters. The medicines include nicotine substitutes delivered by skin patches, gum, a nasal spray or inhaler, and buproprion (Zyban), a pill that helps ease nicotine cravings. Unfortunately, some people get the mistaken idea that stop-smoking medicines are harmful.

"The number one mistake with medication is that people don't use enough. They don't chew enough gum; they only use it for two weeks. They think it's bad to keep putting the nicotine replacement products in their bodies, and then they relapse into smoking, which is much worse," said Geiger.

In reality, Geiger says, "It's not the nicotine that is so bad for you. It's all the other chemicals people inhale when smoking cigarettes." Nicotine replacement therapy also delivers a lower dose of nicotine than cigarettes--just enough to ease withdrawal symptoms so smokers can focus on changing their behavior.

Telephone counseling appeals to people of all ages and smoking habits. Geiger says people even call from the hospital: "I'm going in for surgery and I need to quit smoking."

Callers between 18 to 25 years old worry about the smell, cost, and evil intentions of the tobacco companies. The average age of callers is in the mid-40s, when people no longer feel invincible. "People start having significant life events. Their parents get cancer. A friend keels over from a heart attack," Geiger explained.

It often takes more than one attempt for people to quit for good, so the telephone counselors turn a relapse into a learning experience. When and where did it happen? For one woman having a beer in a bar weakened her resolve. "Should they try to quit again? Absolutely," says Geiger. "Even if this attempt isn't successful, they'll learn something. We'll set another date 2 or 3 months out."

People who relapse are advised to review their reasons for wanting to quit and to make a better plan for next time around. The goal is for smokers to find their own support system and techniques.

While quitlines have double the success of other cessation programs, the number of successful quitters is still small. A recent study showed that after one month, 21% of people who were counseled through the California Smokers' Helpline were not smoking, compared with 10% of a group that did not receive counseling. After a year the success rate for counseling dropped to 8%. These results from one quit attempt are typical for addiction programs but don't show the big picture.

Almost a quarter of US adults--46 million people--are former smokers. Perhaps their parents drummed an old motto into their heads at an impressionable age: "If you don't succeed, try, try again." Quitline callers learn it's well worth trying again.