Heavy, long-term cigarette smoking is often said to cause cancer, most prominently lung cancer and cancer of the larynx. And, the evidence is very strong, amounting to near certainty. But, interestingly enough, exactly how it does so is not fully known. It remains an active area of research.

Normal cells may be damaged, but they have the ability to repair themselves. In other cases, the cells are sloughed off and eliminated by the lymph system, then replaced by new ones. But this process can go awry. Cells can grow abnormally, taking on inappropriate shapes and performing incorrectly. When they do, and that growth reaches a certain level that the body can't cope with, the result is cancer.

It is known that cigarette smoke contains many carcinogenic substances.

Tar, for example, is present in cigarette smoke chiefly from the burning paper that holds the tobacco, about 10-14 mg per cigarette. It gradually builds up in the alveoli, the small sacs in the lung that make possible absorption of oxygen into the blood stream. It's believed that their presence is a continual irritant to the cells. That irritation eventually leads to uncontrolled growth of abnormal cells.

Other compounds, called nitrosamines, are present in varying amounts. They're known to be carcinogenic from hundreds of clinical studies on small mammals. NNK is present in a very low concentration: 56.53 nanograms per cigarette. Other nitrosamines, like NNN and NAT, are present in roughly similar amounts.

A few dozen nanograms (one billionth of a gram - 1 g = 0.0353 oz) may sound like a small amount. But sometimes small amounts can have a large effect. Dog's noses, for example, are so sensitive they can detect a few molecules of certain substances. Some systems in humans are equally sensitive to certain chemicals. Add to that the fact that many of the compounds and their effects are cumulative and the case begins to look very strong.

No study has found any link between cancer and consuming one or two cigarettes per day. But such smokers are extremely rare and the odds of them catching some other serious disease are so much higher it may be masked. A smoker who consumes a pack a day for 20 years has 2-4 times the chances of getting lung cancer than a non-smoker.

Non-smokers do, in fact get it. But that doesn't show that smoking isn't a cause, only that other causes can lead to the same effect. One reason scientists have good cause to believe that smoking increases the odds of getting lung cancer is just the odds cited above. Studies also show that lung cancer was much more rare prior to WWI when smoking rates were much lower. As the number of people smoking cigarettes rose, so did the cancer rate. Similarly, as people smoke more, the rates go up.

No single fact or study proves the case. But put enough of them together, over a long enough period, and eventually the case becomes very strong. So strong that saying 'long-term, heavy smoking greatly increases the odds of acquiring lung cancer' becomes a very reasonable statement indeed. It's estimated that 87% of lung cancers are attributable to that habit.

Don't let the odds get you. Start a stop-smoking program now.

"Just stop", we're told. Stop smoking, that is, by just deciding to stop. Wouldn't it be great if it were that easy? But the fact is that both physiological changes and psychological issues play a role in any stop-smoking program. Even the most determined can rarely just flip a switch and never smoke cigarettes again.

Still, a commitment to do so has to be a part of any program. Only 6% on average will successfully stop smoking their first try. Summoning up the willpower to make that decision permanent is key to succeeding in the long run.

Up your odds by understanding what willpower is and how it functions in a stop smoking program.

In any area of life, we make many small choices. But the big ones are very rarely a matter of snapping the mental fingers and choosing a course of action. It takes more thought and effort than that. Those twin helpers are the link between willpower and achievement of the goal.

Stress is one major factor that starts individuals smoking, and keeps them at it year after year. Some event occurs, it's evaluated as a negative impact over which we have little control, and we feel stress. The next action is to reach for a cigarette to restore calm.

At several points along that moving train of events, it is possible to interrupt the journey.

Start small. Look for those times when reaching for a cigarette is just a habitual move. You get up in the morning and reach for the first cigarette. Put them out of easy reach and exert willpower to forego the effort of getting them. Delay that cigarette after dinner, first by a few extra minutes then more and more. These small victories will reduce the number of cigarettes per day and strengthen your willpower.

As you gradually gain better control over impulses, your self-confidence grows. You feel in control. That reinforces the feeling that your willpower can be effective, that you can direct events rather than have them direct you.

Now, for the long term plan. Pick a day when you'll stop smoking. Estimate how many cigarettes you have left so you run out by that date. Just as you would resist buying an item more expensive than you could afford, remind yourself of the high price of smoking - in dollars and health impact.

The first two weeks will be hardest, making the largest demands on your willpower. The cravings are strongest during this period. The chemical changes taking place as your body adjusts to lower levels of dopamine, flushes smoke ingredient-created compounds out of the body and other physical impacts will create the urge to resume.

Help yourself by thinking of the long term consequences. Stimulate your imagination by viewing photos of diseased lungs, remember the time you were short of breath walking up the hill. Assist your willpower in every way you can.

After that, the really hard part starts: sticking to the plan for a lifetime. Willpower isn't just about choosing an action at the moment, but directing your life toward a better horizon.

Psychotherapy can help you stop smoking permanently. But it need not involve expensive counseling sessions with a professional. Any mixture of self-help and outside assistance can up your odds of a permanent change in behavior, one conducive to long-term health.

Don't limit your choice to any one school of psychotherapy - there are a dozen or more. Use techniques from each to get you to your goal: quitting smoking permanently.

Hypnosis is one popular technique that has proven to be successful. It's been around since the 19th century as a therapeutic method. Though once associated with charlatans, professionals currently see a role for it in helping modify many behaviors. After all, the physical addiction associated with smoking is only one aspect. Long term change requires an adjustment to the mind and hypnosis is well suited for facilitating the adjustment.

Hypnosis involves making suggestions that are retained at a sub-conscious level. Those hidden triggers that encourage the choice to smoke can be combated by instilling other triggers that oppose them.

More conscious efforts are also desirable. Cognitive therapy for example, focuses on discovering and understanding those thoughts and ideas that are in our control. When they're examined carefully, they can be influenced by reference to fact and logic.

One way to use that approach is to make a list of all those events and objects associated with the decision to smoke. Write down the times you reach for a cigarette, and what prompted the choice. Is it a blind habit to light up right after waking up? Do you reach for a cigarette right after a meeting with the boss, who gives you yet another unpleasant assignment?

Looking for those triggers is the key to bringing them into conscious awareness, where they can be subject to conscious control. The approach is similar to traditional psychoanalysis - bringing items up from the subconscious. But cognitive therapy regards them as having been placed there through past thinking, not necessarily unexamined childhood or other events. Therefore, those thoughts can be intentionally replaced with new thoughts by a conscious effort.It's not an automatic process, nor one devoid of any emotional involvement. Quite the opposite: feelings and thought need to be harmonized.

That effort is key to long term success. Simply knowing what motivates you to smoke is only half the exercise. Doing something about it is equally important.That can mean redirecting your focus onto other activities. Instead of having a smoke to relieve stress, do yourself a double favor and exercise for a few minutes. Foregoing one cigarette reduces by that small amount the habit that is injuring your health - give them up one at a time, if necessary. Many people make the mistake of "biting off more than they can chew." If you aren't the type for cold-turkey quitting, then don't set yourself up for failure by attempting it. Exercising is building it up in the direction toward health. Or, instead of reaching for a cigarette to accompany that beer or fine glass of wine, select a small piece of fruit, bread or chocolate.

In each case, the technique is to redirect that decision to smoke a cigarette. It moves onto something that helps both eliminate one smoking episode and presents a desirable yet healthy alternative.

All long-term behavior modification can only come from re-forming habits. There was a time when you didn't smoke. To reach that time again, develop a plan then carry it out, one choice at a time.

The Proper Care and Feeding of A Healthy Quit Smoking Program

We all want this quit to be the quit. We're looking for permanent freedom from nicotine addiction. It takes planning - planning what you will do, and what you won't do. If you can't do cold-turkey, don't beat yourself up over it - it isn't for everyone. Decide what you CAN do successfully - and do it. If you need to cut back 1 cigarette a day to be successful, then do that.

Here are 10 more tips we hope will help get you through this.

Don't be impatient. The natural tendency is to quit smoking and expect to be done with it within a month. Cessation just doesn't work like that. When you quit smoking, you are letting go of a habit that you've had for many years, if not all of your adult life. It's only fair to expect that breaking all of the old associations down will take some time. Sit back, relax, and put some time between you and that last smoke. Have patience with yourself, and with the process.

Don't worry about forever. It can be overwhelming to think you'll never smoke another cigarette.

Don't do that to yourself. Train your mind to stay in the here and now of today. This is where your power is, and always will be. You can't do a thing about yesterday or tomorrow, but you sure can control today. If you find your mind wandering in either direction, pull it back. Pay attention to your thoughts, and do your best to stay focused on the day you have in front of you.

Don't be negative. It's been said that the average person has approximately 66,000 thoughts in a given day, and two-thirds of them are negative. We can be so hard on ourselves! Don't beat yourself up for things you can't change, such as the years you spent smoking. Don't look at past quit attempts as failures. Learn from the experiences you've had and move on. Think about all of the positive changes you're creating in your life. Successful long-term cessation always starts in the mind. Focus on your purpose and develop an attitude of gratitude. We have a way of believing what we tell ourselves over and over. Don't feed yourself negatives. Affirm the changes you are working to create in your life, and action will follow more easily.

Don't neglect yourself. This is a time when you should be taking extra care to make sure all of your needs are getting met. Following these simple guidelines will help you weather withdrawal more comfortably:

Eat a well-balanced diet. Your body needs good quality fuel now more than ever as it works to flush the toxins out of your system.

Get more rest. You will need it, and chances are you'll feel extra fatigue for a few weeks. Don't fight it. Sleep more if you can.

Drink water. Water is a great quit aid. It helps you detox more quickly, works well as a craving-buster, and by keeping yourself hydrated, you'll feel better overall. Drink as much of the stuff as you can manage.

Exercise daily. Walking is a wonderful way to get your exercise if you don't already have a favorite physical activity. It's a good, low impact aerobic workout, and it works well to keep cravings in check. Take a few 15 minute walks every day and see if it improves your spirits.

Take a daily multi-vitamin. Giving your body an extra boost this way isn't a bad idea for the duration of the withdrawal process. Cigarettes deplete so many nutrients. It may help you regain your energy more quickly.

Always keep in mind the fact that withdrawal from nicotine is a temporary condition. Withdrawal isn't a pain-free experience, but it is survivable,and short-lived.

Alcohol and tobacco go hand-in-hand...

Don't drink. I probably don't need to tell you that alcohol and tobacco go hand-in-hand. New quitters are tender. Putting yourself into a social setting where there is drinking too soon after quitting can be dangerous. Don't rush it. The time will come when you can have a drink without it triggering the urge to smoke, but don't expect that to be within the first month, or perhaps even the first few months. We're all a little different in how we go through recovery, so defining a specific time frame isn't realistic. Just be aware of your own situation. If you have an engagement coming up that involves drinking and you feel nervous about that, it may be best to postpone until you're feeling stronger. If that's not an option, have a plan in place for how you'll manage the event smoke free.

Going to try it on your own? Sometimes that works. Here are 20 tips to help see you through it.

1. Believe in yourself. Believe that you can quit. Think about some of the most difficult things you have done in your life and realize that you have the guts and determination to quit smoking. It's up to you.
2. After reading this list, sit down and write your own list, customized to your personality and way of doing things. Create you own plan for quitting.
3. Write down why you want to quit (the benefits of quitting): live longer, feel better, for your family, save money, smell better, find a mate more easily, etc. You know what's bad about smoking and you know what you'll get by quitting. Put it on paper and read it daily.
4. Ask your family and friends to support your decision to quit. Ask them to be completely supportive and non-judgmental. Let them know ahead of time that you will probably be irritable and even irrational while you withdraw from your smoking habit.
5. Set a quit date. Decide what day you will extinguish your cigarettes forever. Write it down. Plan for it. Prepare your mind for the "first day of the rest of your life". You might even hold a small ceremony when you smoke you last cigarette, or on the morning of the quit date.
6. Talk with your doctor about quitting. Support and guidance from a physician is a proven way to better your chances to quit.
7. Begin an exercise program. Exercise is simply incompatible with smoking. Exercise relieves stress and helps your body recover from years of damage from cigarettes. If necessary, start slow, with a short walk once or twice per day. Build up to 30 to 40 minutes of rigorous activity, 3 or 4 times per week. Consult your physician before beginning any exercise program.
8. Do some deep breathing each day for 3 to 5 minutes. Breathe in through your nose very slowly, hold the breath for a few seconds, and exhale very slowly through your mouth. Try doing your breathing with your eyes closed and go to step 9.
9. Visualize your way to becoming a non-smoker. While doing your deep breathing in step 8, you can close your eyes and begin to imagine yourself as a non-smoker. See yourself enjoying your exercise in step 7. See yourself turning down a cigarette that someone offers you. See yourself throwing all your cigarettes away, and winning a gold medal for doing so. Develop your own creative visualizations. Visualization works.
10. Cut back on cigarettes gradually (if you cut back gradually, be sure to set a quit date on which you WILL quit). Ways to cut back gradually include: plan how many cigarettes you will smoke each day until your quit date, making the number you smoke smaller each day; buy only one pack at a time; change brands so you don't enjoy smoking as much; give your cigarettes to someone else, so that you have to ask for them each time you want to smoke.
11. Quit smoking "cold turkey". Many smokers find that the only way they can truly quit once and for all is to just quit abruptly without trying to slowly taper off. Find the method that works best for you: gradually quitting or cold turkey. If one way doesn't work do the other.
12. Find another smoker who is trying to quit, and help each other with positive words and by lending an ear when quitting becomes difficult.
13. Have your teeth cleaned. Enjoy the way your teeth look and feel and plan to keep them that way.
14. After you quit, plan to celebrate the milestones in your journey to becoming a non-smoker. After two weeks of being smoke-free, see a movie. After a month, go to a fancy restaurant (be sure to sit in the non-smoking section). After three months, go for a long weekend to a favorite get-away. After six months, buy yourself something frivolous. After a year, have a party for yourself. Invite your family and friends to your "birthday" party and celebrate your new chance at a long, healthy life.
15. Drink lots of water. Water is good for you anyway, and most people don't get enough. It will help flush the nicotine and other chemicals out of your body, plus it can help reduce cravings by fulfilling the "oral desires" that you may have.
16. Learn what triggers your desire for a cigarette, such as stress, the end of a meal, arrival at work, entering a bar, etc. Avoid these triggers or if that's impossible, plan alternative ways to deal with the triggers.
17. Find something to hold in your hand and mouth, to replace cigarettes. Consider drinking straws or you might try NIC OUT cigarette filters
18. or perhaps Nicotine Transdermal System Patch, Stop Smoking Aid, 7 mg, Step 3, 14 patches. These products have been very successful in helping with smoking cessation.
19. Write yourself an inspirational song or poem about quitting, cigarettes, and what it means to you to quit. Read it daily.
20. Keep a picture of your family or someone very important to you with you at all times. On a piece of paper, write the words"I'm quitting for myself and for you (or "them")". Tape your written message to the picture. Whenever you have the urge to smoke, look at the picture and read the message.
21. Whenever you have a craving for a cigarette, instead of lighting up, write down your feelings or whatever is on your mind. Keep this "journal" with you at all times.