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Whoever said “life is measured by the moments that take your breath away” probably wasn’t talking about cigarettes. Or about other features of the contemporary smoking scene, like hookah (shisha), e-cigarettes, and thirdhand smoke. As old-school as tobacco may seem, you’re probably encountering it in various forms and situations.

Most smokers want to quit. Take the quiz to find out more about the 21st-century smoking scene and what works in resisting tobacco.

Select your answers to view results

1. Could smoking ever make you sexier, or does it make people swipe left?

A. Hey, it worked for Don and Betty Draper.

In 1965, 42 percent of American adults smoked, according to the Centers for Disease Control and Prevention (CDC). By 2013, only 18 percent did. Many quit, many died, many didn’t start.

Smoking has been thought to cause 480,000 deaths in the US each year—a count that may be revised upward to 540,000, according to a 2015 analysis in the New England Journal of Medicine. That’s like the entire population of Colorado getting wiped out in a decade. On average, smokers die 10 years earlier than non-smokers, the CDC says.

B. There's no aphrodisiac like a smoke-flavored mouth. JK. Next!

Smokers aren’t bad people, but in a competitive dating scene it’s a strike against you. Smoking gives you bad breath, stains your teeth, and can reduce fertility. It also ages your skin by a mere one to two decades. But you know this stuff. Keep reading for more about what helps smokers become non-smokers.

C. Smoking eases my social nerves.

Understood. Social angst is a thing. There are ways to relieve social discomfort that have lifelong benefits, not lifelong harms. Check out this option:

Dialetical Behavioral Therapy (DBT) is a form of Cognitive Behavioral Therapy (CBT). The “dialetical” piece refers to two valid but opposing thoughts: e.g., “I want to quit smoking” and “I would feel calmer right now if I had a cigarette.” DBT helps us understand our own stress triggers and develop effective self-soothing techniques. Mindfulness techniques are a foundational skill of DBT. Follow our monthly Mind your mind series on our BetterU pages.

+ Find DBT resources
+ Test: Do you have social anxiety?

2. Not in the office, not in the lecture hall, not in the bedroom. What’s up with secondhand and thirdhand smoke?

A. Because other people don't need to be in the cancer ward with me.

Caring about others is sometimes easier than caring about ourselves (we’ll work on that later). In 50 years, about 2.5 million nonsmokers have died from health problems caused by secondhand smoke.

Ask your health care provider about “motivational interviewing.” This is a counseling approach that helps you come up with your own solutions. In a 2015 Cochrane review of 28 studies, motivational interviewing with health professionals was more successful than traditional health advice. Single, brief sessions appeared effective for quitting.

B. Thirdhand smoke? What?

We’d all rather our hair smelled like peppermint than an ashtray, which is why ashtray shampoo won’t be coming to a salon near you. Particles from smoke linger in clothes and hair for hours or days, even if it’s not yours. Nicotine and other chemicals remaining from smoke can sink into carpet, furniture, cars, walls, and other surfaces and stay there long-term, according to a 2011 study in Environmental Health Perspectives. This contamination is known as thirdhand smoke. It is believed to be a health hazard, especially to children, according to a 2009 study in Pediatrics.

C. Because there's no smoke without fire and no fire without consequences.

Smoking caused an estimated 90,000 fires in the US in 2011, according to the National Fire Protection Association. Just saying. Non-trivial trivia.

3. What about vaping (using e-cigarettes) — is it safe?

A. I've heard they might help me quit.

E-cigarettes are devices that let you inhale nicotine mixed with other chemicals. Some people vape to quit traditional smoking. “We need research to know all of the risks, but if I was a smoker and wanted to quit, I would see vaping as a less harmful alternative,” says Steve Lux, senior health educator at Northern Illinois University. 

The limited data available suggests e-cigarettes “show promise for helping people quit, especially when they haven’t been able to with other products,” said Dr. Carla Berg, assistant professor of behavioral sciences and health education at Emory University’s Rollins School of Public Health in Atlanta (speaking to US News in 2014).

B. They sell e-cigs at the drugstore, so they're probably OK.

E-cigs are new, so we don’t know their long-term effects. Governments are still figuring out what rules and regs might be helpful.

E-cigarettes are not regulated by the FDA. Some may contain higher nicotine doses than their packaging acknowledges.

C. Dude, I don't even know what it does to my body and brain.

It can take years for scientists to figure out the health effects of a new product. We don’t yet have the data on e-cigarettes.

We do know that the nicotine in e-cigs has the potential to harm brain development in people in their early 20s, according to the World Health Organization. Again, it’s about weighing potential benefits and potential risks.

4. Some people buy a latte a day; you buy cigs. Same type of hit, financially?

A. It's more affordable than a weekend trip.

Big tobacco corporations want you to see cigarettes as a cheap vacation, an escape to an exotic land. Remember: Cigarette ads are full of actors. The real smokers have their own TV clips in which they talk about why they can’t walk 30 paces from their front door without gasping.

B. A pack is pretty cheap, but over the year it adds up big.

An average pack of smokes costs $6.36—and also comes with $35 of health-related costs down the road, according to the American Cancer Society. Buying a pack a day costs almost $200 a month. For that, you could lease a car or take a European vacation every year. There’s a broader cost, too. Premature deaths cost the economy $151 billion in productivity each year, says the American Lung Association. On top of that, smoking was to blame for an annual $132–$176 billion in medical spending 2009–2012.

+ How much extra cash would you have without your habit?

C. It's just a temporary habit. Not a major hit.

If your temporary habit turns into a lifetime habit, it will cost you $1–$2 million, according to a 2015 analysis by WalletHub. This is mostly about tobacco prices, and also allows for health costs and lost income. More trivia: The three priciest states to smoke in are Alaska, Connecticut, and New York.

Tobacco costs may be more of a quit-motivator if you get on top of your spending in general. Check out Spend smart in this issue.

5. Out with your people? Is it that bad to have a smoke now and then?

A. Totally bad, unless it's hookah. That gives me less of a burn.

Hookah (shisha) is not a way to reduce the health risk of tobacco. An hour-long hookah session is equivalent to smoking 10 cigs, according to the Centers for Disease Control and Prevention (CDC).

B. When they're smoking, it's difficult not to.

Sure. There is a natural tendency to be like our friends or family and do what they do. To gracefully decline, prep ways to say no. Act confident, even if you don’t feel it. Maybe say something like this:

  • “No thanks, I’m getting in shape for a race.”
  • “Not for me; makes me queasy.”
  • “Can’t risk harming my Olympic triathlon time tomorrow.”
  • “My partner/coach will dump me if I do that.”

If you get socially anxious, check out Question 1.

C. Yah, Bae's not a fan of smoking either.

It always helps to hang out with people who look out for their own health—and yours, if you’re lucky.

It’s also worth checking in with your future self (who is not really some elderly, abstract stranger). Your future self wants to be fit, feel good, and relish and explore life—just like your current self. It’s almost like you’re the same person (spooky).

6. Ready to quit? How are you going to do this?

A. Throw out my pack, tweet “That's it, I'm over this,” and try not to think about it.

Trying to quit without a plan can leave you without a way to cope when you get cravings. You’re more likely to succeed with a structured approach, says Smokefree.gov, a governmental resource for all things tobacco-free. Steps in your tobacco liberation movement include choosing the date you’re ridding yourself of tobacco, telling friends and family about it, and giving your environment a makeover.

+ Get more resources at smokefree.gov
+ Want an app for that? Try quitSTART
+ Quit guide: American Cancer Society

B. Say goodbye to my fellow smokers, smoke breaks, and my social life

If you want quitting to be a permanent lifestyle change, your strategy has to be sustainable. Look for life changes that you can live with. Check out former smokers’ strategies. Make a list of things that are important to you and try to keep doing them after quitting.

+ Tips from former smokers: CDC

C. Talk to a doctor or counselor about what's been shown to work best.

Various approaches to quitting have been evaluated to see how well they work. Effective approaches include:

  • Nicotine replacement therapy (e.g., gum) or prescription medications (e.g., bupropion), according to the Cochrane Collaboration, which reviews medical studies. In studies, using one of these two substances helped 80 percent more people to quit compared to a placebo.
  • Find stressbusting alternatives to “just one” cigarette when you have a bad craving. One cigarette leads to more, according to the Mayo Clinic.
  • Sign up for a text-message, Twitter, or email program for regular quitting tips and support.

+ Daily “quitspiration”
+ Other methods: Do they work?

+ Free personalized quitting support is available in every US state. This typically includes phone and online counseling and free medications, e.g. nicotine patches. Find free support in your state.

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Chris Stuck-Girard is a Boston-based attorney and earned his MPH from Tufts University, Boston, this year. His work has appeared in various Boston Globe publications and Esquire.com.