You're much more likely to succeed with some pharmacological help — and there are plenty of options.

There's never been a worse time to be a smoker. Besides the social criticism smokers face, more is now known about the dangers of smoking than ever before. The 400,000 American lives claimed by smoking each year represent more than those lost to AIDS, alcohol, drug abuse, car crashes, murders, suicides and fires combined.

But there has never been a better time to quit.

Scientists now understand more about the addictive nature of nicotine — the powerful drug in cigarettes and cigars that reaches the brain within seconds of inhaling. (Smoking, which some scientists believe is harder to quit than heroin or cocaine addiction, is so addictive that even after a heart attack, only half of patients who smoke manage to quit.)

Today there are better products to help the 47 million smoking Americans attempt to quit. Bupropion (Zyban) and varenicline (Chantix) join an ever-growing field of nicotine replacement products such as gums, patches, nasal sprays and inhalers.

Although there's no guarantee of success, statistics indicate that many of these products — typically used for 12 weeks — can triple your chances of success compared to trying to quit cold turkey, from about 5% cold turkey to 15% with these products. Your chances of success improve even more, to between 20% and 40%, if you also join a "stop smoking" program that offers individual or group therapy in conjunction with use of these products. As good as our current regimens are in helping people quit the habit, only about 30% to 50% of people who stop, will still not be smoking months later. Some studies suggest that the high failure rate may be related to genetic factors.

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The prescription drug bupropion (Zyban) has been commercially available as an antidepressant for several years (under a different trade name, Wellbutrin). Bupropion, in tablet form, was the first smoking cessation product that worked without delivering nicotine to satisfy the body's desire for it. However, studies show that its effectiveness may be even stronger when it is used along with nicotine replacements.

Advantages: It's easy to use and is nicotine-free, so you can avoid increased heart rate and other symptoms associated with nicotine intake. Scientists are not exactly sure why it works, but bupropion is effective for many smokers — both those who do and don't have a tendency toward depressed moods. One theory is that the drug affects certain chemicals in the brain that are related to nicotine addiction and may mimic actions similar to those of nicotine by releasing dopamine and other brain chemicals. Bupropion also seems to reduce the urge to smoke and decreases the amount of weight gain during quitting.

Disadvantages: The main side effect is a potential to cause seizures, so anyone with a head injury or epilepsy shouldn't take the drug. Also, people with anorexia or bulimia shouldn't take bupropion because, for reasons that are not known, they are more likely to experience seizures when taking the drug. Minor side effects that may occur include dry mouth, difficulty sleeping and skin rash.

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Varenicline is the first new anti-smoking drug to be approved by the U.S. Food and Drug Administration in the past 10 years. It acts directly on nicotine receptors in the brain. The drug tricks brain cells to think that some nicotine is present, so it decreases the desire to smoke. Varenicline also helps dampen nicotine withdrawal symptoms.

Advantages: It is easy to take and side effects tend to be mild. You start the drug one week before your quit date. Take 0.5 milligram once per day for the first day, then 0.5 milligram two times per day for a few more days. Increase the dose to 1 milligram twice per day. You stay on that dose for 12 weeks. After 3 months, you and your doctor can decide if can stop the varenicline or continue taking it for another 12 weeks (assuming you have quit smoking).

Disadvantages: Side effects include nausea, headache and problems sleeping. Some people still have significant withdrawal symptoms. Nicotine replacement should not be combined with varenicline because of increased side effects. Also varenicline can interact with other drugs.

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These products cut the craving to smoke and withdrawal symptoms by delivering a steady stream of nicotine through the skin and into the blood, where it is delivered to the brain. Habitrol, Nicoderm CQ, Nicotrol, ProStep and a generic patch are available without a prescription. All patches work the same way, by delivering nicotine and suppressing withdrawal symptoms.

Advantages: Nicotine patches have few significant side effects and seem to offer the best results. Patches are also easy to use; you simply apply once daily to a relatively hairless part of the body, such as the upper arm.

Disadvantages: Minor skin rashes are common where the patch is placed, and nicotine is delivered slowly to the brain. Many people have episodes of strong urges to smoke even while wearing the patch. There is some evidence that combining the patch with nicotine gum or nasal spray may be helpful for people who still have these strong urges to smoke.

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Nicotine is absorbed through the lining of the mouth; the amount delivered to the brain is determined by how many lozenges or pieces of gum are used throughout the day. Available without a prescription, gums such as Nicorette, lozenges such as Commit and many generics show good results. Alone, they are not as effective as patches, but the success rate is equal when used in conjunction with a "stop smoking" program.

Advantages: The gums and lozenges are easy to obtain and available in multiple dosages.

Disadvantages: The gums and lozenges are bad-tasting to some. You need to learn the proper technique to use these. You have to chew the gum slowly to release nicotine, then hold the gum in the mouth to give the drug time to be absorbed. If you chew too quickly and swallow your saliva, the nicotine isn't absorbed. Also, you can't eat or drink anything while using the gum, and people with dental problems may find it difficult to use.

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Available by prescription, nicotine nasal sprays are used the same way you'd use a decongestant spray for allergies — a quick spurt up the nostrils. Products such as Nicotrol NS produce blood nicotine levels most similar to those produced by smoking, because you get a quick jolt of nicotine, as opposed to the steady level provided by the patch.

Advantages: Nicotine spray may be the best choice for heavy smokers because it will more closely mimic the nicotine delivery they are used to. These products appear to be as effective as nicotine gums and patches.

Disadvantages: The spray is not as convenient as the patch or gum, because you may be in situations in which it would be impossible or inappropriate to use the spray.

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Nicotrol inhalers are nicotine cartridges that are inserted into a plastic tube shaped like a cigarette. The smoker puffs the nicotine through the tube, where it is absorbed through the lining of the mouth.

Advantages: These prescription products are about as effective as nicotine patches or gum and may appeal to people who miss the physical hand-to-mouth action of smoking.

Disadvantages: Inhalers need to be used frequently. They are more obvious and require many puffs per use, especially in the first few weeks after quitting tobacco. Inhalers can cause irritation of the mouth and throat. Similar to the nasal spray, the nicotine inhalers require a prescription.

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Whatever you and your health care provider choose, expect most withdrawal symptoms to subside after the first week or so and to be completely gone within about a month, with the most dramatic decline in the first week or two. The only symptom that persists longer than a month is the craving. And that's where nicotine replacement products and varenicline can be useful for longer periods of time — to quell the cravings.

For very heavy smokers, doctors will sometimes recommend a combination of nicotine replacement products — for example, using a patch for a steady flow of nicotine, along with a nasal spray to deliver periodic "hits." The goal is to eventually wean off both. However, never combine nicotine replacement products on your own without first consulting your health care provider. Getting too much nicotine from replacement products can cause side effects. The amount of nicotine you are getting can add up if you use a combination of these products.

Most people eventually wean themselves off the replacement products.

But some ex-smokers need to continue nicotine replacements for many months, as long as necessary to stay off cigarettes. Other than some cardiovascular-stimulating effects, nicotine itself has few side effects. And considering the cardiovascular and carcinogenic properties of tobacco, the nicotine replacements are definitely preferred.

Quitting the smoking habit is not easy. But the effort is worth it. Once you have quit smoking: