Cigarette smoke is the major cause of lung cancer and can lead to chronic lung disease. Tobacco smoke can also contribute to cancer of the bladder, pancreas and kidnye. JUNE CHEONG finds out about some the ways you can quit.

1. Cold Turkey or Gradual Reduction                                                                                               How it works: In going cold turkey, a quit date is set and smoking has to cease from that day.  In gradual  reduction, a quit date is set too, but the smoker progressively cuts down on the cigarettes until he no longer smokes.

Success rate: Ms Tan Cin Yee, a senior pharmacist at Tan Tock Seng Hospital (TTSH), said: "For cold turkey, the success rate obtained from clinical trials is about 10 per cent."

 She added: "The success rate may increase to 20 per cent if both methods are supplemented by nicotine replacement therapy or prescription medication to help smokers cope with cravings and withdrawal symptoms."

2. Nicotine Replacement Therapy                                                                                                    How it works: Nicotine products like patches, gums and inhalers release small amounts of nicotine into the body, thereby alleviating withdrawal symptoms. Since the amount is small and is absorbed slowly, the products are not addictive.

Success rate: Ms Tan said that the percentage of smokers who stay smoke-free at 12 months when using nicotine patches and nicotine gum are 13.7 per cent and 17.4 per cent respectively.

Dr Kenneth Chan, a consultant at the department of respiratory and critical care medicine at Singapore General Hospital, said: "Nicotine replacement therapy, together with counselling, approximately doubles the chance of success as compared to counselling alone."

3. Prescription Medication                                                                                                                     How it works" Prescription drugs reduce the smoker's cravings and withdrawal symptoms. For example, the  drug Champix interrupts the pleasure that smokers derive from smoking by working on the same receptors in
the brain that nicotine stimulates.

Dr Ong Kian Chung, a consultant respiratory physician at KC Ong Chest ft Medical Clinic at Mount Elizabeth Medical Centre, said: "It stimulates these receptors, producing the same pleasure sensation as nicotine. It also works by occupying these receptors and preventing nicotine from stimulating them.

"When smokers taking Champix take a puff, they do not derive as much satisfaction as before. Thus, they are less likely to want to continue smoking."

Success rate: Ms Tan said the success rates for smokers using bupropion and varenicline at 12 weeks are 30 per cent and 44 per cent respectively.  A Pfizer spokesman said Champix has quit rates of 50 per cent or higher in Asian clinical data.

4. Smoking Cessation Clinic                                                                                                               How it works: Mr Eddy Lim, a senior pharmacist at the National University Hospital, said the counsellor first finds out from the patients their smoking history and lifestyle.

He said: "We also find out what are some of the issues they face when quitting."

"We explore ways to manage withdrawal symptoms and share with them ways or products that can help them. Follow-up sessions focus on the patient's progress, the challenges they faced and how to modify management strategies."

There are a variety of such clinics, from school-based programmes to programmes run by voluntary welfare organisations like the Singapore Heart Foundation. There are also quit centres based in polyclinics, restructured hospital's outpatient services and community organisations.

Success rate: Dr Chan said that one-to-one support and advice leads to a chance of success of between 10 and 15 per cent while undergoing counselling and using medication together raises the success rate to between 20 and 30 per cent.

5. Auricular Therapy                                                                                                                           How it works: According 1 to Mr Louis Goh, the clinic manager of Antismoking Center Singapore, a low frequency electromagnetic pulse machine stimulates the smoker's brain into releasing neurochemicals like
endorphins and dopamine and other hormones. A five-treatment package, spread over six months, costs $980.

Mr Goh added that 75 per cent of his clients need only one treatment to completely stop smoking.

Success rate: Mr Goh claimed the success rate is more than 95 per cent However, doctors could not comment.

6. Bioresonance therapy
How it works: A machine which emits low level electromagnetic waves of specific frequencies - purported to affect neurotransmitters in the brain controlling craving and addiction - is used.

Mr Alvin Chong, centre manager of PHI Integrated Therapy Centre, said: "After each treatment, the smoker's level of craving or urge to smoke is reduced."

"If he is able to reduce his psychological dependence on cigarettes, he will be able to kick the habit."

Each treatment session costs $150 and lasts between 30 and 45 minutes. A smoker of less than five years usually requires up to six sessions while longer-term smokers require more sessions, depending on individual needs.

Success rate" Mr Chong said: "We have had about 50 customers. We have a screening programme for smokers before we initiate treatment as not all are suitable or ready for it. Most of our customers who fit the criteria quit smoking after the intensive programme."

Doctors could not comment on this.

7.  Hypnotherapy or  hypnosis
How it works: Patients are placed under hypnosis to help them quit smoking.

Dr Daniel Kwek, the head and senior consultant at the department of psychological medicine at Tan Tock Seng Hospital, said: "Some people respond to a single session of therapy. It deals with the habits and behaviours associated with smoking and there is no need for any medication."

"It may also deal with the underlying issues of emotional smokers or people who smoke when they are in a lousy mood."

Success rate: Ms Sandy Hui, director of ONE Hypnosis, said that the success rate is 95 per cent. However, Ms Tan of TTSH said: "From the latest clinical trials done overseas, only 20 to 40 per cent of smokers who undergo hypnosis stay smoke-free at 12 months."

8.Alien Carr's Easyway To Stop Smoking                                                                                                 How it works: The late Briton's method involves clinic sessions which focus on why smokers continue to smoke and help remove smoker's fears about quitting through psychotherapy and hypnotherapy.

Conducted by a trained therapist, the first session lasts six hours and participants are encouraged to take regular smoke breaks. The session climaxes with the group smoking a final cigarette before throwing their cigarettes and lighters away.

Ms Pam Oei, 37 an actress and an Alien Carr s Easyway therapist, said that 80 per cent of participants quit smoking after attending one session.

Three sessions with Ms Oei cost $599 and she offers a three-month money back guarantee.

Success rate: Ms Oei said she has helped 200 smokers quit since last year and the success rate is more than 90 per cent. Doctors did not comment on this.