There are people who ask why the public health community continues to focus on tobacco use and smoking when there are so many other health concerns in our country. There are a number of reasons; one being that smoking is the leading cause of preventable death in this country. We also know a lot about tobacco, how it works, how it causes death and disease and how we can stop it.

Every day, almost 1,200 Americans die from smoking related illnesses. In two years time, that number would be equivalent to losing the entire population of Buffalo, Rochester, Syracuse and Yonkers combined. Tobacco use has a direct causal relationship with the following cancers: lung and bronchial, laryngeal, esophageal, stomach, kidney, urinary bladder, cervical cancers and acute myelogenous leukemia, among others.

If you are a smoker and are thinking about quitting in the upcoming New Year, there are some things you might want to know before you attempt to quit. Nicotine has the same pharmacological effect on the brain as other addictive drugs. The effects of nicotine addiction on the brain create pleasure and this is something smokers crave. It also makes it very, very hard to quit smoking. Smoking does not reduce stress, no matter what you have been told or think. The feeling of relaxation or pleasure that smokers identify with the act of smoking is actually the intake of nicotine temporarily reducing withdrawal symptoms. Ask yourself how a cigarette, which is essentially paper, dried up tobacco leaves, nicotine and a lot of chemicals make things better? How does a cigarette take care of your problems? How does it make you a better person? It doesn't. You do all those things and the trick is to learn how to do them without a cigarette in your hand.

Here is what you need to do:

#&149; Understand quitting is a process, not a one-time event

#&149; Have a plan on how

you are going to quit, which includes:

- Setting a quit date

- Getting a support system: friends, family, doctor

- Investigating Nicotine Replacement Products (patch, gum. Lozenge, etc.) and use them

- Asking your doctor if prescription medications such as Chantix are for you

- Understanding what triggers your craving to smoke and come up with a plan to avoid these triggers

- Understanding that you have to decide what you are going to do with your time when you are not smoking, to prevent relapse

- Calling the New York State Smokers' Quitline at (866) NY-QUITS or visit www.nysmokefree.com for free advice and products

- Checking out support groups on the internet, there are some good ones like www.quitnet.com from Boston University or www.BecomeAnEX.org from the American Legacy foundation.

What are the benefits of quitting smoking other than saving a lot of money? Within eight hours, carbon monoxide levels in the blood drop and there is more oxygen in your blood and your lungs will start to clear of mucus, which makes breathing easier. Within two days, your sense of smell and taste are back. Many smokers are surprised that food taste so much better after they have quit. In three months time, your body is better able to fight off infections and colds. In less than a year, the wheezing, sinus congestion and shortness of breath that you have been experiencing has lessened. After one year, your risk of dying of a heart attack is cut in half. In five years, you have significantly cut your risk of having a stroke by quitting smoking. After 10 years of no smoking, your risk of lung cancer is cut in half and precancerous cells have been replaced.

When you quit smoking, you are also protecting the health of others around you. Secondhand smoke can and does harm other people and even the family pet. Secondhand smoke is a Group A carcinogen. There is no doubt that exposure to ssecondhand smoke will cause lung cancer and heart disease in non-smokers. Smoking around children who have asthma will aggravate symptoms and potentially increase emergency room visits. Exposure to secondhand smoke will increase the risk of asthma among children who never had it before.Even animals are affected by secondhand smoke. Dogs living with smokers are more likely to get lung or nasal cancer. Cats exposed to secondhand smoke are more apt to get oral cancer. Even birds are affected with eye problems and respiratory illnesses.

Smoking will effect every organ in your body. It impacts lung function, the respiratory system, can contribute to infertility, osteoporosis and impact diabetes. Diabetics are more likely to have kidney damage, loss of feeling in the extremities and eventual lose of fingers, toes, feet or legs. Once they quit smoking, the energy is back, the blood sugar levels go down, as does blood pressure and cholesterol.

So when Jan. 1 rolls around this week, have your plan to quit in place. Make 2009 the year you start to live a healthier life.

Elane Daly is director of Health and Human Services for Cayuga

County. She can be reached at 253-1560 or cchealth@dfa.state.ny.us