According to the American Lung Association, smoking-related diseases claim an estimated 430,700 American lives each year. Smoking is directly responsible for 87 percent of lung cancer cases and causes most cases of emphysema and chronic bronchitis.

With the annual Great American Smokeout scheduled for Thursday, Nov. 21, this is a good time to answers some important questions on smoking, and offer tips on quitting.

Q: Why is tobacco harmful?

A: Tobacco use is the No. 1 preventable disease-causing agent in the United States. The top three fatal diseases in the United States, as well as in Maine, are heart disease, cancer and stroke. Tobacco is a direct causative agent in all three of these diseases. Tobacco use also causes chemical dependency.

Q: What is in cigarettes?

A: Cigarettes contain 599 chemicals – some make the cigarettes more potent and addictive; others are responsible for keeping the flavor stable in every pack.

Q: What about chewing tobacco, cigars and pipes? Are they as dangerous as cigarettes?

A: If inhaled, pipes and cigars still cause many of the same health problems as cigarettes. If not inhaled, there is still the risk of mouth and lip cancer. With chewing tobacco the nicotine enters the bloodstream quickly through the mucosal lining in the mouth. This lining is an excellent route for entry. Chewing tobacco can cause mouth and lip cancer.

Q: What about secondhand smoke? Is it dangerous?

A: Yes. Secondhand smoke contains more cancer-causing chemicals than direct smoke because the chemicals are not filtered through the end of a cigarette. The Environmental Protection Agency estimates that secondhand smoke causes approximately 3,000 lung cancer deaths and 35,000 heart disease deaths in nonsmokers each year. Secondhand smoke is especially harmful to young children and asthmatics.

Q: Why do people seem to enjoy smoking so much?

A: People don’t actually enjoy smoking. They enjoy satisfying their addiction to nicotine. Nicotine dependency, like many other chemical dependencies, is tied to cravings generated by the hypothalamus, which is a part of the brain. The hypothalamus acts as an off and on switch for many addictive chemicals. When the chemical levels drop, the hypothalamus sends a craving signal. Pleasure is derived from satisfying it.

Q: Why is it so difficult to quit smoking?

A: Quitting is difficult because of the chemical dependency. The addiction is actually stronger than that caused by many illegal drugs, and tobacco is a lot easier to obtain.

Q: What about smoking during pregnancy?

A: Smoking during pregnancy causes small birth-weight babies. It’s never a good idea to smoke while pregnant.

Q: Are the health benefits of quitting as dramatic as I’ve heard?

A: Yes. Just 24 hours after quitting your chance of heart attack begins to decrease. One year after quitting, the risk of coronary heart disease is half that of a smoker’s. In five to 15 years after quitting, stroke risk is reduced to that of a nonsmoker. After 10 years, the lung cancer death rate is about half that of a smoker’s; and the risk of cancer of the mouth, throat, esophagus, bladder, kidneys and pancreas decreases. At 15 years, the risk of coronary heart disease is the same as a nonsmoker’s.

Q: I tried to quit before and failed. Should I keep trying?

A: Absolutely. The average smoker has tried to quit 10 times before kicking the habit for good. Don’t give up. Each time you quit, you’re learning new techniques on handling the urge to smoke. It may seem impossible to quit, but it isn’t.

Q: How do I quit after smoking for so long?

A: Many of us involved in smoking cessation programs have found that a combination of four types of intervention is best: 1) pharmacological, including devices such as patches and gum, as well as Zyban, an anti-anxiety drug that quiets the craving; 2) behavior modification, a key component in many smoking cessation programs; 3) relaxation techniques; and 4) hypnosis. Nicotine addiction is very powerful and the average success rate of a cessation program is 10 percent. So, it’s important to include as many elements in the cessation program as possible to help ensure success.

Q: Aren’t those nicotine replacement products just as bad as smoking cigarettes?

A: They are not as harmful as smoking. The products contain nicotine, but not all the other harmful chemicals, such as formaldehyde. Plus, you wouldn’t stay on replacement products for a long time period.

Q: What are the short- and long-term benefits of quitting?

A: Short-term benefits include lower blood pressure, lower carbon monoxide levels, improved circulation, increased lung function and improved sense of smell and taste. Long-term benefits include reduced risk of stroke; heart attack; and cancers of the lungs, mouth, throat, esophagus, bladder, kidneys and pancreas.

Q: What is the Maine Tobacco HelpLine and has it made a difference?

A: The Maine Tobacco HelpLine is a statewide telephone-based service that links those in need directly to professional counselors who can provide assistance in quitting, including smoking cessation classes.

In the Maine Tobacco HelpLine’s first year of operation, 33 percent of those who called for assistance to quit were not smoking six months after counseling.

Q: Does St. Joseph Hospital offer a program for those who want to quit?

A: Yes. We offer the community a free five-week program – one session per week – that includes nicotine replacement therapy, behavior modification and relaxation. Those who wish may use hypnosis; however there would be a small charge for this component. Those interested in a smoking cessation program at St. Joseph Hospital may call me directly at 262-1161. Our program is also included on the State’s Smoker’s HelpLine at (800) 207-1230.

Ken Huhn is director of Specialty and Outreach Services at St. Joseph Hospital, as well as the hospital’s chairman on tobacco-related issues.