Why Smokers Try, But Can’t Quit

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More than two-thirds of smokers say they want to quit, but few actually succeed, according to a new report from the Centers for Disease Control and Prevention (CDC).

The report found that among smokers who wanted to quit, half tried in 2010, but only about 6% were able to do it. Fewer than one third of smokers who tried to quit sought help through counseling or medication, even though such treatments can double or even triple the odds of success. Slightly less than half of smokers reported receiving advice from their doctors to quit, even though this also can increase quit attempts and the likelihood of success.

During a press teleconference on Thursday, Dr. Tim McAfee, director of the office on smoking and health at the CDC, noted that the study still offered “reassuring” news about smokers: most of them want to kick the habit. Rather than being a “hardened” group that has given up on quitting, the majority of people who still smoke — nearly 1 in 5 American adults — are motivated to overcome their addiction.

“The enthusiasm for smokers of becoming nonsmokers and their actual behavior is at least the same, and in some cases, higher than 10 years ago,” said McAfee.

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Historically, smokers who have quit have largely done it on their own, despite the fact that nicotine addiction is considered by addiction experts as the hardest to kick. It has not always been easy to determine how effective quit-smoking treatments are, because those who seek help are often a self-selected group of smokers who typically have had a harder time quitting without treatment.

“It’s not a random decision as to whether to use counseling or medication,” McAfee acknowledged, but noted that data from studies do show that quit treatments help. “There’s no question, from the basis of dozens if not hundreds of large, very well conducted, randomized controlled trials, with thousands of people, that use of medication — and use of counseling at least [for those who seek it] — significantly increases the likelihood of quitting.”

The medication that has been proven to be most effective in helping smokers quit is the subject of recent controversy. Varenicline (Chantix) has been shown to be superior to other medications like bupropion (Zyban) when compared directly, but studies have also found that Chantix is associated with more psychiatric side effects, including psychotic, suicidal or aggressive impulses and behavior, compared with other anti-smoking medications.

In October, the FDA reviewed data on psychiatric problems and varenicline, and concluded that the benefits of the drug outweighed the risks for smokers trying to quit. But another major study published in November suggested that the drug’s side effects make it too dangerous to use as a first option for smokers trying to quit.

“The short story is that this is an area that is somewhat controversial,” said McAfee. “The evidence for effectiveness is very strong, and there are somewhat conflicting results about the likelihood that these neuropsychiatric effects are actually due to varenicline or due to other factors.”

“My best advice is to talk to your doctor about this and have a solid conversation about the pros and cons,” he said.

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Other data from the new CDC study indicate that African American smokers are more likely than other ethnic groups to want to quit and to attempt to do so — but are less successful. The authors suggested that this could be attributable in part to the fact that African Americans are three times more likely than other groups to smoke menthol cigarettes, which are harder to quit.

The study also found that smokers who have a college degree are nearly three times more likely to kick the habit than those who have less than a high school education, suggesting that socioeconomic factors may also play a role in the racial differences found.

The study was based on a survey of about 27,000 Americans, interviewed between 2001 and 2010, and was published in the CDC’s Morbidity and Mortality Weekly Report in advance of the Great American Smokeout. The annual event, held by the American Cancer Society to support quitting, will take place on November 17.

The good news is that the more you’ve tried to quit smoking, the more likely you are to succeed eventually, according to the research. Click here for resources provided by the CDC for smokers who want to stop.

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Maia Szalavitz is a health writer at TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.