Last gasp;Mind and body
Huddled in her car at mid-morning break, teacher Jo Parrett snatches a reviving drag on a cigarette. Her school, Summerbee Junior in Bournemouth, Dorset, is a strictly no-smoking zone - which is why Jo and her 30-a-day habit are out in the cold.
Now, spurred on by next Wednesday's National No Smoking Day, she's decided to break free of an addiction that kills 120,000 people in the United Kingdom every year.
"Sometimes I feel like a leper," says Jo, a 33-year-old PE and games co-ordinator. "I've been smoking since I was 17, and wish I'd never started. My four-year-old daughter came home from school one day and said: 'You are going to die if you smoke,' and my husband has worked out that what I spend on cigarettes would almost cover our mortgage. I've tried to cut down but I've never tried to stop - the thought has always been too scary."
To date, nicotine replacement products are the only clinically proven method of improving the chances of wishful quitters like Jo. But she had high hopes of Allen Carr's Easyway To Stop Smoking, a method that numbers such famous names as Sir Anthony Hopkins and Richard Branson among its success stories.
Allen Carr's Easyway How it works: Carr's cheerleading tone concentrates on removing psychological dependency on cigarettes and stresses the plus factors of giving up. So Jo joined a group session headed by Anne Emery, a former chain-smoker who runs an Allen Carr centre in Christchurch, Dorset.
"Instead of dwelling on the bad things, she focused on the so-called benefits, bringing home that these are an illusion. We talked about our fear of stopping, and she reassured us that the body takes only 48 hours to rid itself of nicotine.
"Finally we had 35 minutes of hypnotherapy. My body felt heavy, but the man next to me started snoring. It was distracting, and my mind was not 100 per cent receptive.
"We made an affirmation - 'I have given up and I am a non-smoker' - and I threw my packet of 20 into a huge pile in the corner."
Did it work? "By 9.30am the next day I hadn't had a cigarette. Normally I would have had about four by then. I did feel I would have quite enjoyed one, but I wasn't a nervous wreck."
One week later, and Jo is drinking gallons of tea to plug the gap but has not wavered. "It still feels like something is missing," she says. "But it's not stressing me out. Everyone is gobsmacked."
Success rate: claimed to be 90 per cent.
Cost: pound;80 plus VAT for a four-and-half-hour session. A full refund is offered if you attend at least two free back-up sessions within three months and relapse within that time.
Acupuncture How it works: this ancient form of Eastern healing uses ultra-fine needles inserted into the skin to stimulate the body's healing powers and energy flow.
Treatment on the outer shell of the ear gives the best results for addictions such as smoking, according to acupuncturist Laurence McCaffery. He uses two needles, at points that correspond to the lungs and heart, and connects them to a battery-powered stimulator for 20 minutes. This boosts production of endorphins, the feel-good substances that relieve stress and help to suppress cravings.
Rob Coombs, a senior teacher at Winton Primary School in Bournemouth, tried it. He has more motivation than most - a brood of five children, aged 10 to 18 months, who nag him and his wife Jill to give up. Hooked since his teens, he gets through up to 20 a day. "The children would love it if we stopped," says Rob, 39. "I've tried about four times but it's hard when you live with another smoker."
Rob was "very impressed". He says: "The acupuncturist went through my history of smoking, then put a needle in each ear, plus an extra one that is supposed to help me avoid putting on weight. It didn't hurt, and is actually quite relaxing, because you are lying down.
"The only painful part was when he put a stud in each ear after removing the needles. I have to squeeze them if I get the urge to smoke. Four hours later I hadn't touched a cigarette and felt confident that it might actually work."
And so far it has. Rob says: "I haven't had any real craving or even been tempted. Once or twice, when I felt I could have done with one, I squeezed the studs in my ears and that seemed to deal with it."
Success rate: said to be around 70 per cent.
Cost: pound;45 for three 40-minute weekly sessions.
Hypnotherapy How it works: harnesses the power of the subconscious to reinforce positive messages about quitting.
Dorset hypnotherapist Andy Tomlinson helps smokers understand why they reach for a cigarette. He also demolishes common myths: far from relieving stress, for instance, smoking actually stimulates an adrenalin rush.
He says:"We focus on the potential gains of quitting and ways of handling withdrawal. Then I summarise what we have discussed while they are in a light trance. It is simply a relaxed state of mind that allows them to go deep into themselves while remaining conscious and in control. The aim is to ally the conscious and unconscious."
Success rate: claims of just under 70 per cent.
Cost: Between pound;30 and pound;40 for a two-hour session, including a follow-up tape. Expect to pay more in central London.
Nicotine replacement therapy How it works: slow release of nicotine in patches, gum, or nasal spray helps to ease withdrawal symptoms.
Education writer Louise Isaacs smoked her first cigarette at 17 and was soon on 40 a day. Now 32, she has tried to quit around 10 times. She tried nicotine patches.
"I had always ended up climbing the walls by day three," admits Louise. "But the patches helped me give up for a month. They took the edge off the craziness, and I was able to function at work without going for people's throats. The psychological side-effects were harder to cope with, and got worse. I thought about smoking night and a day.
"I finally relapsed, but I didn't use the patches for long enough - it's supposed to be for up to three months. I've managed to cut down from 10 to five a day though, so it has worked to some degree. I can now go fag-free for several hours."
NRT is a medicine, so if you are pregnant or suffer from heart disease, see a GP.
Success rate: clinical trials show NRT can double the chances of quitting, particularly for smokers on 10 to 20 a day.
Cost: around pound;15 for a week's supply of patches or gum, pound;20 a week for spray (prescription only).
Willpower How it works: something triggers the decision to stop.
Sheer determination is the key to this DIY approach, says Giles Pocklington of the charity Quitline, whose helpline receives half a million calls a year.
"There is no quick and easy way, but more than 11 million people in Britain have become successful ex-smokers, and most of those have done so by themselves," he adds.
Quitline's tips for a fight-the-fag programme:
* Make a date and stick to it * Throw out cigarettes and all associated paraphernalia * Organise mutual support - find other people who want to quit and agree to keep in touch daily * Snack on fruit and sugar-free sweets or gum to fend off cravings * Drink lots of fluids * Keep busy * Avoid situations where you used to smoke * Treat yourself with the cash you save * Think positive - symptoms such as irritability and a headache show your body is recovering from an addictive drug * Phone Quitline.
Success rate: a Health Education Authority survey found six out of 10 people who used willpower to stop were still cigarette-free 12 months later.
Cost: free, but psych yourself up for a dose of cold turkey.
* Quitline's free helplines offer help and support from trained counsellors. 0800 00 22 00 (England); 0800 84 84 84 (Scotland); 01232 663281 (Northern Ireland); 0345 697 500 (Wales)l Allen Carr's Easyway To Stop Smoking has eight regional clinics, tel: 0181 944 7761l The British Acupuncture Council, 0181 964 0222, the UK Council for Psychotherapy, 0171 436 3002 and the National Council for Hypnotherapy, 01590 683770 all have details of registered practitionersl Your GP should have details of local support groups