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Roberta Homiski, 59
Retired bank teller in Norwich, Connecticut
Age at first puff: 22
Past quit attempts: the patch, gum

Roberta says: "I go through about a pack or more of Capri Menthol 120s a day. You'd think I'd know better. My father passed away from a smoking-related cancer, and my favorite uncle died of lung cancer. My father-in-law has emphysema and COPD (chronic obstructive pulmonary disease)—he lives next door. And I have COPD myself—I know smoking is one of the causes. But my mother is in the final stages of Alzheimer's, and it's so depressing that it just makes me want to smoke. Recently, I was nervous about the results of some medical tests, so what did I do? I went out and spent $5.22 on a pack."

Dr. Schroeder's suggestion: A higher dose (21 to 22 milligrams over 24 hours) patch than she used before, in combination with NRT lozenges, gum, nasal spray or inhaler. "Since she's had some personal stressors that are causing her to turn to cigarettes for comfort, cognitive behavioral therapy is another avenue she may want to explore. It could help her retrain the thought process that makes her smoke," he says. The fact that she already has lung disease means she can't fool around.