There's a critical women's health problem that we're all ignoring—and it cuts right to the heart of our psychology: Since 1950, the female death rate from lung cancer has soared 600 percent, making it the leading cancer killer of women. Cigarettes are responsible for 87 percent of lung cancer cases. In the United States, heart disease kills more women than any other condition—and smokers are up to six times more likely to have a heart attack.

The information is out, it's in our faces: Smoking is a really great way to commit suicide. So why, with all our intelligence and strength, don't we quit?

There's no doubt that nicotine is powerfully addictive, hooking some smokers in just a few weeks. With each puff nicotine floats on tiny tar droplets to the lungs, where it's absorbed into the blood. In less than 20 seconds it is tampering with your brain, triggering the release of dopamine, a neurotransmitter associated with pleasure. But the effect doesn't last long. As nicotine levels drop, so do your spirits. Impulsively, you reach for the next cigarette to restore the nicotine level in the blood.

Yet physical addiction appears to be the least of women's troubles. Three days after you quit smoking, nicotine has fled the premises, says Norman H. Edelman, MD, scientific affairs consultant to the American Lung Association. For men, this is often enough to kick the habit. But for women, what lingers is an emotional vacancy, a hole in one's identity. Ask them why they smoke and they will describe their Merits, Newports or Marlboros as best friends—the ones that help them through the day when no one else will, ease the awkwardness of sitting in a café alone, and keep them thin. It's as if cigarettes, with the flick of a match, turn into magic wands that foil four formidable enemies: stress, depression, self-consciousness and weight gain.

Cigarettes' charms, all rolled into one, have a way of growing exaggerated in our minds as we begin to associate each puff, wherever we are, with an inhale of support. "Every time you're stressed, you think, 'I better have a cigarette,'" explains John Farquhar, MD, co-author of The Last Puff (Norton) and director of the Stanford Wellness Center in Palo Alto, California. "Pretty soon you get conditioned to having a smoke with coffee, with alcohol, when you turn the keys in your car, when the phone rings. And eventually, each time that you're exposed to these stimuli, you want a smoke."

Quitting, in many cases, requires an act of bravery, a leap of faith. And it calls for a hard look in the mirror. Is five pounds worth risking your life? Is it worth jeopardizing the health of those around you? If you can't get past your vanity, think about combing your hair after chemotherapy; envision wrinkles creeping over your face where the skin is still smooth. Does the company of cigarettes seem too hard to give up? Think about your children, mourning and missing a mother who died prematurely from lung cancer or heart disease.


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