Denise Ellis, a law firm receptionist, knew she was addicted when, despite doctor’s orders, she lit up and puffed away before undergoing medical tests that required she not smoke.

There were also her must-have, wake-up smokes first thing in the morning. Still, Ellis says, she didn’t feel addicted and so she continued the habit.

Then her father died.

“I knew his dying had a lot to do with the effect of smoking on his heart,” Ellis says. “I wanted to quit. I didn’t want to die young like he did, so I went cold turkey.”

But Ellis’s smoke-free days didn’t last. Her resolve swiftly evaporated as smoking’s unpleasant withdrawal symptoms overwhelmed her.

“[After quitting,] I wasn’t comfortable in my own skin,” Ellis recalls. “I gained a lot of weight that I’d never had before. It was just such an uncomfortable feeling, so I started smoking again. This time, though, I probably smoked a pack and a half a day for about a month.”

Several years later, Ellis prepared to try again. This time, her pregnancy provided the motivation. She figured she’d quit after having her child.

But once again, withdrawal symptoms besieged her. “When I tried to quit, the irritability that goes with it was just ridiculous,” Ellis says. “I couldn’t adjust. That’s when I realized that I had a problem.”

By this time, however, smoking wasn’t Ellis’s only problem. She’d began having shortness of breath. Ellis says it probably didn’t help that she already suffered from allergies and breathed in smog-laden Kentucky air each day.

“My doctor had been telling me all along [to stop smoking],” Ellis says. “I didn’t smoke a lot, but he wanted me to quit.”

Just one of many health consequences of smoking, shortness of breath may be a prelude to emphysema and other chronic lung diseases, such as COPD (chronic obstructive pulmonary disease) and chronic bronchitis.

“It’s awful how many illnesses are caused by tobacco,” says Michael Burke, EdD, a certified tobacco treatment specialist. “In terms of the death toll, each day as many people die from tobacco [smoke] as if three 747s crashed.”

Burke says that the first evidence that tobacco caused health problems was when researchers made the connection between smoking and lung cancer.

“By the 1950s, it was the leading cause of cancer death among men,” Burke says. “And by 1987, it became the leading cause of cancer death among women.”

But although lung cancer is probably the most famous smoking-related disease, it is only one of several illnesses that smoking is proved to cause. Others include cardiovascular disease and stroke.

Smoking also raises the risk of developing a host of other health problems including erectile dysfunction (ED) in men, lupus, glaucoma and macular degeneration, which causes blindness. And according to one large study, chronic tobacco use harms the brain and accelerates mental decline that may lead to Alzheimer’s disease.

Not that any of this is top secret. “All of the diseases are summarized in the 2004 Surgeon General’s Report,” Burke points out.

The report reads like a list of deadly reasons why no one should ever begin smoking in the first place. But the reality is people still do.

“When I was younger, I smoked because I thought I was being cool,” Ellis says. “It took me a long time to realize that I had a problem.”

She’s not alone. Many people begin smoking for the same reason.

In fact, according to the American Heart Association (AHA), a national survey on drug use and health estimated that each day more than 4,000 people younger than 18 try their first cigarette.

Those figures translated into more than 730,000 new smokers every year.

Ellis doesn’t recall exactly what age she started smoking, but she guesses it was 13. “I remember that age [in particular] because that’s when my mother found out I smoked,” she explains. “I was burning my clothes trying to hide the cigarette from her.”

Most smokers take up the habit as teens, confirms the American Cancer Society (ACS). The reasons are tied to curiosity and peer pressure. But the ACS also points out the influence of advertising and the billions spent by the tobacco industry to glamorize smoking as safe and exciting.

Burke says that researchers using the Hooked On Nicotine Checklist can accurately predict which of the teens who try smoking will become addicted.

But what exactly gets people hooked?

Cigarettes supply the addictive drug nicotine to the brain very quickly, Burke explains. Nicotine gives smokers pleasurable feelings they come to desire then crave. Once the craving kicks in, people find themselves hooked and smoking daily.

That’s where Ellis found herself in 2006 when her doctor suggested she try Chantix, a medication to help her stop smoking.

“But I just wasn’t ready,” Ellis says. “Right then, I had a lot of other things going on in my life. When you want to quit, you really have to focus, and I just wasn’t there.”

The next year, however, found Ellis prepared. She had an “Aha!” moment that propelled her to commit to quitting.

“I was washing one weekend, and I just got totally out of breath,” Ellis recalls. “I collapsed at the top of the steps and lay there trying to catch my breath. Incredibly, I smoked another cigarette.”

After Ellis told her doctor she wanted to try Chantix, he put her on the pill for three months.

But along with the medication, Ellis also modified her behavior and changed her daily routine to support her quitting effort. “I immediately cleaned out my car, the rooms where I smoked and where I let company smoke,” Ellis says. “I knew that I had to change my habits and do things differently than when I smoked.”

Ellis also enlisted support from her coworkers. She told them she was quitting and needed their help and understanding. She also announced she would no longer go outside to take her breaks. Instead, she’d take a five-minute walk through the halls.

Anticipating the irritability she knew would accompany her goodbye to cigarettes, Ellis told coworkers not to take it personally if she snapped at them. “I told them if that happened, it would be unintended and I apologized in advance,” she says.

When she finished the regimen, Ellis was smoke-free.

Burke notes that doctors can use medications and counseling to treat tobacco dependence as effectively as they do diseases such as hypertension and diabetes.

People have many options, Burke adds. “Talking to a health care provider can really help. Many places have tobacco treatment specialists available to the local hospitals.”

He suggests finding a local tobacco treatment specialist in your area by calling 800-QUITNOW. He also recommends visiting online resources, such as becomeanex.org, which offers a great social support network as well as information to those trying to live smoke-free.

As Burke sums up: “The take-home message is that it’s a combination of medication and counseling that really works—in addition to getting all the information you need to get help and make it happen.”