Antidepressant medicines, nicotine replacement products, and counseling can all help a smoker stick with that New Year's resolution to kick the habit. But a study by American Cancer Society researchers finds that few smokers make use of the help that is available.

In a paper published in the American Journal of Preventive Medicine (Vol. 28, No. 1: 119-122), the researchers examined data from a national survey of US adults taken in 2000. Nearly 4,000 smokers in the survey said they had tried to quit for at least 1 day in the previous year. But overall, only 22% of them had used one of these types of quitting aids.

That figure shows that use of quitting aids hasn't kept pace with innovation in the field, said lead author Vilma Cokkinides, PhD.

In 1986, the last time usage was measured, 15% of smokers reported using some type of quitting aid. But in the intervening time, the availability and variety of effective aids has increased.

For instance, the antidepressant Zyban (bupropion) was approved in 1997, and the nicotine nasal spray was approved in 1996. Nicotine gums and patches became available over-the-counter in 1996. And health insurance coverage for tobacco cessation is on the rise.

Cokkinides and her colleagues found that the type of insurance coverage a smoker had influenced whether they used any type of quitting aid.

About 25% of people with private or military health insurance got some type of help in quitting. Only about 18% of people on Medicare and 16% of those on Medicaid used a quitting aid. People with no health insurance were least likely to use something to help them quit; just 13% said they had.

Among smokers who did use a quitting aid, most chose some type of medication (nicotine replacement or antidepressants). Only about 1%-2% of those with private or military insurance used counseling, as did barely 1% of those with Medicare, Medicaid, or no insurance.

Better insurance coverage of cessation tools could inspire more people to use them, Cokkinides said. One step in the right direction: Medicare plans to begin paying for quit-smoking counseling for some beneficiaries later this year, and prescription quitting medicines will be covered under the Medicare prescription drug plan that begins in 2006.

Doctors should also be sure they're encouraging patients to kick the habit, Cokkinides said. In her study, people who were advised to quit by a doctor were more likely to use a quitting aid.

Although the study didn't measure success, previous research has shown that using medication or counseling can double a smoker's chances of quitting for good.