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"I'm not surprised that people report satisfaction when the objective facts suggest they shouldn't be satisfied," Healton said. "Anyone who is addicted to nicotine is at least ambivalent about the concept of giving it up. It's a very uncomfortable concept since smoking is highly reinforcing and satisfying to the brain."

The survey also found that 54 percent of smokers who talked to their health-care providers about tobacco use reported negative feelings, including guilt, uneasiness, embarrassment, annoyance and pressure.

Healton, who was once a smoker herself, said that pregnant women and people with such problems as depression and alcoholism might be especially hesitant to talk about their smoking.

But doctors need to treat smokers with respect, said Dr. Norman H. Edelman, chief medical officer of the American Lung Association. "Everybody who smokes was addicted as a teen or preteen," he said. "They don't deserve to be treated with scorn or as if they've inflicted this disease on themselves."

People might need to make even six or seven attempts to quit before they actually stop smoking, Edelman said. But cold turkey isn't the answer.

"The critical thing is, you can't simply stop smoking," he said. "You have to explain to them how it's done, how you need a support system and a pharmaceutical if you want the best chance of results."

As for the findings of the survey, Edelman said they highlight the fact that "physicians are not taking smoking cessation as seriously as they should."

More information

Learn how to quit smoking at smokefree.gov

SOURCES: Cheryl G. Healton, Dr.P.H., president and CEO, American Legacy Foundation, Washington D.C.; Norman H. Edelman, M.D., chief medical officer, American Lung Association, Chicago; April 1, 2008, survey,
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