It’s been 43 years since Arthur P. Mullaney asked people in Randolph, Mass., to give up cigarettes for a day and donate the money they would have spent on cigarettes to a high school scholarship fund.

On Nov. 18, 1976, the California Division of the American Cancer Society got nearly one million smokers to quit for the day, marking essentially, the first Great American Smokeout. The Cancer Society took the program nationwide the following year, and since then dramatic changes have occurred in the way society views tobacco use and even its advertising. Many public places and work areas are now smoke-free, protecting non-smokers and smokers who want to quit.

And though it has been 30 years since San Francisco passed the first strong workplace smoking restrictions, including bans on smoking in restaurants and private workplaces, tobacco use is still a great health concern as we mark another year of the Great American Smokeout.

In spite of the fact that, throughout the late 1980s and 1990s, many state and local governments initiated smoking bans, raised taxes on cigarettes, limited cigarette promotions and discouraged teen tobacco use, nearly one in five of us still smoke. Smoking is still responsible for nearly one in three cancer deaths, and one in five deaths from all causes. More than 8.5 million people live with serious illnesses caused by smoking.

The good news, according to a report released earlier this year by the National Center for Health Statistics, 18 percent of American adults were cigarette smokers in 2012, down from 18.9 percent the previous year. Cigarette smoking among young people has also been declining slowly - but steadily - over the last decade, with the latest estimates for high school students at just under 16 percent.

According to the U.S. Surgeon General, “smoking cessation (stopping smoking) represents the single most important step that smokers can take to enhance the length and quality of their lives.”

The downside is that is it also among the most difficult lifestyle changes one can make, especially if you’re trying to do it alone. Less than 7 percent of people are able to quit smoking on any given attempt without medicines or other help. But, as I mentioned, the numbers are coming down and you can be one of them.

Getting your mind around it is half the battle. Many smokers are afraid to make the attempt because of the fear of failure. Understand that there will be failures. Most smokers try numerous times before they actually quit. Each time becomes progressively easier and your motivation greater. To that end, the American Cancer Society recommends:

• Make the decision to quit • Pick a Quit Day - like the Great American Smokeout on Nov. 21. • Plan to deal with withdrawal • Stay tobacco-free (maintenance techniques)

Talk with your doctor about whether you want to try nicotine replacement, or prescription medication that may be used in conjunction with nicotine replacement. I, and most health care professionals, do not recommend using electronic cigarettes for this purpose.

Research shows that smokers are most successful in kicking the habit when they have support, such as:

• Telephone smoking-cessation hotlines 1-800-Quit-Now (1-800-784-8669) • Stop-smoking groups • Online quit groups • Counseling • Nicotine replacement products • Prescription medicine to lessen cravings • Guide books • Encouragement and support from friends and family members

Using a combination of these measures to help you quit smoking works better than using any one of them alone.

If you want to quit smoking, or know someone who does, we hope you’ll remind them of the annual event on the third Thursday of November (Nov. 21 this year) and get behind the best change you can make in your life and the lives of those you love.

Lera Foster is a respiratory therapist and the Regional Director of Pulmonary Services and Sleep Centers at St. Mary’s Medical Center. She can be reached at 816-655-5365 or 816-655-5394.