Counselors took advantage of a 'teachable moment' after the Sept. 11, 2001 attacks to successfully urge New York City firefighters to quit smoking, the New York Times reported May 2.

The stress related to the death of colleagues and the subsequent cleanup at the World Trade Center caused smoking to increase among firefighters -- even those who previously had quit. "Tobacco calms your nerves, increases awareness, allows you to stay up," said David J. Prezant, chief medical officer for the NYFD. "These are all things that people want in the middle of a disaster. It's not their fault that they start smoking more."

But a smoking-cessation program launched in the wake of the attack was successful in getting one-third of enrollees to quit and remain abstinent after 12 months -- a better result than found in most such programs.

The free, voluntary program confirmed self-reported results with drug tests and testimony from family members. Light smokers -- those who smoked fewer than 5 cigarettes daily -- were treated with a nicotine inhaler. Heavier smokers were given nicotine patches and inhalers. Those who smoked more than two packs a day were given these plus a nicotine nasal spray. All met periodically with counselors, as well.

Prezant credited the multiple medications for the success of the program. He added that while the crisis and aftermath of Sept. 11 was a unique prompt for many firefighters to quit, similar opportunities exist for other smokers. "Healthcare professionals have to find the moment. They have to keep asking," he said. "Maybe a relative just died of cancer. Maybe a child was just admitted to a hospital after an asthma attack. Maybe events like this present the opportunity to quit. It's this constant quest for the moment that we need to understand."

An analysis of the program appears in the April 2006 issue of the journal Chest.