Ashlyn Blocker, the Girl Who Feels No Pain


Jeff Riedel for The New York Times


Ashlyn Blocker, who feels no pain, at home in Patterson, GA.







The girl who feels no pain was in the kitchen, stirring ramen noodles, when the spoon slipped from her hand and dropped into the pot of boiling water. It was a school night; the TV was on in the living room, and her mother was folding clothes on the couch. Without thinking, Ashlyn Blocker reached her right hand in to retrieve the spoon, then took her hand out of the water and stood looking at it under the oven light. She walked a few steps to the sink and ran cold water over all her faded white scars, then called to her mother, “I just put my fingers in!” Her mother, Tara Blocker, dropped the clothes and rushed to her daughter’s side. “Oh, my lord!” she said — after 13 years, that same old fear — and then she got some ice and gently pressed it against her daughter’s hand, relieved that the burn wasn’t worse.









Tara Blocker

When Ashlyn was 2, her mother had to wrap her hands to keep her from biting them.






“I showed her how to get another utensil and fish the spoon out,” Tara said with a weary laugh when she recounted the story to me two months later. “Another thing,” she said, “she’s starting to use flat irons for her hair, and those things get superhot.”


Tara was sitting on the couch in a T-shirt printed with the words “Camp Painless But Hopeful.” Ashlyn was curled on the living-room carpet crocheting a purse from one of the skeins of yarn she keeps piled in her room. Her 10-year-old sister, Tristen, was in the leather recliner, asleep on top of their father, John Blocker, who stretched out there after work and was slowly falling asleep, too. The house smelled of the homemade macaroni and cheese they were going to have for dinner. A South Georgia rainstorm drummed the gutters, and lightning illuminated the batting cage and the pool in the backyard.


Without lifting her eyes from the crochet hooks in her hands, Ashlyn spoke up to add one detail to her mother’s story. “I was just thinking, What did I just do?” she said.


Over six days with the Blockers, I watched Ashlyn behave like any 13-year-old girl, brushing her hair, dancing around and jumping on her bed. I also saw her run without regard for her body through the house as her parents pleaded with her to stop. And she played an intense game of air hockey with her sister, slamming the puck on the table as hard and fast as she could. When she made an egg sandwich on the skillet, she pressed her hands onto the bread as Tara had taught her, to make sure it was cool before she put it into her mouth. She can feel warmth and coolness, but not the more extreme temperatures that would cause anyone else to recoil in pain.


Tara and John weren’t completely comfortable leaving Ashlyn alone in the kitchen, but it was something they felt they had to do, a concession to her growing independence. They made a point of telling stories about how responsible she is, but every one came with a companion anecdote that was painful to hear. There was the time she burned the flesh off the palms of her hands when she was 2. John was using a pressure-washer in the driveway and left its motor running; in the moments that they took their eyes off her, Ashlyn walked over and put her hands on the muffler. When she lifted them up the skin was seared away. There was the one about the fire ants that swarmed her in the backyard, biting her over a hundred times while she looked at them and yelled: “Bugs! Bugs!” There was the time she broke her ankle and ran around on it for two days before her parents realized something was wrong. They told these stories as casually as they talked about Tristen’s softball games or their son Dereck’s golf skills, but it was clear they were still struggling after all these years with how to keep Ashlyn safe.


A couple of nights after telling me the story about putting her hand in the boiling water, Ashlyn sat in the kitchen, playing with the headband that held back her long brown hair. We had all been drawing on napkins and playing checkers and listening to Ashlyn and Tristen sing “Call Me Maybe,” when all of a sudden Tara gasped and lifted the hair away from her daughter’s ears. She was bleeding beneath it. The headband had been cutting into her skin entire time we were sitting there.



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Israel Steps Up Aerial Strikes in Gaza


Tyler Hicks/The New York Times


A man injured by bombing in the Zaitoun neighborhood of Gaza City on Saturday that also killed one person. More Photos »







GAZA CITY — Israel broadened its assault on the Gaza Strip on Saturday from mostly military targets to centers of government infrastructure, obliterating the four-story headquarters of the Hamas prime minister with a barrage of five bombs.




The attack came a day after the prime minister, Ismail Haniyeh, hosted his Egyptian counterpart in that very building, a sign of Hamas’s new legitimacy in a radically redrawn Arab world. That stature was underscored Saturday by a visit to Gaza from the Tunisian foreign minister and the rapid convergence in Cairo of two Hamas allies, the prime minister of Turkey and the crown prince of Qatar, for talks with the Egyptian president and the chairman of Hamas on a possible cease-fire.


But the violent conflict showed no sign of abating as it finished its fourth day. Gaza militants again fired long-range missiles at the population center of Tel Aviv, among nearly 60 that soared into Israel on Saturday, injuring five civilians in an apartment building in Ashdod, in southern Israel, and four soldiers in an unidentified location.


Israel said it hit more than 200 targets overnight and continued with afternoon strikes on a Hamas commander’s home in the Gaza City neighborhood of Zeitoun and on a motorcycle-riding militant in the southern border town of Rafah. Israel has also made preparations for a possible ground invasion.


Hamas health officials said 45 Palestinians had been killed and 385 wounded since Wednesday’s escalation in the cross-border battle; 3 Israelis have died and 63 civilians have been injured.


“Everybody is afraid of what’s next,” said Mkhaimar Abusada, a political science professor at Al Azhar University in Cairo, predicting that the rockets fired at Tel Aviv and, on Friday, at Jerusalem, would provoke a rerun of Israel’s ground invasion four years ago.


Mr. Abusada and Efraim Halevy, a former head of Israel’s intelligence service, both said there is no clear endgame to the conflict, since Israel neither wants to re-engage in Gaza nor to eliminate Hamas and leave the territory to the chaos of more militant factions. “Ultimately,” Mr. Halevy said, “both sides want Hamas to remain in control, strange as it sounds.”


But Mr. Abusada cautioned that “there is no military solution to the Gaza problem,” saying: “There has to be a political settlement at the end of this. Without that, this conflict is just going to go on and on.”


In Cairo, a senior official of Egypt’s Muslim Brotherhood, the Islamist group allied with President Mohamed Morsi, said he was working furiously on Saturday to secure a cease-fire. Mr. Morsi met with the Turkish premiere, Recep Tayyip Erdogan, while Egypt’s foreign minister huddled with the Qatari prince and its intelligence chief sat with Khaled Meshaal, the chief of Hamas’s political wing, Egyptian media reported.


Hamas, which has controlled the Gaza Strip since 2007 but is considered a terrorist organization by Israel and the United States, wants to turn its Rafah crossing with Egypt into an open, free-trade zone, and for Israel to withdraw from the 1,000-foot buffer it patrols on Gaza’s northern and eastern borders. The Brotherhood official said that the Israeli side of the talks remained “the sticking point,” though he would not be specific about the issues.


Ben Rhodes, Mr. Obama’s deputy national security adviser, told reporters aboard Air Force One en route to Asia that the president had spoken daily with Prime Minister Benjamin Netanyahu of Israel since the crisis began, as well as to Mr. Erdogan and Mr. Morsi.


“They have the ability to play a constructive role in engaging Hamas and encouraging a process of de-escalation,” Mr. Rhodes said of the Turkish and Egyptian leaders. Describing rocket fire coming from Gaza as “the precipitating factor for the conflict,” he added, “We believe Israel has a right to defend itself and they’ll make their own decisions about the tactics that they use in that regard.”


But the Tunisian foreign minister, standing outside Al Shifa Hospital here, told reporters that Israel “has to respect the international law to stop the aggression against the Palestinian people.”


Mr. Netanyahu, for his part, spoke Saturday with the leaders of Germany, Italy, Greece and the Czech Republic, according to a statement from his office.


Jodi Rudoren reported from Gaza City and Isabel Kershner from Jerusalem. Reporting was contributed by Fares Akram and Tyler Hicks from the Gaza Strip, Carol Sutherland and Iritz Pazner Garshowitz from Jerusalem, and David D. Kirkpatrick and Mayy El Sheikh from Cairo.



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Nintendo seeks to shake up gaming again with Wii U
















LOS ANGELES (AP) — It can scan zombies, replace a TV remote, open a window into virtual worlds and shoot ninja stars across a living room. It’s the Wii U GamePad, the 10-by-5-inch touchscreen controller for the successor to the Wii out Sunday, and if you ask the brains behind the “Super Mario Bros.” about it, they say it’s going to change the way video games are made and played.


“You can’t manufacture buzz,” said Nintendo of America president Reggie Fils-Aime. “You can’t manufacture word of mouth. All we can do is to provide the product and the games to foster some sparks that hopefully enable that to happen. We think we have that with Wii U.”













Much like the iPad, the curvaceous GamePad features a touchscreen that can be manipulated with the simple tap or swipe of a finger, but it’s surrounded by the kinds of buttons, bumpers, thumbsticks and triggers that are traditionally found on a modern-day game controller. There’s also a camera, stylus, microphone, headphone jack and speakers.


While the Wii U can employ its predecessor’s motion-control remotes with a sensor bar that similarly detects them in front of the TV, the console’s focus on two-screen experiences makes it feel more like a high-definition, living-room rendition of the Nintendo DS and 3DS, the Japanese gaming giant’s dual-screen hand-held devices, than the original Wii.


“It’s a second screen like a tablet or a cellphone, but it’s different,” said Mark Bolas, professor of interactive media at the University of Southern California. “In addition to providing more information, the GamePad is also a second viewpoint into a virtual world. Nintendo is letting you turn away from the TV screen to see what’s happening with the GamePad.”


The touchscreen controller can also serve as a makeshift TV remote control and online video aggregator for services like Netflix and Amazon Instant Video. (Nintendo cheekily calls it TVii and announced Friday that it won’t be available until December.) Some games have the ability to flip-flop between the TV screen and the GamePad screen, allowing for non-gaming use of the TV.


There are limitations to the GamePad: it won’t work after it’s been moved 25 feet away from the Wii U console; it lasts about three to five hours after charging; and while its touchscreen is intuitive as those that have come before it, the GamePad is not quite as simple to use as the Wii controllers that had everyone bowling in their living rooms.


“Is the GamePad more complex than the Wii Remote was six years ago? Certainly,” said Fils-Aime. “On the other hand, I believe consumers will easily grasp the GamePad and what we’re trying to do with the varied experiences we’ll have not only at launch but over the next number of years in this system’s life.”


The abilities of the GamePad are most notably showcased by Nintendo Co. in the amusement park-themed mini-game collection “Nintendo Land,” which comes with the deluxe edition of the console. “Nintendo Land” turns the GamePad into several different tools, such as the dashboard of a spaceship or the ultimate advantage in a game of hide-and-seek.


In other titles, the controller mostly eliminates the need to pause the action to study a map in order to figure out where to go next or scour an inventory for just the right weapon. That can all be achieved simultaneously on the GamePad screen, which is best illustrated among the launch titles in Ubisoft’s survival action game “ZombiU.”


The GamePad acts as a high-tech scanner in “ZombiU” that can analyze a player’s surroundings in a version of London overrun by zombies. It pumps up the terror by drawing players’ attention away from the horrors lurking around them.


Will gamers who’ve grown up with their eyes glued to the TV and hands gripped on a controller adapt to glimpsing at another screen? The Wii U edition of “Call of Duty: Black Ops II,” for example, invites players to customize their arsenal on the fly on the GamePad, as well as engage in multiplayer matches without needing to split the TV in half.


Nintendo expects 50 games will be available for the Wii U by March 2013. There will be 23 games released alongside the console when it debuts Sunday, including the platformer “New Super Mario Bros. U,” karaoke game “Sing Party,” an “armored edition” of “Batman: Arkham City” and the Mickey Mouse adventure “Disney Epic Mickey 2: The Power of Two.”


“New consoles come along and nobody exploits their full capabilities for the first two to three years,” said Warren Spector, creative director at “Epic Mickey 2″ developer Junction Point Studios. “It’s only after you’ve had two or three projects that you fully understand what the hardware is capable of doing. We’re going to be experimenting with it more.”


Fils-Aime said he’s already envisioning ways that developers will innovate with future games. He pointed to some of the console’s features that aren’t on display in the launch line-up, such as the ability to play with two GamePads at once or utilize the console’s near-field communication technology to interact with other gadgets in the room.


“I think that developers and consumers are ready for new experiences,” said Fils-Aime. “More than anything else, I think that’s what is driving excitement for Wii U. They’ve experienced what this generation has to offer. They’re ready for something new.”


___


Online:


http://www.nintendo.com/wiiu


___


Follow AP Entertainment Writer Derrik J. Lang on Twitter at http://www.twitter.com/derrikjlang.


Gaming News Headlines – Yahoo! News



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Lacy scores 3 TDs, No. 4 Bama rolls over WCU 49-0

TUSCALOOSA, Ala. (AP) — AJ McCarron, Eddie Lacy and Alabama settled this one in the opening minutes instead of waiting for a tense finale.

Lacy rushed for three first-half touchdowns and McCarron set the fourth-ranked Crimson Tide's single-season record for passing TDs in a decidedly drama-free 49-0 victory over Western Carolina on Saturday.

Alabama (10-1) rebounded from a loss to No. 9 Texas A&M by building a 42-0 halftime lead against the Catamounts (1-10), a Football Championship Subdivision team with two wins in as many seasons. It was the Tide's third shutout this year.

"I was pleased with the way our guys competed in the game," Alabama coach Nick Saban said. "We went out there and tried to play to a standard and executed fairly well. Western Carolina, those guys played hard and they were a little bit outmanned, and our guys played the way we want them to play.

"Everything is ahead of us as a team."

Alabama still left Bryant-Denny Stadium needing a couple of upsets to make a return trip to the national title game.

McCarron completed all six of his attempts for 133 yards and his 21st touchdown before exiting midway through the second quarter. Lacy ran for 99 yards on 10 carries with two 7-yard touchdowns and a 3-yarder. Neither played after halftime.

"It's not about them, it's about what you do, so we had to go out there and take care of business and not worry about everybody else," McCarron said.

Cornerback Deion Belue returned a fumble 57 yards in the final seconds before halftime.

The 42 points were the most Alabama had scored in the first half since producing the same amount against Georgia State on Nov. 18, 2010.

Still hoping for a shot at a second straight national title, the Tide can secure a spot in the Southeastern Conference championship game against No. 5 Georgia with a victory over rival Auburn.

This one was a welcome respite for Alabama after games against No. 8 LSU and the Aggies went down to the final minute. It followed three straight against opponents ranked in the top 15 at the time of the game, including Mississippi State.

"You're coming off a loss; it's easy to get distracted," Belue said. "We handled that real well, just coming in and staying focused on what we need to do."

Alabama outgained the Catamounts 463-163 in total yards and outrushed them 300-70. The Catamounts have lost all 14 meetings against SEC teams and haven't beaten a Division I (FCS or FBS) opponent since topping The Citadel on Oct. 2, 2010.

"There's a reason this place is where it's at, at the top," Western Carolina first-year coach Mark Speir said. "Excellent football team that we could not stop, obviously. Defensively, they pretty much had their way. They knocked us off the ball."

Alabama reached 10 wins for the fifth season in a row, the longest such streak since the 1971-75 teams.

McCarron, who threw his first two interceptions of the season last week, broke the single-season mark set by Greg McElroy in 2010. He hit Christion Jones on a 29-yard touchdown with 8:15 left in the second quarter to cap a 99-yard drive and then became a spectator.

The junior also moved past McElroy into third place on the Tide career list with 40 touchdown passes, behind Brodie Croyle (41) and John Parker Wilson (47).

T.J. Yeldon ran for 55 yards and a touchdown on seven carries before leaving with a sprained foot. Saban said he could have returned.

Backup quarterback Blake Sims was only 2 of 6 for 27 yards in his most significant action but also rushed for 70 yards, including a 5-yard touchdown.

Wide receiver Kevin Norwood was held out of the game for an unspecified injury and backup tailback Kenyan Drake was suspended for violating team rules.

Even Alabama's mistakes turned into Tide points. Western Carolina fumbled it right back after Jones lost the ball on a punt return, and Belue scooped it up for another score with 14 seconds left before halftime.

Alabama also drew a roughing penalty on the punt, prompting Saban to make a furious leap into the air on the sideline even with the huge lead.

Western Carolina backup quarterback Eddie Sullivan set up the Catamounts' best scoring chance before Alabama made a fourth-down stop from the 14 late in the third quarter.

"We should have gone for the field goal and got some points," Speir said. "That's stupid. That's my fault."

Sullivan rushed for 28 yards and was 4 of 12 for 63 yards after replacing freshman Troy Mitchell.

The Tide didn't punt until the fourth quarter. Plus, a bunch of reserves got into the game.

"We were trying to get as many guys in the game as we possibly could," Saban said.

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Well: Meatless Main Dishes for a Holiday Table

Most vegetarian diners are happy to fill their plates with delicious sides and salads, but if you want to make them feel special, consider one of these main course vegetarian dishes from Martha Rose Shulman. All of them are inspired by Greek cooking, which has a rich tradition of vegetarian meals.

I know that Greek food is not exactly what comes to mind when you hear the word “Thanksgiving,” yet why not consider this cuisine if you’re searching for a meatless main dish that will please a crowd? It’s certainly a better idea, in my mind, than Tofurky and all of the other overprocessed attempts at making a vegan turkey. If you want to serve something that will be somewhat reminiscent of a turkey, make the stuffed acorn squashes in this week’s selection, and once they’re out of the oven, stick some feathers in the “rump,” as I did for the first vegetarian Thanksgiving I ever cooked: I stuffed and baked a huge crookneck squash, then decorated it with turkey feathers. The filling wasn’t nearly as good as the one you’ll get this week, but the creation was fun.

Here are five new vegetarian recipes for your Thanksgiving table — or any time.

Giant Beans With Spinach, Tomatoes and Feta: This delicious, dill-infused dish is inspired by a northern Greek recipe from Diane Kochilas’s wonderful new cookbook, “The Country Cooking of Greece.”


Northern Greek Mushroom and Onion Pie: Meaty portobello mushrooms make this a very substantial dish.


Roasted Eggplant and Chickpeas With Cinnamon-Tinged Tomato Sauce and Feta: This fragrant and comforting dish can easily be modified for vegans.


Coiled Greek Winter Squash Pie: The extra time this beautiful vegetable pie takes to assemble is worth it for a holiday dinner.


Baked Acorn Squash Stuffed With Wild Rice and Kale Risotto: Serve one squash to each person at your Thanksgiving meal: They’ll be like miniature vegetarian (or vegan) turkeys.


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Privatizing Greece, Slowly but Not Surely


Eirini Vourloumis for The International Herald Tribune


Potential privatization hit a wall at Katakolo, a seaside town where Christos Konstantopoulos paused near abandoned beachfront homes. More Photos »







THE government inspectors set out from Athens for what they thought was a pristine patch of coastline on the Ionian Sea. Their mission was to determine how much money that sun-kissed shore, owned by the Greek government, might sell for under a sweeping privatization program demanded by the nation’s restive creditors.




What the inspectors found was 7,000 homes — none of which were supposed to be there. They had been thrown up without ever having been recorded in a land registry.


“If the government wanted to privatize here, they would have to bulldoze everything,” says Makis Paraskevopoulos, the local mayor. “And that’s never going to happen.”


Athens agreed. It scratched the town, Katakolo, off a list of potential properties to sell. But as Greece redoubles its efforts to raise billions to cut its debt and stoke its economy, the situation in Katakolo illustrates the daunting hurdles ahead.


In the three years since the International Monetary Fund, the European Central Bank and the European Commission — the so-called troika of lenders — first required Greece to sell state assets, a mere 1.6 billion euros have been raised. Last Tuesday, European leaders said Greece needed an additional 15 billion euros in aid through 2014 to meet debt-reduction targets — partly because Athens has failed to make money on privatization.


Now, the troika may consider cutting an already lowered target for Greece to raise 19 billion euros by 2015 to about 10 billion euros as investors worry that Greece may have to leave the euro. The troika is requiring that Greece must still raise 50 billion through privatizations by 2022.


The I.M.F. estimates that those funds, should they materialize, will trim only up to 1 percent from Greece’s debt, which is expected to rise to a staggering 189 percent of the nation’s economic output in 2013, from 175 percent this year.


But with Greece’s economy headed into its sixth year of recession, and unemployment at 25 percent, the nation’s immediate goal is to lure any investment it can through long-term leases on state properties to create jobs and get money flowing into depleted public coffers.


“This could put the economy back in motion,” says Andreas Taprantzis, the executive director of the Hellenic Republic Asset Development Fund, a new agency set up to hasten privatization. If investors develop land, restructure highways or build business parks, the activity would “help employment, which is a major issue for Greece,” he says.


Indeed, privatization is one of the last hopes here for luring foreign cash.


Efforts stumbled anew last summer, when the government fell and two chaotic elections were held, amplifying fears of what is known in financial circles as a “Grexit” — a Greek exit from the euro. Investor confidence fell so low that a recent survey by the BDO consulting firm found that Greece was considered more risky for investment than Syria.


Yet as Prime Minister Antonis Samaras took steps last week to secure an additional 31.5 billion euros of bailout money from creditors, the thinking is that if one major asset can be sold now, investors will feel better about spending their money on Greece.


OFFICIALS are trotting out Greece’s most tempting offer: OPAP, the highly profitable gambling company in which the government has a major stake. Its gambling agencies abound around Athens and in Greek villages. Last week, as the government went on a road show to China to drum up investor interest, eight bids landed, including one from a Chinese concern.


Still, Mr. Taprantzis’s agency faces a daunting task. The idea of the country selling off its crown jewels touches a raw nerve here. Many Greeks say the government is buckling to decrees from the troika. Citizen protests have flared over nearly every state asset up for offer, including ones that have long bled cash — even if shedding them would help Greece’s finances.


Others say the government is so desperate that prime assets will be sold too cheaply. In the case of OPAP, Greeks grumble about the government’s logic in selling one of the few things that brings a steady stream of money to the treasury.


Given the culture of clientelism that pervades business dealings in Greece, others are concerned that properties will wind up in the hands of powerful Greek oligarchs who, these critics worry, may be waiting for an opportunity to get them at a cut-rate price.


Dimitris Bounias contributed reporting.



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AP source: Melky Cabrera, Blue Jays reach deal

NEW YORK (AP) — The busy Toronto Blue Jays struck again Friday with their latest big deal: All-Star game MVP Melky Cabrera is set to join them in his return from a drug suspension.

A person familiar with the negotiations said the free agent outfielder and the Blue Jays have reached agreement on a two-year contract worth $16 million. The deal is pending a physical, the person told The Associated Press on condition of anonymity because there was no official announcement.

ESPN Deportes first reported the agreement Friday.

Earlier this week, the Blue Jays got All-Star shortstop Jose Reyes and pitchers Josh Johnson and Mark Buehrle from the Miami Marlins in a blockbuster trade that could involve a dozen players.

Toronto has not reached the playoffs since winning its second straight World Series in 1993, and has often been stuck behind big spenders in the AL East. After going 73-89 this year, the Blue Jays have made quite a splash in the offseason.

The 28-year-old Cabrera was leading the National League in hitting at .346 for the San Francisco Giants when he drew a 50-game suspension Aug. 15 for a positive testosterone test.

Cabrera later asked to be removed from consideration for the NL batting title, feeling it would be a tainted crown — a rule change in the number of required plate appearances for the champion let Giants teammate and eventual NL MVP Buster Posey win at .336.

The Giants didn't put Cabrera on their postseason roster on the way to winning the World Series, even after he became eligible at the start of the NL championship series.

Cabrera hit 11 home runs with 60 RBIs in his lone year with San Francisco. He hit .305 with 18 homers and 87 RBIs the previous season with Kansas City, then was traded to the Giants.

Cabrera made his major league debut in 2005 with the New York Yankees and stayed with them until being traded to Atlanta after the 2009 season.

The Blue Jays had their share of sluggers — Edwin Encarnacion hit 42 homers and two-time home run champ Jose Bautista hit 27 — but didn't score at an exceptional rate.

Toronto averaged 4.42 runs per game last season, slightly below the AL average.

Cabrera is friendly with Encarnacion and Bautista, another reason he felt comfortable joining the Blue Jays.

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Personal Health: Quitting Smoking for Good

Few smokers would claim that it’s easy to quit. The addiction to nicotine is strong and repeatedly reinforced by circumstances that prompt smokers to light up.

Yet the millions who have successfully quit are proof that a smoke-free life is achievable, even by those who have been regular, even heavy, smokers for decades.

Today, 19 percent of American adults smoke, down from more than 42 percent half a century ago, when Luther Terry, the United States surgeon general, formed a committee to produce the first official report on the health effects of smoking. Ever-increasing restrictions on where people can smoke have helped to swell the ranks of former smokers.

Now, however, as we approach the American Cancer Society’s 37th Great American Smokeout on Thursday, the decline in adult smoking has stalled despite the economic downturn and the soaring price of cigarettes.

Currently, 45 million Americans are regular smokers who, if they remain smokers, can on average expect to live 10 fewer years. Half will die of a tobacco-related disease, and many others will suffer for years with smoking-caused illness. Smoking adds $96 billion to the annual cost of medical care in this country, Dr. Nancy A. Rigotti wrote in The Journal of the American Medical Association last month. Even as some adult smokers quit, their ranks are being swelled by the 800,000 teenagers who become regular smokers each year and by young adults who, through advertising and giveaways, are now the prime targets of the tobacco industry.

People ages 18 to 25 now have the nation’s highest smoking rate: about 34 percent counted in the National Survey on Drug Use and Health in 2010 reported smoking cigarettes in the previous month. I had to hold my breath the other day as dozens of 20-somethings streamed out of art gallery openings and lighted up. Do they not know how easy it is to get hooked on nicotine and how challenging it can be to escape this addiction?

Challenging, yes, but by no means impossible. On the Web you can download a “Guide to Quitting Smoking,” with detailed descriptions of all the tools and tips to help you become an ex-smoker once and for all.

Or consult the new book by Dr. Richard Brunswick, a retired family physician in Northampton, Mass., who says he’s helped hundreds of people escape the clutches of nicotine and smoking. (The printable parts of the book’s provocative title are “Can’t Quit? You Can Stop Smoking.”)

“There is no magic pill or formula for beating back nicotine addiction,” Dr. Brunswick said. “However, with a better understanding of why you smoke and the different tools you can use to control the urge to light up, you can stop being a slave to your cigarettes.”

Addiction and Withdrawal

Nicotine beats a direct path to the brain, where it provides both relaxation and a small energy boost. But few smokers realize that the stress and lethargy they are trying to relieve are a result of nicotine withdrawal, not some underlying distress. Break the addiction, and the ill feelings are likely to dissipate.

Physical withdrawal from nicotine is short-lived. Four days without it and the worst is over, with remaining symptoms gone within a month, Dr. Brunswick said. But emotional and circumstantial tugs to smoke can last much longer.

Depending on when and why you smoke, cues can include needing a break from work, having to focus on a challenging task, drinking coffee or alcohol, being with other people who smoke or in places you associate with smoking, finishing a meal or sexual activity, and feeling depressed or upset.

To break such links, you must first identify them and then replace them with other activities, like taking a walk, chewing sugar-free gum or taking deep breaths. These can help you control cravings until the urge passes.

If you’ve failed at quitting before, try to identify what went wrong and do things differently this time, Dr. Brunswick suggests. Most smokers need several attempts before they can become permanent ex-smokers.

Perhaps most important is to be sure you are serious about quitting; if not, wait until you are. Motivation is half the battle. Also, should you slip and have a cigarette after days or weeks of not smoking, don’t assume you’ve failed and give up. Just go right back to not smoking.

Aids for Quitting

Many if not most smokers need two kinds of assistance to become lasting ex-smokers: psychological support and medicinal aids. Only about 4 percent to 7 percent of people are able to quit smoking on any given attempt without help, the cancer society says.

All 50 states and the District of Columbia have free telephone-based support programs that connect would-be quitters to trained counselors. Together, you can plan a stop-smoking method that suits your smoking pattern and helps you avoid common pitfalls.

Online support groups and Nicotine Anonymous can help as well. To find a group, ask a local hospital or call the cancer society at (800) 227-2345. Consider telling relatives and friends about your intention to quit, and plan to spend time in smoke-free settings.

More than a dozen treatments can help you break the physical addiction to tobacco. Most popular is nicotine replacement therapy, sold both with and without a prescription. The Food and Drug Administration has approved five types: nicotine patches of varying strengths, gums, sprays, inhalers and lozenges that can curb withdrawal symptoms and help you gradually reduce your dependence on nicotine.

Two prescription drugs are also effective: an extended-release form of the antidepressant bupropion (Zyban or Wellbutrin), which reduces nicotine cravings, and varenicline (Chantix), which blocks nicotine receptors in the brain, reducing both the pleasurable effects of smoking and the symptoms of nicotine withdrawal. Combining a nicotine replacement with one of these drugs is often more effective than either approach alone.

Other suggested techniques, like hypnosis and acupuncture, have helped some people quit but lack strong proof of their effectiveness. Tobacco lozenges and pouches and nicotine lollipops and lip balms lack evidence as quitting aids, and no clinical trials have been published showing that electronic cigarettes can help people quit.

The cancer society suggests picking a “quit day”; ridding your home, car and workplace of smoking paraphernalia; choosing a stop-smoking plan, and stocking up on whatever aids you may need.

On the chosen day, keep active; drink lots of water and juices; use a nicotine replacement; change your routine if possible; and avoid alcohol, situations you associate with smoking and people who are smoking.


This post has been revised to reflect the following correction:

Correction: November 16, 2012

An earlier version of this column stated imprecisely the rate of smoking among young adults. According to the National Survey on Drug Use and Health, in 2010 about 34 percent of people ages 18 to 25 smoked cigarettes in the month before the survey -- not daily. (About 16 percent of them reported smoking daily, according to the survey.)

This post has been revised to reflect the following correction:

Correction: November 14, 2012

An earlier version of this column misstated the rate of smoking among young adults. According to the National Survey on Drug Use and Health, in 2010 about 34 percent of people ages 18 to 25 smoked cigarettes, not 40 percent. (That is the share of young adults who use tobacco products of any kind, according to the survey.)

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Industrial Production Declines





WASHINGTON — Hurricane Sandy depressed industrial output in the United States in October, while production of machinery and equipment in particular declined sharply, reflecting a more cautious outlook among businesses, the Federal Reserve said Friday.




Industrial production fell 0.4 percent last month, after a 0.2 percent gain in September, the Fed said. Excluding the hurricane’s impact, output at the nation’s factories, mines and utilities would have risen about 0.6 percent.


Factory output, the most important component, fell 0.9 percent and would have been unchanged without the storm, the Fed said. Utility output dipped 0.1 percent, while mining, which includes oil and gas production, rose 1.5 percent.


Manufacturing has weakened since spring, in part because companies have scaled back purchases of long-lasting goods that signal investment plans. That trend appeared to continue in October: machinery production fell 1.9 percent, while production of electrical equipment, appliances and components declined 1.4 percent.


Many businesses are worried about tax increases and federal spending cuts that will take effect in January unless Congress reaches a budget deal before then. Most economists predict the economy will suffer a recession in the first half of 2013 if lawmakers and President Obama can’t come to an agreement..


Hurricane Sandy also hurt the economy, although most economists expect the storm’s impact to fade in the coming weeks. The storm hit the Northeast on Oct. 29 and disrupted businesses from North Carolina to Maine.


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