Q: You talk about this a lot, but I just bombed out one more time on my stop-smoking attempt. I have tried patches, group support, daily mantras, exercising. But I always go back. Any new ideas? --Phil Y., Dunedin, Fla.

A: Your dedication is terrific and the key to success. Dont give up! Its important to realize that doctors and researchers see tobacco use as a chronic, relapsing substance-use disorder. Getting free takes time. Around 55% of Americans who smoke tried to quit in the previous year, but only 7.5% succeeded. Most people try to quit five to seven times before they do it for good. The new news is that there are some breakthroughs in understanding whats most effective.

Incentive: Its more important than ever to quit, since a new study in Thorax found people who smoke and test positive for COVID-19 are 200% more likely to end up in the hospital and 50% more likely to report over 10 COVID-19-related symptoms, including loss of smell, skipping meals, diarrhea, fatigue, confusion or muscle pain. More symptoms indicate a more severe case of COVID-19.

A plan: A recent study in JAMA says using varenicline is more effective than a nicotine patch or bupropion and using varenicline and a patch is even more powerful, although there is a slight increase in side effects.

Varenicline is a drug that reduces cravings for and the pleasurable effects of tobacco. You can take it before you quit to help you get there and after you quit to help you stay the course. The researchers recommend that varenicline be used for 12 weeks or longer. The problem: You cant drive or operate heavy machinery while taking it, so start while youre working from home!

The study also stresses that behavioral therapy should be part of a quit plan. Check out the Centers for Disease Control and Preventions 800-QUIT-NOW for info and coaching help. You can do it!

Q: Every time I have to interact with my health insurance, a doctors office or a hospital, I end up with the nagging feeling that Im not getting the best care I could be. Why does the U.S. health care system seem like such a mess?

Jess H., Lincoln, Neb.

A: It breaks our heart, but according to a well-done new study in JAMA Internal Medicine, the U.S. spends more than $3.5 trillion per year on healthcare, 25% more per capita than the next-highest-spending country. However ... compared with countries tracked by the Commonwealth Fund, the U.S. ranks behind every country on causes of preventable mortality that could have been addressed by health system interventions.

Where does that leave you? With a lot of work to make sure you stay healthy and a lot of work to make sure youre getting the best care you can. Fortunately, you can accomplish those things if you follow some pretty straightforward advice. In his upcoming book The Great Age Reboot, Dr. Mike predicts that scientific breakthroughs in aging research will help you live 30 years longer and younger. But you need to adopt a great lifestyle to benefit fully from these scientific breakthroughs. So here are four steps to help you regain control of your wellbeing day-to-day and when interacting with the health care system.

1. Follow the lifesaving nutritional advice in Dr. Mikes book What to Eat When and look at OzTube on doctoroz.com (search for exercise) for a complete rundown of activity choices.

2. Stay up to date with your regular checkups and vaccinations dont put it off.

3. Go to your doctor with written-out questions; take a family member or friend with you so they can ask questions too. Insist on being heard. Never hesitate to go for a second opinion.

4. If you go into the hospital, arrange to have the patient ombudsman talk to you so you know your rights, have an advocate and get answers to questions especially if family cannot be at your bedside.

Mehmet Oz, M.D. is host of The Dr. Oz Show, and Mike Roizen, M.D. is Chief Wellness Officer Emeritus at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily@sharecare.com.

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New help to quit smoking; how to get the health care you need - The Union Leader