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If you see fewer smokers clustered outside office buildings on Thursday, it might be because it’s once again time for the Great American Smokeout.

When the Smokeout started 30 years ago as a way for people to stop using tobacco – even for a single day – a lot more people lit up regularly, about one in three adults. By last year, the figure dropped to fewer than one in five. And Colorado now ranks ninth in the nation for lowest prevalence of adult smoking, with 17.9 percent of the population using tobacco. Officials attribute the decline to the 2004 tobacco tax increase that funds tobacco-education programs and to the 2006 state ban on indoor smoking.

Smokers have even less company as more businesses put bans into place.

Last week, Exempla St. Joseph Hospital announced that employees, patients and visitors would be prohibited from smoking on any of its properties – including parking lots – starting in January. The company says it will help employees quit by offering gum, patches and other tools.

Despite declining nicotine use, about 4,000 Coloradans die each year from smoking-related cancers, according to statistics from the state Department of Public Health and Environment.

The risks that smoking poses to a person’s health are widely known – particularly its contribution to heart disease, cancer, stroke and lung disease – but it’s a highly addictive substance, says Diana Maier, administrator of New West Physicians’ Quality Performance and Excellence Program. New West has 13 clinics in the Denver area.

Maier says people want to quit, they just don’t know how.

With grant funding from the Colorado Clinical Guidelines Collaborative through State Tobacco Education and Prevention, New West developed a smoking cessation program whereby patients are asked on each visit about their tobacco use, their willingness to quit and their exposure to secondhand smoke.

Those who want to quit are given referrals to the Colorado Quitline, which offers coaching, and such medications as free nicotine patches.

Would-be quitters also are invited to classes to learn about resources and medication they can use to help them kick the habit. Maier says those who are able to quit usually employ a combination of methods.

On successive visits to the office, or during follow-up calls, patients are asked to give New West feedback on how their efforts are going.

“Most patients will try to quit three to seven times,” Maier says. “Tobacco is extremely addicting. But today there are many more resources people can use and that their primary-care doctor can provide. The message should be more empowerment than failure if you aren’t able to quit on the first try. It’s a learning process.”

Try these tips

Among the things New West Physicians recommends to those trying to quit: