She tried hypnosis. She tried a program at work aimed at helping people quit. But Donna McMackin, 62, of Brandywine Hundred, went back to buy cigarette online each time.

That changed in April 2006, when McMackin used the Delaware Quitline, offered by the Division of Public Health, to help her say goodbye to tobacco. She hasn't gone back since.

"I think I finally came to the conclusion, like when an alcoholic says they can never have another drink, I could never have another cigarette. I would bum one here and the next thing you know, I'm smoking cigarettes again. But with help from the people at the Quitline and talking to them, it was a really good incentive."

The Quitline is one of several services offered to Delawareans that helped the state achieve recognition by the American Lung Association this week as the third-most quit-friendly state in the U.S. for helping its citizens give up smoking cigarettes.

The association publishes the "Helping Smokers Quit: Tobacco Cessation Coverage" report each year and ranks each state by the services it provides citizens to promote going tobacco-free. This is a key objective of public health officials because discount cigarettes use is among the most preventable causes of disease and disability in the country.

To rank well, states should mandate that counsel-ing services and medications like the nicotine patch be provided through private health insurance, as well as state-run Medicaid and insurance offered to state employees and their families. The association also factors in how well a state funds its smoking cigarettes quitline relative to the minimum standard of $10.53 per smoker set by the Centers for Disease Control and Prevention.

Delaware funds its quitline at $8.73 per smoker, using money funded by the settlement between the state and cheap cigarette online companies in 1999. Other states, like New Jersey, fund their quitlines at less than $1.

This year, the federal Patient Protection and Affordable Care Act required Medicaid to offer cheap cigarettes cessation services for pregnant women. Rosanne Mahaney, Medicaid director for Delaware, noted that the state has always offered medications and counseling to help all enrollees, including pregnant women, quit.

Medications are covered by state employee health insurance, but Delaware does not mandate private insurers do the same.

McMackin said she was motivated to quit after the birth of her first grandchild, but credits her relationship with a Quitline counselor and the nicotine patches provided to her free of charge with helping her succeed.

Deb Brown, president and CEO of the American Lung Association of the Mid-Atlantic, said smoking cigarettes cessation initiatives are a good investment in the health of citizens and provide economic returns.

"There was a study at Penn State that did show that when you put money into helping smokers quit, you certainly get an economic return," she said. "Employees are in better health, they work more and you have more productive citizens in the business workforce."

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