If you’re a smoker, chances are you’d prefer not to be.

"Most smokers want to quit and wish they’d never started," said Michael Eriksen, director of the Institute of Public Health at Georgia State University.

An ex-smoker himself, Eriksen was director of the Centers for Disease Control and Prevention’s Office on Smoking and Health from 1992 through 2000.

"It’s a very powerful addiction; there’s no question about it," he said. "But we could get smoking rates down to the single digits if we really put in an effort."

On Thursday, the American Cancer Society is asking smokers to make a personal effort. Nov. 20 is the Great American Smokeout, when smokers are encouraged to give up cigarettes for at least one day, and hopefully for the rest of their lives.

Last week, the CDC reported that an estimated 19.8 percent of U.S. adults were current smokers in 2007, down from 20.8 percent in 2006.

The most recent data from the Georgia Department of Human Resources indicates that about 19 percent of Georgia adults are smokers. But some health advocates have noticed worrisome trends.

"We’re seeing a decline in adult smoking, but it’s going up among kids. We don’t know why," said Rena Pendley, spokeswoman for the American Cancer Society chapter in Gainesville.

One reason may be that the money Georgia gets from the national tobacco lawsuit settlement is no longer being spent on tobacco use prevention. Magazine ads and televised public service announcements urging teens not to smoke were common a few years ago; now they’ve disappeared.

But the burden of tobacco still exists. More than 10,000 Georgians die every year from tobacco-related illnesses such as lung cancer and emphysema. Treating these illnesses costs Georgia $1.8 billion a year, and the state is drained of another $3.4 billion a year due to lost productivity among workers.

Angie Caton, an oncology nurse at Northeast Georgia Medical Center, is spearheading a project to remind people of the true costs of smoking.

Because about 1,200 people die in the U.S. every day as a result of tobacco-related illnesses, Caton and her colleagues are organizing "Remembering the Soles." They’re collecting 1,200 pairs of shoes, one pair for each life lost.

On Thursday, volunteers will line up the shoes along Downey Boulevard on the east side of the medical center. They also plan to have people out there from 7 a.m. until dark, waving signs with anti-smoking messages.

"Hopefully, it will be a way to raise awareness about (the effects of) tobacco," said Caton.

Anyone who wants to donate shoes can call Caton at 770-533-8842. After the event, she said, the shoes will be given to Goodwill and the Salvation Army.

Caton tries to convey the reality that it is much easier never to smoke than it is to quit once you’ve started the habit.

"The message I always put out to kids is that you can become addicted," she said. "You think you can control it, but you can’t."

A study released last month suggested that smokers who try to quit now are much more addicted to nicotine than smokers were 20 years ago.

One reason is that most smokers who could quit easily already have done it. The remaining smokers are more heavily addicted; they’ve tried repeatedly to quit, but keep relapsing.

Some activists blame cigarette manufacturers for increasing the amount of nicotine in their products. But Eriksen said the key factor is how quickly nicotine is delivered to the bloodstream.

"Cigarettes are designed to facilitate nicotine absorption," he said. ""Chemicals are added to make nicotine easier to absorb, whether the actual amount of nicotine is high or not.

Eriksen said nicotine replacement products, which are supposed to make it easier to quit smoking, aren’t effective for some people because they don’t replicate the physiological experience of smoking.

"Nicotine in the blood spikes after inhaling cigarette smoke," he said. "Nicotine patches and gums deliver a steady dose and can’t duplicate that ‘hit,’"

However, Eriksen said the patches, gums and other devices do double the success rate for quitting. Only about 10 percent of smokers succeed in going cold turkey; with the tobacco cessation products, the rate increases to about 20 percent.

Eriksen said the most effective approach is "multicomponent therapy." That means a combination of a quitting aid, such as nicotine replacement or the prescription drug Chantix, along with behavioral modification.

The Cancer Society offers a smoking cessation class called Fresh Start, but Pendley said participation is disappointingly low, even among smokers who say they really want to quit.

"It is hard to get people to come," she said.

For smokers who need emotional support but don’t want to go to a class, there a couple of options they can use at home. The American Lung Association offers an online course called Freedom from Smoking, and the Georgia Division of Public Health sponsors the Georgia Tobacco Quit Line, a phone counseling service.

But participation in the phone hotline is down, because in recent years the state has had no money to advertise it.