'THIS is your task for next week," says Lizzie Evans, looking sternly around the group of men and women seated at the table. "Nobody to have a cigarette at all." There are a few smothered groans, a shifting of chairs. Then a babble of talk and tension-relieving laughter breaks out. "I tell you, these are brilliant," says one woman, waving a black plastic tube that can be used as a surrogate cigarette. "Sit in the pub making a fool of yourself smoking a bit of plastic!" They all laugh.

The people in a meeting room at York District Hospital are of all ages and from all walks of life. One thing has brought them together. They all want to give up smoking.

As the chatter subsides, Lizzie breaks in again. "I know it's hard. It's really really hard," she commiserates. "But is anyone else feeling better?"

By 'anyone else', she means anyone other than Bob Cook. At 53, the former Army sergeant-major, who now runs Adams House Hotel in Fulford, is becoming a veteran of smoking cessation clinics.

He has attended three of the seven-week courses run by Lizzie. He was a 40-a-day man. Giving up wasn't easy. But now, after his third try, he has managed to quit.

He says his last cigarette was on May 27. It was the day before Quit Day: the third session of his third course of stop-smoking clinics, at which every member of the group resolved to give up at the same time. He had planned it meticulously with that date in mind, rationing his buying of cigarettes for the two weeks before so by the time it came to that final evening, he would have only one left. He smoked it at 10.30pm, before he went to bed.

"It wasn't even a particularly nice one," he says. "But I woke up the next morning, and I have never smoked since."

He knew he had to quit. His family has a history of heart disease. Both his parents died because of it: and one of his brothers died after a heart attack.

Bob suffers with angina. He used to get regular chest pains which spread to his arm, and before he quit, couldn't walk anywhere without special medication in a 'puffer'.

His decline into ill health came as a shock. During his 34 years in the Army he was always fit - and that masked his underlying health problems. When he left the Army a few years ago it caught up with him.

He knew he had to do something. The knowledge of what had happened to other members of his family was preying on his mind. "I knew it was killing me," he says.

But giving up wasn't easy. He had been smoking since he was 12, apart from a few years when he managed to stop while in the Army. And he enjoyed it - except for those odd times when his mouth felt 'claggy'. "It's almost like a coating on your teeth or tongue," he says.

He tried hypnotherapy, and acupuncture, both without success. Then his doctor referred him to the North Yorkshire Stop Smoking Service.

It runs a series of stop-smoking clinics across the county. In York and Selby they are organised by the Selby and York Primary Care Trust and run by Lizzie, the trust's specialist smoking cessation adviser.

The clinics are almost like an Alcoholics Anonymous group for smokers.

Smokers can be referred by their doctor, or can ring up and ask to be put on a course. Each course involves a group session (of 15-20 people) once a week for seven weeks.

At the first session, group members are introduced and asked to tell each-other something about themselves. Lizzie explains the range of stop-smoking aids available - nicotine patches, the drug Zyban - and talks through with each member of the group which might be most likely to work for them.

She also introduces what she describes as the 'small steps to stopping', asking group members to leave it at least 20 minutes between cigarettes, suggesting they 'nominate' a single room only where they will smoke - and asking them to leave it as long as possible in the morning before smoking their first cigarette of the day.

The 'good' news for smokers on that first day is that they are not asked to give up straight away. Bob says there is generally a sigh of relief at that.

The 'bad' news is that they are given a definite deadline. The third session, two weeks after the first, is set as Quit Day, when all members of the group will be asked to try to give up together.

It's important to give them that lead-in time, says Lizzie, because it enables them to plan ahead, begin to cut down and start using their nicotine patches.

The great advantage about giving up with a group is the mutual encouragement and support you get. One of the biggest motivators, says Bob, was the way at each session every group member who had not had a cigarette that week got a round of applause. "It is quite funny, but you feel really proud of that," he says.

Another big motivator is the carbon monoxide reading taken for each group member at the beginning of each session. The monitor, which looks a bit like a breathalyser, registers carbon monoxide levels in the lungs.

For non-smokers, the reading should be five or less. For smokers, it can be up to 45. That can be a real motivator, Lizzie acknowledges. "It is a poisonous gas, carbon monoxide," she points out.

In the later stages of the course, group members are given a 'smoking buddy' - someone they can ring up if they feel they are going to have a cigarette, who can talk them out of it. Lizzie also gives advice on coping with withdrawal symptoms - such as the hacking cough which is quite normal after giving up - and problems such as compensation eating. (Eat carrots instead of cream cakes, advises Bob).

Group members also have a laugh, and swap stories about how much money they have saved and what they're going to do with it, whether they have put on any weight - and how much better they are feeling.

It still isn't easy. But one of the things which impressed Bob was the realisation that if you failed the first time, you would not be made to feel ashamed - and that there was nothing to stop you coming back to join another group for a second course, or a third.

He wasn't ready to be able to give up on his first seven-week course. But he learned something, he says. By his second course, he was more committed. He still wasn't able to give up, so asked to come back a third time.

By then, he was able to plan the whole process more, and was ready for the big effort of Quit Day.

He hasn't smoked since - and apart from feeling very proud, feels 'immensely' better for it. "My nose is clear and I can breathe with my mouth shut," he says. "I'm eating better, sleeping better. I wake easily, I'm using my bike more than I have in the last four years - and I don't need to carry my angina spray, because I haven't felt that pain in my left arm. It is just amazing, really."

Now he is back with Lizzie's latest group to give them a pep talk. They are in week six, with just one more session to go, and they have been hanging on his words.

"Is anyone else feeling better?" Lizzie asks.

The woman with the plastic cigarette substitute speaks up again. "It is nice breathing fresh air!" she says. They all laugh.

The Selby and York Primary Care Trust is increasing the number of smoking clinics it runs. The next round of clinics will begin in early September. There will be six altogether, in various parts of York, plus Selby and Easingwold. Success rates are high - 70 per cent of those who set a quit date succeed in stopping, says Lizzie. To find out more, or book a place, call the North Yorkshire Stop Smoking Service on 01904 663310 or ask your GP or practice nurse.

Updated: 09:08 Monday, August 26, 2002