Well: Quitting Smoking for Good

Few smokers would claim that it’s easy to quit. The addiction to nicotine is strong and repeatedly reinforced by circumstances that prompt smokers to light up.

Yet the millions who have successfully quit are proof that a smoke-free life is achievable, even by those who have been regular, even heavy, smokers for decades.

Today, 19 percent of American adults smoke, down from more than 42 percent half a century ago, when Luther Terry, the United States surgeon general, formed a committee to produce the first official report on the health effects of smoking. Ever-increasing restrictions on where people can smoke have helped to swell the ranks of former smokers.

Now, however, as we approach the American Cancer Society’s 37th Great American Smokeout on Thursday, the decline in adult smoking has stalled despite the economic downturn and the soaring price of cigarettes.

Currently, 45 million Americans are regular smokers who, if they remain smokers, can on average expect to live 10 fewer years. Half will die of a tobacco-related disease, and many others will suffer for years with smoking-caused illness. Smoking adds $96 billion to the annual cost of medical care in this country, Dr. Nancy A. Rigotti wrote in The Journal of the American Medical Association last month. Even as some adult smokers quit, their ranks are being swelled by the 800,000 teenagers who become regular smokers each year and by young adults who, through advertising and giveaways, are now the prime targets of the tobacco industry.

People ages 18 to 25 now have the nation’s highest smoking rate: 40 percent. I had to hold my breath the other day as dozens of 20-somethings streamed out of art gallery openings and lighted up. Do they not know how easy it is to get hooked on nicotine and how challenging it can be to escape this addiction?

Challenging, yes, but by no means impossible. on the Web you can download a “Guide to Quitting Smoking,” with detailed descriptions of all the tools and tips to help you become an ex-smoker once and for all.

Or consult the new book by Dr. Richard Brunswick, a retired family physician in Northampton, Mass., who says he’s helped hundreds of people escape the clutches of nicotine and smoking. (The printable parts of the book’s provocative title are “Can’t Quit? You Can Stop Smoking.”)

“There is no magic pill or formula for beating back nicotine addiction,” Dr. Brunswick said. “However, with a better understanding of why you smoke and the different tools you can use to control the urge to light up, you can stop being a slave to your cigarettes.”

Addiction and Withdrawal

Nicotine beats a direct path to the brain, where it provides both relaxation and a small energy boost. But few smokers realize that the stress and lethargy they are trying to relieve are a result of nicotine withdrawal, not some underlying distress. Break the addiction, and the ill feelings are likely to dissipate.

Physical withdrawal from nicotine is short-lived. Four days without it and the worst is over, with remaining symptoms gone within a month, Dr. Brunswick said. But emotional and circumstantial tugs to smoke can last much longer.

Depending on when and why you smoke, cues can include needing a break from work, having to focus on a challenging task, drinking coffee or alcohol, being with other people who smoke or in places you associate with smoking, finishing a meal or sexual activity, and feeling depressed or upset.

To break such links, you must first identify them and then replace them with other activities, like taking a walk, chewing sugar-free gum or taking deep breaths. These can help you control cravings until the urge passes.

If you’ve failed at quitting before, try to identify what went wrong and do things differently this time, Dr. Brunswick suggests. Most smokers need several attempts before they can become permanent ex-smokers.

Perhaps most important is to be sure you are serious about quitting; if not, wait until you are. Motivation is half the battle. Also, should you slip and have a cigarette after days or weeks of not smoking, don’t assume you’ve failed and give up. Just go right back to not smoking.

Aids for Quitting

Many if not most smokers need two kinds of assistance to become lasting ex-smokers: psychological support and medicinal aids. Only about 4 percent to 7 percent of people are able to quit smoking on any given attempt without help, the cancer society says.

All 50 states and the District of Columbia have free telephone-based support programs that connect would-be quitters to trained counselors. Together, you can plan a stop-smoking method that suits your smoking pattern and helps you avoid common pitfalls.

Online support groups and Nicotine Anonymous can help as well. To find a group, ask a local hospital or call the cancer society at (800) 227-2345. Consider telling relatives and friends about your intention to quit, and plan to spend time in smoke-free settings.

More than a dozen treatments can help you break the physical addiction to tobacco. Most popular is nicotine replacement therapy, sold both with and without a prescription. The Food and Drug Administration has approved five types: nicotine patches of varying strengths, gums, sprays, inhalers and lozenges that can curb withdrawal symptoms and help you gradually reduce your dependence on nicotine.

Two prescription drugs are also effective: an extended-release form of the antidepressant bupropion (Zyban or Wellbutrin), which reduces nicotine cravings, and varenicline (Chantix), which blocks nicotine receptors in the brain, reducing both the pleasurable effects of smoking and the symptoms of nicotine withdrawal. Combining a nicotine replacement with one of these drugs is often more effective than either approach alone.

Other suggested techniques, like hypnosis and acupuncture, have helped some people quit but lack strong proof of their effectiveness. Tobacco lozenges and pouches and nicotine lollipops and lip balms lack evidence as quitting aids, and no clinical trials have been published showing that electronic cigarettes can help people quit.

The cancer society suggests picking a “quit day”; ridding your home, car and workplace of smoking paraphernalia; choosing a stop-smoking plan, and stocking up on whatever aids you may need.

On the chosen day, keep active; drink lots of water and juices; use a nicotine replacement; change your routine if possible; and avoid alcohol, situations you associate with smoking and people who are smoking.

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Changing of the Guard: Chinese Communist Party Faces Calls for Democracy

BEIJING — As the Communist Party’s 18th Congress approached, Li Weidong, a scholar of politics, made plans to observe a historic leadership battle in one of the world’s great nations.

Instead of staying in Beijing to monitor China’s once-a-decade transfer of power, Mr. Li boarded a plane.

“I’m going to the United States to study the elections,” Mr. Li said in a telephone interview during a stopover in Paris. After witnessing the American presidential election on Tuesday, Mr. Li went on the radio for another interview. “I still think China’s politics remain prehistoric,” he said. “I often joke that the Chinese civilization is the last prehistoric civilization left in the world.”

With China at a critical juncture, there is a rising chorus within the elite expressing doubt that the 91-year-old Communist Party’s authoritarian system can deal with the stresses bearing down on the nation and its 1.3 billion people. Policies introduced after 1978 by Deng Xiaoping lifted hundreds of millions out of poverty and transformed the country into the world’s second-largest economy. But the way party leaders have managed decades of growth has created towering problems that critics say can no longer be avoided.

Many of those critics have benefited from China’s stunning economic gains, and their ranks include billionaires, intellectuals and children of the party’s revolutionary founders. But they say the party’s agenda, as it stands today, is not visionary enough to set China on the path to stability. What is needed, they say, is a comprehensive strategy to gradually extricate the Communist Party, which has more than 80 million members, from its heavy-handed control of the economy, the courts, the news media, the military, educational institutions, civic life and just the plain day-to-day affairs of citizens.

Only then, the critics argue, can the government start to address the array of issues facing China, including rampant corruption, environmental degradation, and an aging population whose demographics have been skewed because of the one-child policy.

“In order to build a real market economy, we have to have real political reform,” said Yang Jisheng, a veteran journalist and a leading historian of the Mao era. “In the next years, we should have a constitutional democracy plus a market economy.”

For now, however, party leaders have given no indication that they intend to curb their role in government in a meaningful way.

“We will never copy a Western political system,” Hu Jintao, the departing party chief, said in a speech on Thursday opening the weeklong congress.

The party’s public agenda, which Mr. Hu described in detail in his 100-minute address, was laid out in a 64-page report that is in part intended to highlight priorities for the new leaders, who will be announced later this month. Much of the document had retrograde language that emphasized ideology stretching back to Mao and had little in the way of bold or creative thinking, said Qian Gang, the director of the China Media Project at the University of Hong Kong.

Most telling, there was no language signaling that the incoming Politburo Standing Committee, the group that rules China by consensus, would support major changes in the political system, whose perversions many now say are driving the nation toward crisis.

While Chinese who are critical of the current system generally do not expect a wholesale adoption of a Western model, they do favor at least an openness to bolder experimentation.

“To break one-party rule right now is probably not realistic, but we can have factions within the party made public and legalized, so they can campaign against each other,” said Mr. Yang, who added that there was no other way at the moment to ensure political accountability.

Only in the last few years has the idea of liberalizing the political system gained currency, and urgency, among a broad cross-section of elites. Before that, as the West foundered at the onset of the global financial crisis, many here pointed to the triumph of a “China model” or “Beijing consensus” — a mix of authoritarian politics, a command economy and quasi-market policies.

But the way in which China weathered the crisis — with the injection of $588 billion of stimulus money into the economy and an explosion of lending from state banks — led to a spate of large infrastructure projects that may never justify their cost. As a result, many economists now say that China’s investment-driven, export-oriented economic model is unsustainable and needs to shift toward greater reliance on Chinese consumers.

Constant lip-service is paid to that goal, and on Saturday, Zhang Ping, a senior official, reiterated that stance. But it will not be easy for the new leaders to carry it out. At the root of the current economic model is the political system, in which party officials and state-owned enterprises work closely together, reaping enormous profits from the party’s control of the economy. Under Mr. Hu’s decade-long tenure, these relationships and the dominance of state enterprises have only strengthened.

“What happens in this kind of economy is that wealth concentrates where power is,” said Mr. Yang, the journalist.

The 400 or so incoming members of the party’s Central Committee, Politburo and Politburo Standing Committee, as well as their friends and families, have close ties to the most powerful of China’s 145,000 state-owned enterprises. The growing presence of princelings — the children of notable Communist officials — in the party, the government and corporations could mean an even more closely meshed web of nepotism. It is a system that Xi Jinping, anointed to be the next party chief and president and himself a member of the “red nobility,” would find hard to unravel, even if he wanted to.

Mia Li contributed research.

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Mind Faded, Darrell Royal’s Wisdom and Humor Intact Till End

Three days before his death last week at 88, Darrell Royal told his wife, Edith: “We need to go back to Hollis” — in Oklahoma. “Uncle Otis died.”

“Oh, Darrell,” she said, “Uncle Otis didn’t die.”

Royal, a former University of Texas football coach, chuckled and said, “Well, Uncle Otis will be glad to hear that.”

The Royal humor never faded, even as he sank deeper into Alzheimer’s disease. The last three years, I came to understand this as well as anyone. We had known each other for more than 40 years. In the 1970s, Royal was a virile, driven, demanding man with a chip on his shoulder bigger than Bevo, the Longhorns mascot. He rarely raised his voice to players. “But we were scared to death of him,” the former quarterback Bill Bradley said.

Royal won 3 national championships and 167 games before retiring at 52. He was a giant in college football, having stood shoulder to shoulder with the Alabama coach Bear Bryant. Royal’s Longhorns defeated one of Bryant’s greatest teams, with Joe Namath at quarterback, in the 1965 Orange Bowl. Royal went 3-0-1 in games against Bryant.

Royal and I were reunited in the spring of 2010. I barely recognized him. The swagger was gone. His mind had faded. Often he stared aimlessly across the room. I scheduled an interview with him for my book “Courage Beyond the Game: The Freddie Steinmark Story.” Still, I worried that his withering mind could no longer conjure up images of Steinmark, the undersize safety who started 21 straight winning games for the Longhorns in the late 1960s. Steinmark later developed bone cancer that robbed him of his left leg.

When I met with Royal and his wife, I quickly learned that his long-term memory was as clear as a church bell. For two hours, Royal took me back to Steinmark’s recruiting trip to Austin in 1967, through the Big Shootout against Arkansas in 1969, to the moment President Richard M. Nixon handed him the national championship trophy in the cramped locker room in Fayetteville. He recalled the day at M. D. Anderson Hospital in Houston the next week when doctors informed Steinmark that his leg would be amputated if a biopsy revealed cancer. Royal never forgot the determined expression on Steinmark’s face, nor the bravery in his heart.

The next morning, Royal paced the crowded waiting room floor and said: “This just can’t be happening to a good kid like Freddie Steinmark. This just can’t be happening.”

With the love of his coach, Steinmark rose to meet the misfortune. Nineteen days after the amputation, he stood with crutches on the sideline at the Cotton Bowl for the Notre Dame game. After the Longhorns defeated the Fighting Irish, Royal tearfully presented the game ball to Steinmark.

Four decades later, while researching the Steinmark book, I became close to Royal again. As I was leaving his condominium the day of the interview, I said, “Coach, do you still remember me?” He smiled and said, “Now, Jim Dent, how could I ever forget you?” My sense of self-importance lasted about three seconds. Royal chuckled. He pointed across the room to the message board next to the front door that read, “Jim Dent appt. at 10 a.m.”

Edith and his assistant, Colleen Kieke, read parts of my book to him. One day, Royal told me, “It’s really a great book.” But I can’t be certain how much he knew of the story.

Like others, I was troubled to see Royal’s memory loss. He didn’t speak for long stretches. He smiled and posed for photographs. He seemed the happiest around his former players. He would call his longtime friend Tom Campbell, an all-Southwest Conference defensive back from the 1960s, and say, “What are you up to?” That always meant, “Let’s go drink a beer.”

As her husband’s memory wore thin, Edith did not hide him. Instead, she organized his 85th birthday party and invited all of his former players. Quarterback James Street, who engineered the famous 15-14 comeback against Arkansas in 1969, sat by Royal’s side and helped him remember faces and names. The players hugged their coach, then turned away to hide the tears.

In the spring of 2010, I was invited to the annual Mexican lunch for Royal attended by about 75 of his former players. A handful of them were designated to stand up and tell Royal what he meant to them. Royal smiled through each speech as his eyes twinkled. I was mesmerized by a story the former defensive tackle Jerrel Bolton told. He recalled that Royal had supported him after the murder of his wife some 30 year earlier.

“Coach, you told me it was like a big cut on my arm, that the scab would heal, but that the wound would always come back,” Bolton said. “It always did.”

Royal seemed to drink it all in. But everyone knew his mind would soon dim.

The last time I saw him was June 20 at the County Line, a barbecue restaurant next to Bull Creek in Austin. Because Royal hated wheelchairs and walkers, the former Longhorn Mike Campbell, Tom’s twin, and I helped him down the stairs by wrapping our arms around his waist and gripping the back of his belt. I ordered his lunch, fed him his sandwich and cleaned his face with a napkin. He looked at me and said, “Was I a college player in the 1960s?”

“No, Coach,” I said. “But you were a great player for the Oklahoma Sooners in the late 1940s. You quarterbacked Oklahoma to an 11-0 record and the Sooners’ first national championship in 1949.”

He smiled and said, “Well, I’ll be doggone.”

After lunch, Mike Campbell and I carried him up the stairs. We sat him on a bench outside as Tom Campbell fetched the car. In that moment, the lunch crowd began to spill out of the restaurant. About 20 customers recognized Royal. They took his photograph with camera phones. Royal smiled and welcomed the hugs.

“He didn’t remember a thing about it,” Tom Campbell said later. “But it did his heart a whole lot of good.”

Jim Dent is the author of “The Junction Boys” and eight other books.

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In Soldier’s Hearing, Afghans Tell of Horror

JOINT BASE LEWIS-McCHORD, Wash. — Through a live video feed from half a world away in Afghanistan, in an extraordinary night court session, descriptions of chaos and horror poured into a military courtroom here as if from an open spigot.

Lois Silver/FR 170774 Associated Press, via Associated Press

In a courtroom sketch, Staff Sgt. Robert Bales, lower right, is shown during testimony on Friday.

Reuters

Sergeant Bales, left, during a 2011 training exercise in Fort Irwin, California.

“Their brains were still on the pillows,” said Mullah Khamal Adin, 39, staring into the camera with his arms folded on the table, describing the 11 members of his cousin’s family he found dead in the family compound — most of the bodies burned in a pile in one room.

Mr. Adin, in a hearing that started here late Friday, was asked about the smell. Was there an odor of gasoline or kerosene?

Just bodies and burned plastic, he replied through a translator.

The Army’s preliminary hearing in the case against Staff Sgt. Robert Bales, accused of killing 16 Afghan civilians in Kandahar Province this year, unfolded last week mostly in the bustling daylight of a working military base an hour south of Seattle. But to accommodate witnesses in Afghanistan, and the 12-and-a-half-hour time difference, the schedule was shifted at week’s end, with testimony through cameras and uplinks in Afghanistan and here at Lewis-McChord starting at 7:30 p.m. Pacific time on Friday and running until shortly after 2 a.m. Saturday.

The attacks, which occurred on March 11 in a deeply poor rural region while most of the victims were asleep, were the deadliest war crime attributed to a single American soldier in the decade of war that has followed the terrorist attacks of Sept. 11, 2001, and they further frayed the relationship between the American and Afghan governments.

The military says Sergeant Bales, 39, was serving his fourth combat tour overseas when he walked away from his remote outpost in southern Afghanistan and shot and stabbed members of several families in a nighttime ambush on two villages. At least nine of the people he is accused of killing were children, and others were women. After the victims were shot, some of the bodies were dragged into a pile and burned.

“ ‘What are you doing? What are you doing?’ ” one witness, a farmer named Haji Naim, said he had shouted to the American soldier, whom he described as wearing a blindingly bright headlamp in a house that, without electricity, was pitch black. The gunman said nothing, Mr. Naim said, and simply kept firing.

“He shot me right here, right here, and right here,” he said, indicating wounds from which he has apparently recovered.

Most of the testimony, however graphic, was circumstantial, pointing to a lone American gunman but not directly implicating Sergeant Bales. The villagers testified on the fifth day of a military proceeding known as an Article 32 investigation, held to establish whether there is enough evidence to bring Sergeant Bales before a court-martial. If a court-martial is ordered and the Army decides to continue the prosecution as a capital case, the sergeant could face the death penalty.

Sergeant Bales, a decorated veteran of three tours in Iraq before being sent to Afghanistan last December, was deployed from Joint Base Lewis-McChord. He was held at the military prison at Fort Leavenworth in Kansas before being brought here for the hearing.

Witnesses earlier in the week talked about the blood-soaked clothes that Sergeant Bales was seen wearing when he returned to his base in Kandahar and his comments to fellow soldiers about having done “the right thing.” There was also testimony about the test for steroids in his system that came back positive three days after the killings.

The hearing’s night sessions, which were scheduled to continue on Saturday, were all about the violence that unfolded the night of March 11. Mr. Adin, who was summoned to his cousin’s compound by a telephone call early the next morning, told of boot prints that were on some bodies, including the head of a child who had apparently been shot and stomped or kicked. Mr. Adin talked about a small child who he said appeared to have been “grabbed from her bed and thrown on the fire.” But Mr. Adin never saw the gunman, arriving after the fact.

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Bits Blog: On Twitter, Steve Jobs Is Immortal

Steve Jobs is gone, but on Twitter his @name lives on. And on.

The chief executive of Apple, who died in 2011, is memorialized on Twitter by about a thousand fans, parodists, traffic seekers, unrepentant haters and crypto-historians, among others. The accounts use his name as either as a title or, with many variations, as an address.

The copycats include @FakeSteveJobs, @FauxSteve and @SteveJobsFalso, a collection of admitted imposters who are following in the footsteps of a parody Web site that was active from 2006 to 2011. Other versions include @RememberSteve, @PulseonJobs and @RealSteveJobs. There are a couple of @BlackSteveJobs, plus Twitter accounts by various articles of clothing and body parts.

Several of the accounts are operated by start-ups hoping to generate attention for themselves. Their tweets contain links to corporate Web pages. Some of the accounts are in languages like Arabic, Thai or Japanese. Many others use Mr. Jobs’s name for the account but have a different address.

Searching the name “Steve Jobs” on Twitter yields about 1,080 accounts, some of which are unrelated to the Apple co-founder; there are people on Twitter who are really named Steve Jobs.

Twitter does not keep score of how many of its 140 million accounts are fakes, but it generally supports the idea of parody accounts. “It’s very helpful for political dissidents, who can’t write under their own name,” said Rachael Horwitz, a company spokeswoman. She also noted that Dick Costolo, Twitter’s chief executive, has a parody account. Jack Dorsey, the chairman of the company’s board, is likewise roasted.

Possibly for his close identification with technology, Mr. Jobs does appear to be the most popular identity on Twitter to leverage. President Obama has about 600 versions of his name, either through the “@” address, or in the name of the account. Given much of the venom of the recent election, several of these accounts are remarkably ugly, certainly worse than the treatment afforded Mr. Jobs. Michelle Obama, who like the president has an official and verified Twitter account, has about 500 copycats.

Bill Gates, Mr. Jobs’s longtime nemesis and eventual frenemey, does better than the president and first lady, with about 840 imitators and parodists. There is also a Klingon version of him, which to date Mr. Jobs’s name does not appear to share. There also appear to be a lot more people on Twitter who are simply named “Bill Gates,” a characteristic that must fill their lives with a lot of predictable humor.

Justin Beiber gets a mere 240 people hoping for a bit of his lustre. John Lennon, Mr. Jobs’ idol, has fewer than 100.

Twitter will take down parody accounts, but usually when it is not clear that they are parodies. That is not a problem in the case of most public figures. “It’s a form of speech,” Ms. Horwitz said. On the Internet, everyone needs a thicker skin. The situation does come up enough that the company has published formal policies on acceptable parody and fan accounts , along with impersonation.

There are parody accounts for Oracle’s chief executive, Larry Ellison; for Larry Page, the chief executive and co-founder of Google; and for Mark Zuckerberg, the chief of Facebook. With so many parody accounts around, some technology chief executives may worry if they are not being parodied.

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Black Friday Deals Will Start Earlier This Year

There was an outcry last year when some retailers opened at midnight on Thanksgiving, with workers and shoppers saying the holiday should be reserved for family, not spent lining up for the start of the Christmas shopping season.

This year, retailers are responding to the criticism by opening even earlier on Thanksgiving evening — and a handful are even planning to be open all day.

The lesson of 2011 was clear: earlier shopping hours were good for the top line. Retailers said their midnight openings drew a younger crowd who wanted to party — and shop — late rather than get up early. At Macy’s Herald Square store in Manhattan, for instance, about 9,000 people were in line as it opened, compared with 7,000 for an early Friday opening the previous year.

“We got customer feedback that says, ‘I like to shop earlier so I can go to bed earlier,’ so as we looked at the balance of being competitive in the marketplace and being customer-centric,” said Duncan Mac Naughton, chief merchandising and marketing officer for Wal-Mart, which will put its first doorbuster items on sale at 8 p.m. on Thanksgiving.

Just a few years ago, most major stores opened about 5 a.m. on the Friday after Thanksgiving, usually the busiest shopping day of the year. This year, not only are the openings scattered across two days, but several retailers are offering staggered deals — some items at a certain time, other items a few hours later, still others over the weekend.

“We had Black Friday pretty cleanly teed up, with, here are the ads, here are the stores opening Friday morning, pick a retailer and go,” said Brad Wilson, who lists Black Friday ads at BradsDeals. “Now you have this multiday affair, and you can go at different times.”

Kmart has perhaps the most confusing hours. Like last year, it will open at 6 a.m. on Thanksgiving. It will then stay open until 4 p.m., close from 4 to 8 p.m., reopen at 8, stay open until 3 a.m. on Friday, close from 3 to 5 a.m., reopen at 5, and then stay open until 11 p.m. on Friday.

Sears, which was closed on Thanksgiving last year, will open at 8 p.m. on Thursday night.

Sears Holdings, which owns both Sears and Kmart, said in a news release that customers wanted “more flexible Black Friday in-store shopping times.”

Lord & Taylor was closed last year on Thanksgiving, but this year it will be open from 10 a.m. to 7 p.m.

Walmart, which is generally open 24 hours anyway, is offering the first deals on Thanksgiving two hours earlier than last year. Mr. Mac Naughton said customer feedback and competitiveness with other retailers were factors.

Target, which last year got angry feedback from employees when it opened at midnight on Thanksgiving, this year moved it up three hours to 9 p.m., according to a holiday circular posted online on Friday.

Some workers object to Thanksgiving Day holiday openings, saying it cuts into family time. It shows “disregard for all of our families,” said Mary Pat Tifft, a Walmart employee in Kenosha, Wis., who is part of the union-backed OUR Walmart group, in a statement. But in many cases, it can also mean a higher hourly pay rate for holiday duty.

Now, the handful of retailers who are holding off until midnight on Thanksgiving suddenly look like the respectful ones.

“We believe that Thanksgiving Day is a time to spend and celebrate with family, and we want our associates to do so,” said Jim Sluzewski, a spokesman for Macy’s, which will open at midnight. Kohl’s will also open at midnight Thanksgiving, as will Best Buy, according to a circular posted online Friday.

Companies are also sprinkling sales throughout the weekend in an effort to keep traffic coming.

After its initial 8 p.m. sale, Walmart will put another set of items on sale at 10, and a third group at 5 a.m. Friday. “Whether they like to start early, stay up late, or go to bed early and get up early, we’re going to have three different events that will meet their needs,” Mr. Mac Naughton said. Then, Walmart will “kick off a weekend full of savings with more specialty offers” on items like jewelry, sewing machines and tools.

Target, after its 9 p.m. doorbuster special, will offer a free gift card for purchases made between 4 a.m. and noon on Friday, according to the circular posted on Mr. Wilson’s site and elsewhere. (Target declined to confirm the authenticity of the circular, saying it had not yet publicly announced holiday details.)

Sears will do a second wave of promotions at 4 a.m. on Friday, eight hours after it opens. Sports Authority will do some doorbusters at its midnight opening, then put numerous others on sale over the weekend. And Ace Hardware is offering different percentages or dollars off, on Friday, Saturday and Sunday.

Mr. Wilson of BradsDeals says the retailers may be intentionally trying to confuse shoppers. “They’re trying to introduce more variables,” he said, to make it harder to figure out exactly which is the best deal.

All of the twists and turns, though, may just end up frustrating consumers.

Only 6 percent of shoppers plan to hit stores on Thanksgiving night, and just under one-fifth will go to stores on Black Friday, according to a new survey from Ipsos and Offers.com, accurate within three percentage points.

At least one major retailer is going against the grain. Sam’s Club, which last year opened at 5 a.m. on Black Friday, this year is opening two hours later, at 7 a.m., and offering coffee and pastries to shoppers.

“If they want to chill out on Thanksgiving day and not go out and get into the rat race of everything, they can do that,” said Todd Harbaugh, executive vice president for operations at Sam’s Club. “Our members said they want hassle-free shopping.”

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FEMA Chief Tours Damaged NYU Langone Medical Center

The federal government’s emergency management chief trudged through darkened subterranean hallways covered with silt and muddy water Friday, as he toured one of New York City’s top academic medical centers in the aftermath of Hurricane Sandy. The basement of the complex, NYU Langone Medical Center in Manhattan, smelled like the hold of a ship — a mixture of diesel oil and water.

“You’re going to deal with the FUD — fear, uncertainty and doubt,” W. Craig Fugate, administrator of the Federal Emergency Management Agency, told NYU Langone officials afterward, as they retreated to a conference room to catalog the losses. “Don’t look at this. Think about what’s next.”

NYU Langone, with its combination of clinical, research and academic facilities, may have been the New York City hospital that was most devastated by Hurricane Sandy. What’s next is a spectacularly expensive cleanup.

Dr. Robert I. Grossman, dean and chief executive of NYU Langone, looking pale and weary — as if he were, indeed, struggling to hold back the FUD — estimated that the storm could cost the hospital $700 million to $1 billion. His estimate included cleanup, rebuilding, lost revenue, interrupted research projects and the cost of paying employees not to work.

As the hurricane raged, the East River filled the basement of the medical center, at 32nd Street and First Avenue, knocked out emergency power and necessitated the evacuation of more than 300 patients over 13 hours in raging wind, rain and darkness. It disrupted medical school classes and shut down high-level research projects operating with federal grants.

Mr. Fugate arrived to inspect the damage and help plot the institution’s recovery, the advance guard of what aides said would be a hospital task force. He was brought in by Senator Charles E. Schumer of New York, who kept saying that there was nothing like seeing the damage firsthand to understand how profound it really was.

“What was that movie — ‘Contagion?’ ” Mr. Schumer said, marveling at the hellish scene.

NYU Langone’s patients, a major source of revenue, have been scattered to other hospitals, creating a risk that they may never return. Dr. Grossman said he was counting on those patients’ loyalty.

John Sexton, president of New York University, which includes NYU Langone, and who also met with Mr. Fugate, raised fears that researchers might be lured away to other institutions because their grants were ticking away on deadline or because they must publish or perish. Outside the hospital, tanks of liquid nitrogen testified to the efforts to keep research materials from spoiling.

In inky blackness, the group stood at the brink of the animal section of the Smilow Research Center, where rodents for experiments had been kept, but they did not go inside. On Nov. 3, a memo sent to NYU Langone researchers said the animal section, or vivarium, was “completely unrecoverable.”

Dr. Grossman said that scientists had managed to save some rodents by raising their cages to higher ground.

A modernized lecture hall with raked seats used by medical students had been filled “like a bathtub,” he said, though it was dry on Friday. The library, he said, “is basically gone.”

Four magnetic resonance scanners, a linear accelerator and gamma knife surgery equipment, kept in the basement, were now worthless. Dr. Grossman said that in the future, he wanted to move such equipment, which is very heavy, to higher floors.

Electronic medical records were protected by a server in New Jersey, he said.

Richard Cohen, vice president for facilities operations, took the group past piles of sandbags and a welded steel door that had been blown out by the force of the flood. “That door was put in around 1959 to 1960, when doors were really doors,” Mr. Cohen said. “And this thing is completely torsionally twisted. I’ve never seen anything like that.”

Walking to the back of the hospital, Mr. Cohen used a loading dock as a measuring stick to estimate that the surge had risen to 14 ½ feet. “We were prepared for 12 feet, no problem,” Dr. Grossman said.

Dr. Grossman said it would take a couple of more weeks of assessing the damage to determine when the hospital could reopen. Outpatient business is already returning. Research and some inpatient services will come next.

Mr. Fugate said his agency would help cover the uninsured losses, and urged NYU Langone officials to move ahead.

At this point, Dr. Grossman said, he could only theorize as to why the generators had shut down. All but one generator is on a high floor, but the fuel tanks are in the basement. The flood, he said, was registered by the liquid sensors on the tanks, which then did what they were supposed to do in the event, for instance, of an oil leak. They shut down the fuel to the generators.

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FEMA Chief Tours Damaged NYU Langone Medical Center

The federal government’s emergency management chief trudged through darkened subterranean hallways covered with silt and muddy water Friday, as he toured one of New York City’s top academic medical centers in the aftermath of Hurricane Sandy. The basement of the complex, NYU Langone Medical Center in Manhattan, smelled like the hold of a ship — a mixture of diesel oil and water.

“You’re going to deal with the FUD — fear, uncertainty and doubt,” W. Craig Fugate, administrator of the Federal Emergency Management Agency, told NYU Langone officials afterward, as they retreated to a conference room to catalog the losses. “Don’t look at this. Think about what’s next.”

NYU Langone, with its combination of clinical, research and academic facilities, may have been the New York City hospital that was most devastated by Hurricane Sandy. What’s next is a spectacularly expensive cleanup.

Dr. Robert I. Grossman, dean and chief executive of NYU Langone, looking pale and weary — as if he were, indeed, struggling to hold back the FUD — estimated that the storm could cost the hospital $700 million to $1 billion. His estimate included cleanup, rebuilding, lost revenue, interrupted research projects and the cost of paying employees not to work.

As the hurricane raged, the East River filled the basement of the medical center, at 32nd Street and First Avenue, knocked out emergency power and necessitated the evacuation of more than 300 patients over 13 hours in raging wind, rain and darkness. It disrupted medical school classes and shut down high-level research projects operating with federal grants.

Mr. Fugate arrived to inspect the damage and help plot the institution’s recovery, the advance guard of what aides said would be a hospital task force. He was brought in by Senator Charles E. Schumer of New York, who kept saying that there was nothing like seeing the damage firsthand to understand how profound it really was.

“What was that movie — ‘Contagion?’ ” Mr. Schumer said, marveling at the hellish scene.

NYU Langone’s patients, a major source of revenue, have been scattered to other hospitals, creating a risk that they may never return. Dr. Grossman said he was counting on those patients’ loyalty.

John Sexton, president of New York University, which includes NYU Langone, and who also met with Mr. Fugate, raised fears that researchers might be lured away to other institutions because their grants were ticking away on deadline or because they must publish or perish. Outside the hospital, tanks of liquid nitrogen testified to the efforts to keep research materials from spoiling.

In inky blackness, the group stood at the brink of the animal section of the Smilow Research Center, where rodents for experiments had been kept, but they did not go inside. On Nov. 3, a memo sent to NYU Langone researchers said the animal section, or vivarium, was “completely unrecoverable.”

Dr. Grossman said that scientists had managed to save some rodents by raising their cages to higher ground.

A modernized lecture hall with raked seats used by medical students had been filled “like a bathtub,” he said, though it was dry on Friday. The library, he said, “is basically gone.”

Four magnetic resonance scanners, a linear accelerator and gamma knife surgery equipment, kept in the basement, were now worthless. Dr. Grossman said that in the future, he wanted to move such equipment, which is very heavy, to higher floors.

Electronic medical records were protected by a server in New Jersey, he said.

Richard Cohen, vice president for facilities operations, took the group past piles of sandbags and a welded steel door that had been blown out by the force of the flood. “That door was put in around 1959 to 1960, when doors were really doors,” Mr. Cohen said. “And this thing is completely torsionally twisted. I’ve never seen anything like that.”

Walking to the back of the hospital, Mr. Cohen used a loading dock as a measuring stick to estimate that the surge had risen to 14 ½ feet. “We were prepared for 12 feet, no problem,” Dr. Grossman said.

Dr. Grossman said it would take a couple of more weeks of assessing the damage to determine when the hospital could reopen. Outpatient business is already returning. Research and some inpatient services will come next.

Mr. Fugate said his agency would help cover the uninsured losses, and urged NYU Langone officials to move ahead.

At this point, Dr. Grossman said, he could only theorize as to why the generators had shut down. All but one generator is on a high floor, but the fuel tanks are in the basement. The flood, he said, was registered by the liquid sensors on the tanks, which then did what they were supposed to do in the event, for instance, of an oil leak. They shut down the fuel to the generators.

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Citing Affair, Petraeus Resigns as C.I.A. Director

The sudden development came just days after President Obama won re-election to a second term. Mr. Petraeus, a highly decorated general who had led the wars in Iraq and Afghanistan, had been expected to remain in the president’s administration.

Instead, Mr. Petraeus said in the statement that the president accepted his resignation on Friday after he had informed him of his indiscretion a day earlier.

“After being married for over 37 years, I showed extremely poor judgment by engaging in an extramarital affair,” Mr. Petraeus wrote. “Such behavior is unacceptable, both as a husband and as the leader of an organization such as ours. This afternoon, the president graciously accepted my resignation.”

Mr. Obama released a statement praising Mr. Petraeus for his “extraordinary service” to the country and saying that Michael J. Morell, the deputy director of the C.I.A., would take over once again as acting director. He served in that position briefly after Leon E. Panetta left the agency last year.

“By any measure, through his lifetime of service, David Petraeus has made our country safer and stronger,” the president said. Without directly addressing the affair, Mr. Obama added: “Going forward, my thoughts and prayers are with Dave and Holly Petraeus, who has done so much to help military families through her own work. I wish them the very best at this difficult time.”

The development came as a shock to the national security establishment. In a statement, James R. Clapper, the director of national intelligence, called the decision “a loss” to the country.

“Dave’s decision to step down represents the loss of one of our nation’s most respected public servants.” Mr. Clapper wrote. “From his long, illustrious Army career to his leadership at the helm of C.I.A., Dave has redefined what it means to serve and sacrifice for one’s country.”

By acknowleding an extramarital affair, Mr. Petraeus, 60, was confronting a sensitive issue for a spy chief. Intelligence agencies are often concerned about the possibility that agents who engage in such behavior could be blackmailed for information.

In his statement, Mr. Petraeus did not provide any details about his behavior, saying that he asked the president to be allowed “for personal reasons” to resign.

Mr. Petraeus praised his colleagues at the C.I.A.’s headquarters in Langley, Va., calling them “truly exceptional in every regard” and thanking them for their service to the country. He made it clear that his departure was not how he had envisioned ending a storied career in the military and in intelligence.

“Teddy Roosevelt once observed that life’s greatest gift is the opportunity to work hard at work worth doing,” he said. “I will always treasure my opportunity to have done that with you, and I will always regret the circumstances that brought that work with you to an end.”

Over the last several years, Mr. Petraeus had become one of the most recognizable military officials, serving as the public face of the war effort in Congress and on television.

Under President George W. Bush, Mr. Petraeus was credited for helping to develop and put in place the “surge” in troops in Iraq that helped wind down the war in that country. Mr. Petraeus was moved to Afghanistan in 2010 after Mr. Obama fired General Stanley H. McChrystal over comments he made to a magazine reporter.

In Afghanistan, Mr. Petraeus led the push for a similar increase in troops ordered by Mr. Obama, but he was unable to replicate the success he had in the Iraq conflict.

Last year, Mr. Obama persuaded Mr. Petraeus to leave the Army after 37 years to lead the C.I.A., succeeding Mr. Panetta, who moved to the Defense Department.

This article has been revised to reflect the following correction:

Correction: November 9, 2012

An earlier version of this article incorrectly stated that David H. Petraeus was expected to remain in President Obama’s cabinet. The C.I.A. director is not a cabinet member in the Obama administration.

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Groupon Earnings Miss Expectations on Weakness in Europe

SAN FRANCISCO (Reuters) — Groupon reported financial results late Thursday that fell short of Wall Street’s already cautious expectations, as the daily-deal company failed to turn around its struggling European business.

Groupon also confirmed that it had laid off about 80 employees, mainly in sales, as part of an effort to automate the way it handles its deals.

The company’s shares fell as low as $3.21 in after-hours trading, down as much as 18 percent from their closing price of $3.92. Groupon was the darling of investors during last year’s consumer dot-com boom in initial public offerings, but now it has shed more than 80 percent of its value since making its public debut at $20 a share.

Wall Street has grown uneasy about Groupon’s prospects as daily-deals fever wanes among consumers and merchants, and as growth rates sputter. Adding to the difficulties, the S.E.C. has been looking into Groupon’s accounting and disclosures, an area of controversy during its initial public offering.

Groupon reported third-quarter revenue of $568.6 million, compared with $430.2 million a year earlier. Analysts had expected revenue of $590 million, according to Thomson Reuters.

The company posted a quarterly net loss of $3 million, or break-even on a per-share basis, compared with a net loss of $54.2 million, or 18 cents a share, in the third quarter of 2011.

Andrew Mason, chief executive of Groupon, said a “solid performance” in North America was offset by weakness in Europe. International revenue, including Europe, grew 3 percent to $277 million; North American revenue surged 80 percent to $292 million.

Europe has been a particular problem for Groupon, partly because the sovereign debt crisis there has hurt demand for higher-price deals. Groupon was also offering steeper discounts, disappointing some merchants.

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