Scott & White Health Plan

The SWHP Heartbeat

Stopping Smoking
by Dr. G. Evans

While walking this morning, I was listening to a podcast from NYC radio. The discussion was about bringing about behavioral changes and stopping smoking was one of the examples.

One woman after many, many years and numerous failed attempts to stop smoking finally decided to do something more compelling than all her prior attempts. She swore to a friend that she would give $5,000 to the KKK (her most detested organization) if she ever smoked another cigarette. With that pressure, she immediately stopped.

The discussion about that example and others was quite interesting.

How do you make a commitment?

How do deal with a decision today which is difficult to keep in the future when temptation keeps getting in the way?

They discussed the thought that there are 2 parts to each of us and on any given day, one or the other may take charge. If you could find a way to make them co-exist temporally, you could get the favored one to prevail. The woman whose good half gave up smoking and put the onus of a very undesirable option upon the weak half, by announcing a donation to the KKK, succeeded.

Perhaps without thinking about it in this way, I have been counseling smokers for many years with great success apparently using a similar approach.

1. I present convincing evidence that smoking is not an addiction; indeed it is quite easy to stop without significant withdrawal which takes away the biggest excuse leading to failure.
2. The likelihood of premature death from vascular disease is very high in smokers and is totally reversible. I spell this out with convincing medical data.
3. The emphysema, coughing, social ostracism, disappointment from the children, cost et al are already known by all, but it doesn't hurt to remind smokers.
4. I insist they go public telling everyone that as of this date, I am stopping smoking. This puts positive pressure (like the KKK donation) on yourself to succeed.
5. There are a bunch of small specific steps which enhance the likelihood of success which I will not spell out here, but know that the likelihood of success with this approach exceeds 90%.
6. I tell them they need to have a conversation with themselves in which they tell themselves that "I no longer smoke and I mean it!" Indeed, if you make that commitment to yourself, you indeed are no longer a smoker.
7. You must stop "cold turkey" and please don't take nicotine gum, patches, or drugs. You must get all the nicotine out of your system and keep it out for a period of 2-3 weeks to be home free. Weaning or using substitutes keep nicotine in your system during your peak motivation period and will almost certainly negate your good effort.

Dr. Gerald Evans is an experienced and accomplished cardiologist who practiced for many years in the town of Framingham Massachusetts, the site of the famed Framingham Heart Study. Dr. Evans has spent the last decade after a successful practice teaching heart health especially to promote workplace wellness and founded his organization, Heart Ventures, to promote cost effective, educational programs for consumers to learn more about how to take care of their heart health. He will be a regular contributor to our newsletter in the section titled: Heart Beat.