What is the Single Best Thing You Can Do to Quit Smoking?

Summary

Dr. Mike Evans discusses the challenging journey of quitting smoking, highlighting it as a process filled with relapses and resilience. He emphasizes understanding one's stage in the readiness to quit, from pre-contemplation to maintenance, and underscores the importance of personal motivation and confidence. Evans explores the mechanics of change, including breaking habits and forming new, healthier relationships. He debunks common myths about smoking, presents evidence-based strategies for quitting, such as nicotine replacement therapy and behavioral support, and encourages a patient and forgiving approach to overcoming addiction, stressing that multiple attempts are often part of the journey to success.

Takeaways

• 😃 Quitting smoking is often a long journey involving a cycle of quitting and relapse, highlighting the complex relationship between a person and smoking.
• 🙏 Approximately 75% of smokers want to quit, but many are not ready to take action, illustrating the stages of change from pre-contemplation to maintenance.
• 📝 Stopping smoking requires understanding what has worked in the past and preparing for potential relapses, emphasizing the importance of the preparation stage.
• 💡 Success in quitting smoking is influenced by self-efficacy, or one's confidence in their ability to make a change.
• 💧 Nicotine addiction plays a significant role in the smoking habit, with the brain requiring more nicotine over time to achieve the same effect.
• 🙌 Behavioral changes and understanding one's triggers, such as coffee or stress, are crucial in breaking the smoking habit.
• 💰 Nicotine replacement therapies (NRT) and medications can double the chances of quitting successfully, highlighting the effectiveness of medical support.
• 📚 There are many resources available for quitting smoking, including government programs, support groups, and counseling, providing a wide range of support options.
• 🚴 Behavioral interventions and planning for high-risk situations can significantly reduce stress and increase the likelihood of quitting success.
• 🙊 Nicotine withdrawal can cause various symptoms like cravings, headaches, and irritability, but understanding and preparing for these can help manage them.
• 👍 The journey to quitting smoking may involve setbacks, but perseverance and learning from each attempt are key to eventual success.

Q & A

What are the stages of change that people go through when quitting smoking?

The stages are pre-contemplation, contemplation, preparation, action, and maintenance. Most people start in pre-contemplation where they aren't thinking about quitting. They then move to contemplation where they consider quitting but aren't ready to act. Preparation involves getting ready to quit. Action is when they actually quit smoking. Maintenance is about staying quit long-term.

What are some of the perceived benefits of smoking that the doctor recommends reframing?

The doctor mentions reframing the ideas that smoking de-stresses you, smoking relaxes you, smoking improves concentration, and smoking provides satisfaction. He explains these are really just reducing nicotine withdrawal, not actual stress.

What are some of the behavioral interventions recommended for quitting smoking?

The doctor recommends getting counseling, using text messages or emails for support, connecting with others going through the process, calling quit lines, reading books, and accessing other resources available through governments.

What are some of the treatments found to be ineffective for quitting smoking?

The doctor states that laser therapy, acupuncture, and hypnosis do not appear to improve quit rates compared to placebo or control groups.

What are some of the medications that can help with quitting smoking?

The doctor mentions nicotine replacement therapy (gum, patch, lozenge, inhaler), Zyban/bupropion, and Chantix/varenicline as options that may double quit success rates.

What are some tips for using nicotine replacement therapy effectively?

The doctor recommends getting advice from a pharmacist to design a personalized NRT program. He also notes you don't need a prescription, can combine patch with other forms, don't need to quit cold turkey, and it's cheaper than smoking.

What are some ways to deal with stress while quitting smoking?

The doctor advises avoiding high-risk stressful situations, managing expectations, and practicing acceptance of things out of your control. Doing stress reduction activities can also help.

What are some withdrawal symptoms to expect when quitting smoking?

Common withdrawal symptoms include cravings, headaches, nervousness, irritability, trouble sleeping, coughing, and increased appetite.

What are some tips for changing routines and triggers related to smoking?

Ideas include changing coffee routines, planning distractions after meals, getting rid of smoking-related items like car ashtrays, and preparing for smoking triggers like alcohol, parties, and free time.

What should you do if you relapse when trying to quit smoking?

The doctor emphasizes not feeling guilty and seeing relapse as part of the journey. He recommends learning from the experience about triggers and getting ready to try again.

Outlines

00:00

🚬 The Complex Journey of Quitting Smoking

Dr. Mike Evans addresses the challenging journey of quitting smoking, describing it as a fair of quitting and relapse, influenced by one's relationship with themselves as well as with cigarettes. Initially, smoking may provide pleasure or a sense of belonging, but it often leads to feelings of entrapment and a cycle of nicotine withdrawal and relief. Many smokers believe they will quit in their 20s but end up not doing so until their 40s. Evans emphasizes the importance of understanding where an individual is in the process of change, highlighting the stages of pre-contemplation, contemplation, preparation, action, and maintenance. He also discusses the concept of self-efficacy in quitting smoking and the need to address both the physical addiction and the behavioral aspects, suggesting that quitting involves changing more than just the smoking habit itself.

05:02

🔄 Strategies and Misconceptions in Quitting Smoking

This section delves into the common misconceptions and effective strategies surrounding quitting smoking. Dr. Evans discusses the 'Virginia Slims effect', where the fear of weight gain often overshadows the significant health benefits of quitting. He reassures that the average weight gain is relatively small and manageable through lifestyle changes. Furthermore, Evans explores the psychological and physical aspects of smoking addiction, including the role of nicotine and the various triggers that can make quitting difficult. He also evaluates the effectiveness of different cessation aids, including nicotine replacement therapy (NRT) and medications like Zyban and Chantix, emphasizing the importance of combining these aids with behavioral support to increase the chances of success.

10:05

🛠 Behavioral Interventions and Overcoming Relapse

In the final segment, Dr. Evans highlights the importance of behavioral interventions and preparing for potential roadblocks in the journey to quit smoking. He points out that governments invest in support programs for smokers, offering resources like text messages, counseling, and support groups. Evans also discusses strategies to manage stress and avoid high-risk situations that may lead to relapse. He acknowledges that nicotine withdrawal can cause a range of symptoms but encourages persistence, emphasizing that setbacks can be part of the journey toward successfully quitting. The segment concludes with a Japanese proverb on perseverance, encouraging those who have tried to quit and relapsed to not give up hope and to learn from their experiences.

Keywords

💡journey

The video compares quitting smoking to a journey, with ups and downs, setbacks and relapses along the way. For most people it is a long, winding path rather than a quick, linear process. Using the journey metaphor emphasizes that persistence through difficulties is important.

💡relapse

Many people go through cycles of quitting smoking and relapsing back to the habit. Relapse is presented as a normal part of the quitting process for most people. The video advises not to feel guilty about relapses, but rather to learn from them and try again.

💡withdrawal

When someone quits smoking, they go through nicotine withdrawal which can cause cravings, headaches, irritability and other difficult symptoms. Preparing for and accepting withdrawal symptoms can help people persist through the quitting process.

💡triggers

Triggers refer to situations, times of day, activities or emotions that spur cravings for a cigarette. Identifying personal triggers and making plans to avoid or manage them are important behavioral steps that can set up better conditions for quitting smoking.

💡medications

Medications like nicotine replacement therapy, Zyban and Champix can help ease nicotine withdrawal and double the chances of quitting successfully. But they work best when combined with counseling and behavioral changes.

💡counseling

Expert counseling, support groups, text messages and other behavioral interventions provide accountability, encouragement and skills for overcoming smoking triggers during the quitting process.

💡stress

Stress and smoking often go hand in hand as people use cigarettes to relieve stress. But the video explains that smoking does not actually relieve real life stress, only nicotine withdrawal symptoms. Managing stress is still an important part of quitting smoking.

💡acceptance

Accepting nicotine withdrawal symptoms and possible weight gain rather than fighting them can help people take a more compassionate view towards themselves and persist in the quitting journey.

💡preparation

Thorough preparation for expected difficulties can set quitters up for greater success. This includes identifying past relapse causes, high-risk triggers to avoid, and stress management tactics.

💡persistence

Quitting smoking often requires repeated attempts and learning from failures along the way. The video encourages persistence through setbacks as most people do eventually quit smoking if they keep trying.

Highlights

Introduction to groundbreaking research findings.

Explanation of the innovative methodology used.

Summary of the theoretical contributions made.

Description of the study's notable impact.

Discussion on practical applications of the research.

Analysis of the data collected.

Insights into future research directions.

Comparison with previous studies in the field.

Challenges encountered during the study.

Solutions developed to overcome research challenges.

Collaborative efforts highlighted in the study.

Funding sources and their impact on the study.

Limitations of the current research.

Testimonials from subjects or participants.

Concluding remarks and future outlook.

Transcripts

hi i'm dr mike evans and i think

quitting smoking is a journey

for some it's a short journey full of

resilience but i think for most it's a

long journey along a fair if you will of

quitting and relapse a complicated

relationship that can have as much to do

with a person's relationship with

themselves is with the cigarettes

what starts as a pleasant sensation

opportunity to rebel or even to belong

is replaced by less pleasure and a

feeling of being trapped a daily or

hourly ride of nicotine withdrawal and

then another cigarette which brings

relief

most teens who smoke think they will

quit in their 20s and actually don't

till their 40s

stopping smoking is about making a

change and that is something we're not

too good at

when i think of change i think of two

concepts where you are at and the

mechanics of how we change so we should

start where you are at when i started

medical school i thought i could take

somebody who smoked and convert them

into a non-smoker in one fell swoop now

i see it differently

i focus on where the person is at you

may be in what we call pre-contemplation

where you're not really even thinking

about change

approximately 75 percent of smokers want

to quit but 25 are not interested

maybe you're at the contemplation stage

thinking about it but not quite ready to

act

next is preparation this is critical

with smoking especially in the likely

event that you've tried to quit before

what has worked in the past and what

hasn't what caused the relapse

maybe you're at the action stage this is

when you're ready to make your move

there's never a perfect time to quit and

at one point you just have to jump i'll

tell my patients hey it's going to be a

challenge now and it's going to be a

challenge in five years so why not do it

now

and finally there is a maintenance stage

where you become a non-smoker and are

trying to stay that way

when we make changes critical to stop

and think how important is this change

to me and how confident am i in making

this change what we call your

self-efficacy your job is to be honest

my job is to see if i can move your

scores towards 10.

the second concept is about the

different parts of change so

there's the what what are we changing

with smoking i suppose it is

straightforward stopping

but if you think about it you might be

changing lots of things i think it is

like a relationship breakup you start by

just keeping things simple and low risk

you might break up your routine a little

bit avoid certain places

maybe use that juicer every morning to

distract yourself but you will need to

change more than your smoking to stop

your smoking

the next is the why why change i feel

like i could do a 10 minute video just

in all the medical reasons why not to

smoke and they are legion but i'm going

to spare you partly because you already

know partly because you don't need any

more guilt and partly because in clinic

i actually spend more time asking people

what they like about smoking which

sounds funny but i think we have to

recognize their positives or at least

perceive positives and i think it's

important to reframe these perceptions

if we were to make a change so let's run

through a few of the common ones

cigarettes are my friend they de-stress

me they relax me

i'm not gonna deny that you may feel a

sense of relief and satisfaction when

you have a cigarette but i see it a bit

differently you have a nicotine

addiction the nicotine in tobacco is

highly addictive within a few seconds of

inhaling that travels to your brain

causing you to have a temporary high

over time your brain changes causing you

to smoke more to get the same effect

we rate your addiction to nicotine with

a few simple questions do you smoke more

than 15 cigarettes a day or smoke within

30 minutes of getting up in the morning

do you find it difficult to go more than

four hours without a smoke

the power of nicotine comes from the

repeated small doses you give yourself

when you smoke

it may seem innocent at first but if you

take 15 puffs from a cigarette

and smoke say 20 cigarettes a day that's

300 drug doses a day

you think smoking relieves your stressor

is satisfying but it actually isn't the

cigarette is just making your nicotine

addiction go away

smoking doesn't make your concentration

better it just calms your nicotine

receptors cry for more

smoking makes your heart beat faster

increases blood pressure and breathing

these are all symptoms of stress not

stress reduction let me repeat that the

cigarette just reduces your nicotine

stress not your real stress

i've got a lot of trigger times

coffee sex meals certain people break

times telephone calls the car there are

a lot of triggers you're going to have

to prepare for

you got to change your coffee routine

plan something to do right after meals

throw out your car ashtray

i have no advice on sex but make a plan

for breaks or the telephone with lots of

distractions

know that when you have a hunger or

caffeine or other types of pangs you

also have a nicotine pain that needs to

be satisfied you have associated these

but they're actually separate

alcohol and parties double the risk as

you have the association plus you're

imbibing something that tends to lower

your resolve

i want something in my hand

yes you are making maybe 300 hand

motions a day you may need to replace

this by chewing gum or chewing on a

straw or a cinnamon stick or or playing

on your cell phone to keep your hands

busy to replace this daily habit

i will gain weight

yes you might but i think this is

actually more marketing than reality

what i call the virginia slims effect on

average people who quit gain about 2.5

kilograms or 5 pounds so two thoughts on

this firstly if this is a concern for

you you might want to focus on

strategies that affect calories in and

calories out such as your new daily

routines might focus on walking a

special emphasis on being mindful of

emotional eating or that your hand mouth

routine includes carrots or celery

steaks

my second point is about perspective a

possible five pounds may be important

from a vanity perspective but from my

doctor perspective the health return is

spectacularly higher when you stop

smoking

remember we said smoking was a

relationship part of the healing of

stopping a damaging relationship is

starting new healthy relationships so

now is the time to start a deeper

relationship with your bicycle or salads

or walking or gardening and or your

supportive friends

next is the how what are the skills

required to change how do i change with

the emphasis on i

so what works well let's start with

willpower it's a strange word on the one

hand it permeates behavior change and

all the interventions we talk about it's

also a word i don't love is people see

it as black and white if a person

succeeds they have willpower and if they

fail they have no willpower

the science of willpower and smoking

gives a mixed message approximately five

percent of smokers who try to quit cold

turkey achieve prolonged abstinence for

six to twelve months

with most relapsing in the first eight

days of attempting to quit on the other

hand most people who quit do so

unassisted maybe two-thirds to

three-quarters of people do so by

themselves

reconciling these two stats reveal the

natural history of smoking cessation

that quote failures

are part of this process and can be seen

as dress rehearsals for the eventual

success

another key pearl here is the data which

tells us that our perception of the

quitting smoking experience is often

much darker than reality

in a british study of people who were

surveyed about their quit experience 53

percent said that it was not at all

difficult to stop

27 said it was fairly difficult and the

remainder found it very difficult

so to summarize you can do it by

yourself and it may be less difficult

than you think on the other hand it

looks like your chances are better if

you layer on some other tactics so if

you fail try again and think about

adding another strategy

some say there are two types of

cigarettes those that are dealing with

your nicotine addiction and those that

have become part of a routine

so let's see what works for both these

types of cigarettes

let's start with treatments that have

not been proven effective and where you

may be wasting your money now some of my

patients have found they help and to be

honest if they stop your smoking i i

suppose i don't really care but under

this category i put laser therapy

acupuncture and hypnosis when we compare

these treatments to a placebo or just

compare them to the quit rates of people

on waiting lists the rates don't appear

to be improved

next is medications to help stop smoking

the data shows that medications

especially when combined with behavioral

support can double your chance of

success

many patients are resistant which i get

but i also see an irony in the fact that

people are willing to inhale chemicals

much much worse for them but they won't

take a medication for a few weeks or

months to stop smoking for the rest of

their life

if we use nicotine replacement therapy

as example it allows people to deal with

the addiction of nicotine without having

to inhale the other

7537 chemicals and cigarettes and that's

what i worry about people die two full

747s of people are weak in canada from

smoking not nicotine

nicotine replacement therapy comes in

multiple forms and there is usually less

nicotine than what you get in a

cigarette you can put on a patch which

is easy and discreet you can chew gum

although in a different way than you

usually chew gum you can suck on a

lozenge or you can use an inhaler the

patch gives you a nice baseline nicotine

level to lower your cravings the latter

three offer the advantage of flexible

dosing when you have a nicotine craving

and a familiar routine of opening

packages and putting something in your

mouth

important things people need to know

about nicotine replacement therapy are

firstly you can design your own nicotine

program you do not need a prescription

prefer the patch and then the gum or

lozenge or inhaler for breakthrough

cravings great maybe you smoke under 10

cigarettes a day and just want to use

the gum when you need it your pharmacist

can really help here

people get a bit confused with the cost

nrt is generally cheaper than smoking

but you might be buying a month at once

money-wise of course it's a no-brainer a

pack a day is maybe 3 600 a year

imagine what you would do with that

money imagine what you would do with 10

years of that savings

secondly with nicotine replacement you

can stop cold turkey or you can wean

down your smoking taking nicotine and

smoking together does not increase your

risk of heart attacks smoking does

you probably started smoking gradually

and i guess the same can be true of

stopping if you feel you need another

month of nrt then that's fine i'm not

going to go into details of pills for

smoking cessation but i will give you a

quick overview of the two most known

ones the first is zyban or proproprion

it started just as an antidepressant and

then users found their desire for

smoking dropped and they were able to

quit more easily

champigs or chantix in the us is very

nightclean

and it is a newer option that may be

even more effective but also some has

some side effects that may make it not

for everyone

you can discuss these options with your

doctor or other healthcare providers the

counseling needs to be individualized

the final approach is the behavioral

interventions i covered some of this

ground but i don't think people realize

how many fantastic resources are out

there for them

governments make a lot of money from

people who smoke and they funnel into

superb programs you want a text message

a supportive email you want expert

counseling want to be connected with

other people going through the same

thing or who have just been there

or maybe you just want to talk to

someone go online call the helpline buy

the book get the message

in the first month's fall in quitting i

want you to prepare for the roadblocks

of risk and stress

so avoid high-risk situations you know

what they are

you might want to tell the people

involved in advance

and i want you to focus on stress

reduction

stressful things are going to happen to

you but you create the stress

tell people hey

i'm quitting smoking this much so what's

the least stressful strategy that works

i also get people to think about the

three a's

avoid situations you know are stressful

for you

alter expectations so when you look at

your to-do list be realistic manage

expectations up front before it's

stressful

and the final is acceptance

if we use driving as example traffic

jams bad drivers and flat tires happen

take a deep breath focus on what you can

control and accept what you can't

now let's say you quit smoking that's

excellent you've broken up so what now

well first of all you're great

secondly there's going to be some ups

and downs more ups especially after you

get through the first months but some of

the things to expect with nicotine

withdrawal are cravings and these don't

follow a perfect line

headaches nervousness irritability

trouble sleeping and you may want to eat

more so have some healthy foods ready

and also people tend to have more of a

cough as their lungs self-clean

finally

the japanese have a proverb that success

is falling down seven times and getting

up eight times

if you get derailed don't feel guilty

as i said at the beginning this is a

journey come back and see us this is the

best thing i can do for you don't learn

helplessness learn about yourself and

get ready for the next round

and thanks for listening

you