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

Summary

该视频探讨了戒烟的过程,强调它是一个需要时间和努力的旅程,提供了有价值的建议帮助吸烟者成功戒烟。

Takeaways

• 😀 Quitting smoking is a challenging journey that often involves relapse before achieving success.
• 😀 Understanding the stages of change can help determine where a smoker is at in their quitting process.
• 😀 Nicotine is highly addictive and smoking triggers are often linked to routines.
• 😀 Willpower alone has low smoking cessation success rates - additional support and tactics work better.
• 😀 Perceived difficulty in quitting is often greater than reality.
• 😀 Medications and nicotine replacement therapy can double quit success rates.
• 😀 Behavioral interventions and support resources also help with smoking cessation.
• 😀 Preparing for triggers, stressors and withdrawals makes quitting smoother.
• 😀 Relapse is common and should not prevent trying again.
• 😀 Quitting smoking has huge health benefits and is absolutely worth the effort.

Q & A

戒烟是一个什么样的过程?

戒烟对许多人来说是一个长期的过程,会经历反复的戒烟和复吸。这更多地与一个人与自我的关系有关,而不仅仅是与香烟的关系。

为什么青少年认为他们会在20多岁时戒烟?

大多数开始吸烟的青少年认为他们会在20多岁时戒烟,但事实上他们直到40多岁才真正成功地戒烟。

改变的两个关键概念是什么?

改变的两个关键概念是你现在的状态和改变的机制。我们需要考虑这一改变对你的重要性,以及你对成功进行这一改变的自信度。

戒烟中需要改变哪些方面?

戒烟需要改变的不仅仅是停止吸烟这一行为。例如改变生活习惯、避免某些场所、找到其他让自己分心的事情等,都是支持成功戒烟的重要措施。

吸烟与减压有关吗?

吸烟实际上不能减轻压力,它只是暂时满足了尼古丁的需求。吸烟会增加心率、血压等,这些都是压力的表现而不是压力减轻。

戒烟会增加体重吗?

戒烟后的平均体重增加大约2.5公斤。尽管担心体重增加也许合理,但与吸烟带来的健康损害相比,这点体重变化可以忽略不计。

有哪些戒烟药物可供选择?

常见的戒烟药物有尼古丁替代疗法、贝拉旋片(也称为尼禄定)和西那曲罗。这些药物与行为干预结合使用,可以使成功戒烟的机会翻倍。

行为干预有哪些?

行为干预包括短信支持、专家辅导、与其他戒烟者交流等。准备充分并利用这些资源,可以大大提高戒烟成功率。

刚戒烟时会出现哪些症状?

刚戒烟时常见的戒断反应包括渴求、头痛、紧张、易怒、睡眠问题和食欲增加等。这都是尼古丁依赖严重的表现。

如何应对戒烟后复吸的情况?

复吸不是失败,而是戒烟过程的一部分。不要感到内疚,而要了解自身,做好下一轮戒烟的准备。这个过程需要多次尝试,最终获得成功。

Outlines

00:00

🚬 戒烟是一个旅程

本段主要阐述戒烟是一个长期的过程,需要时间和努力。作者认为,对大多数人来说,戒烟更像是一个反复的过程,会有多次失败和重启。烟瘾的形成与人们获得的愉悦感有关,后来这种愉悦感会被烟瘾所替代。作者还提出戒烟需要考虑的两个关键概念:当前状态和改变的机制。需要诚实评估自身的决心和自信心。作者的角色是提供帮助和支持。

05:02

🍬 体重问题也不可怕

本段讨论了戒烟后体重增加的问题。研究表明,戒烟后平均会增重2.5公斤。作者建议,如果担心体重问题,可以采取一些措施控制热量摄入和消耗。更重要的是要从健康的角度考虑,戒烟的健康收益远大于体重增加的影响。戒烟后,可以培养些健康的生活习惯,建立积极的人际关系,以帮助成功戒烟。

10:05

💪 坚持不懈 戒烟路上再起航

本段总结了戒烟后的注意事项。首先,表扬已经成功戒烟的人。其次,戒烟初期会出现一些身体症状,需要有心理准备。最后,作者引用日本谚语“七摔八起”来鼓励大家,即使失败也不要气馁,而要吸取教训,重新出发。需要学习自己并为下一次戒烟做好准备。

Keywords

💡journey

The video compares quitting smoking to a journey, with different stages and setbacks along the way. It emphasizes that for most people it is a long, winding path rather than a quick transition.

💡stages

There are different stages of change in quitting smoking: pre-contemplation, contemplation, preparation, action, and maintenance. Understanding which stage someone is in can help guide treatment approaches.

💡relapse

Many people go through cycles of quitting smoking and relapsing. Relapses are seen as common events along the journey and do not mean failure.

💡withdrawal

When someone stops smoking, they go through nicotine withdrawal leading to cravings and symptoms like headaches and irritability. Preparing for this can help cope with it.

💡triggers

There are often specific triggers associated with smoking, like coffee or drinking alcohol. Identifying personal triggers and making plans to avoid or manage them is key.

💡medications

Medications like nicotine replacement therapy or prescription pills can help manage cravings and double chances of successfully quitting smoking.

💡counseling

Getting individualized behavioral counseling and support can improve the chances of quitting smoking for good.

💡stress

Stress and avoiding high stress situations early on is important for maintaining smoking cessation.

💡acceptance

Accepting stressors that cannot be controlled, rather than fighting them, can help prevent relapse when facing challenges.

💡resilience

Having resilience and not giving up after slips or setbacks is crucial to ultimately achieving smoking cessation.

Highlights

Quitting smoking is a journey, often a long one with a cycle of quitting and relapse.

Most teens who smoke think they'll quit in their 20s but end up not quitting until their 40s.

Stopping smoking involves understanding where you are in the change process, from pre-contemplation to maintenance.

About 75% of smokers want to quit, but 25% are not interested at all.

The mechanics of change include understanding what to change and why, and the skills required for change.

Nicotine addiction is a powerful force, with cigarettes providing temporary relief from withdrawal symptoms.

Smokers often have to deal with multiple triggers and need strategies to handle them.

Nicotine replacement therapy (NRT) and medications can double the chances of quitting successfully.

Behavioral interventions and support resources are crucial for quitting smoking.

Expect ups and downs during the quitting process, including nicotine withdrawal symptoms.

Success in quitting smoking often involves multiple attempts and learning from each experience.

The Japanese proverb on success emphasizes the importance of perseverance: falling down seven times and getting up eight.

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