Monday, August 26, 2013

Hidden danger of e-cigarettes

At a recent social event a man seated next to me pulled an e-cig out of his pocket he said, "I hope you don't mind, but this isn't a real cigarette, it's only vapor."
"I guess you don't know what I do for a living?" was my response.
Steve had quit smoking 15 years ago. He had smoked two packs a day and quit cold turkey. Now he was using 8 to 10 cartridges a day in his e-cig.
When I asked why he started using the e-cigarette after having quit smoking so long ago, his answer was-- curiosity. But now Steve is hooked on nicotine again and spending up to $150 a week.
Some people in tobacco control have been endorsing e-cigarettes as "harm reduction" which is when a smoker, who either can't or won't quit smoking, switches to an e-cigarette because it is "less harmful" than smoking regular cigarettes. But for Steve this isn't about reducing his need to smoke but re-starting his addiction to nicotine and someone is making a lot of money off of Steve's addiction.
E-cigarettes are big business, expected to generate $1 to 2 Billion in sales in 2013. The tobacco companies are adding e-cigs to their list of products. But could it be that since over half of all smokers have quit, that a new marketplace is opening up? Former smokers who can be lured back into nicotine addiction with e-cigarettes and teens who would never think of lighting up a cigarette but don't see an e-cigarette as anything but a fad to try.
So while the rate of smoking has been declining over the years and we have made great strides in preventing teens from starting, I think the real hidden danger of e-cigarettes is that we will be seeing a rise in the number of nicotine addicts. Since few double blind studies have been done and currently there are no one regulating the manufacture and marketing of e-cigarettes, is this the next tobacco epidemic or will nicotine be just another "harmless" addiction like caffeine?



Tuesday, August 13, 2013

The ultimate way to increase your willpower to stop smoking forever

Zelda became fast friends with Mary another smoker when they both became members of the Congress of Racial Equality (CORE).  CORE is a civil rights organization which helped organize the March on Washington and ended with Martin Luther King giving his famous "I have a dream" speech. 

After smoking for 30 years Zelda and Mary decided to quit together. While it was difficult, Mary was successful but Zelda was not. Like many smokers, over the years she tried many times to quit but her willpower was not stronger than the temptation to smoke. 

Years later they met up again at conference and Mary said, "Why are you still smoking?"

Zelda didn't have a good answer but Mary's words haunted her for the next few days. When she drove Mary to the airport, Zelda turned to her and said, "If I ever smoke again, I'll write a check for $5000 to the Klu Klux Klan."

She quit cold turkey right then and every time she was tempted to smoke a cigarette, she thought of writing that check to the KKK which was such an abhorrent thought that she never smoked again.
Click here to hear Zelda's story

Zelda gave herself no way out of this deal. This type of action is called a "pre-commitment" which involves making a binding agreement with a huge cost if a temptation is acted upon. Neuroimaging studies on the brain are now showing how pre-commitment is different than willpower and uses different parts of the brain. Click here to read about it.

As any smoker who has tried to quit knows, using willpower alone makes it almost impossible to resist temptation when it pops up. Even with the best of intentions and having good reasons to quit, the long term benefits of becoming smoke-free are not strong enough to overcome that immediate pleasure of smoking a cigarette. Willpower breaks down when an immediate temptation creates that strong impulse or craving to act now by smoking.

Using a functional MRI, we can now see how pre-commitment can help in staying smoke-free. Our brains have a memory and a smoker's brain may recognize that in past experiences willpower has failed to resist temptation and that failure is repeated when faced with a new temptation. But when a smoker has made a pre-commitment and is tempted to smoke, a different part of the brain is used which eliminates this short term temptation. A pre-commitment, or a binding choice becomes an alternative to willpower.

So the trick is to make a deal with yourself that is so horrible that you will do anything to avoid it and tie that commitment to the act of smoking, like Zelda did by imagining writing a $5000 check to the KKK if she smoked even one cigarette.

What deal will you make with yourself? Make the decision to follow through if you do smoke and stick to it. Give yourself no way out. Making a pre-commitment may be all you need to stay smoke-free forever.


Monday, August 5, 2013

The Biggest Mistake When Motivating Smokers to Quit

A friend and I were at the park when a young man approached us and said: "Can I bum a smoke?"

My response was, "Boy, did you ask the wrong person. I help smokers trying to quit. Do you know why someone your age shouldn't smoke?"

"Yeah, I know..... cancer.", he said defiantly.

"No that's not why. Smoking is the major cause of impotency. Do you want to be able to have sex for the rest of your life?", I said.

After the young man wandered off, my friend said he disagreed with what I said. He went into great detail of what motivated him to not start smoking when he was young, which was a huge fear of getting lung cancer.

Ask anyone who has never smoked and they can list their reasons for not starting to smoke. This list is always about the consequences of smoking but it is a huge mistake is to think these are the same reasons why people will quit. After all, they have already started smoking--it's too late for prevention.

Never-smokers have never experienced the enjoyment and benefits of smoking so they only look at the consequences. Yet every smoker knows about lung cancer and has already weighed the future, maybe it-won't-happen-to-me consequences against their current enjoyment of smoking. The future threat of cancer won't motivate them to stop.The reasons to quit smoking are totally different than the reasons to not start.

To effectively motivate someone means their reasons to become smoke-free have to be more important than their reasons to continue smoking. Nobody wants to give up something they enjoy unless there is some more important to them. Besides, every time they see their doctor, he listens to their chest and says, "Your lungs sound fine to me."  A smoker hears that statement to mean he isn't at risk for lung cancer.

I knew I only had a few moments with this cigarette-bummer, so I gave him a reason that might be more important than a cigarette because I don't know of any man in his 20's that doesn't think sex is important. I will never know whether my words had an effect on him but I planted a seed because he hesitated  for a very long time before he answered me, "That's what Viagra is for."