I Keep a Pack of Cigarettes in My Office.

It was a gift from a patient who decided, after nearly 20 years of my encouraging, cajoling, and quite frankly nagging, that it was finally time to give them up.  That’s the thing about changing habits. Sometimes it takes a long time.

We have different ways of understanding how people approach change. One of the most universally used is something we call “the stages of change.” People move from not being willing to even consider the downsides of their current habits, to seeing those downsides and weighing the advantages of a change, to making plans to develop new behaviors, and then to actively practicing these new habits. From my perspective, “practice” is the often under emphasized concept there. Developing new habits, and breaking old ones, takes lots and lots of practice.

Whatever your goal is— becoming a non-smoker, losing weight, completing your first marathon, or even cleaning out your garage— it helps to have a concrete plan of action. Expect setbacks. I like to tell my patients that babies don’t learn to walk overnight. First, they roll, then they sit, then they crawl, then they cruise along the furniture, and finally they take those first unsteady steps. It takes them about a year to get to that point. Along the way, they fall, a lot. But they keep getting back up to try it again, and in what seems like the blink of an eye, they start running away from you at bedtime.

There are some take home lessons in that story. First, change is a process. A daunting challenge is more approachable if you break it down into smaller, incremental steps. “Getting healthy” is hard. Getting to bed half an hour earlier is easier. Second, consider yourself a learner. I love to encourage smokers not to think of it as quitting smoking, but as learning to be a non-smoker. If you are quitting, and you have a cigarette with your coffee, it’s tempting to decide you’ve failed and throw in the towel. If you view it instead as learning not to smoke, it’s easier to finish that cigarette, and try again.

​Learners aren’t failures when they haven’t mastered their topic. If you smoke that cigarette, ask yourself “why?” And then ask yourself, “what can I do instead, next time?” Keep asking yourself those questions. Keep getting back up. Keep trying again.

Tenacity pays off. I have a pack of cigarettes to prove it.

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