May
18
I have a rule. I don’t do smoking cessation work with people whose families want them to stop smoking.
I only do it with people who, themselves, personally, want to stop smoking.
I learned this after two unsuccessful experiences with clients in their 20s who were booked in, and brought along, by their mothers. The young man was pretty clearly just there because it was the path of least resistance; the young woman, I think, wanted to be able to say to her mother that she’d tried and it hadn’t worked (so that her mother would shut up about it).
Neither of them were motivated to change for themselves. It wasn’t a priority for them, it wasn’t important to them, and they didn’t really believe they could do it anyway.
So if someone rings up on behalf of their son, daughter, partner, mother, father, brother, sister or friend, I politely turn them away, because the outcome’s not going to be good for anyone. It’s like trying to teach a pig to sing. You waste your time, it annoys the pig, and the farmer thinks you’re a bad singing teacher.
 photo credit: The Pug Father
But if there’s a change you’ve been thinking about, and wondering about, but just not doing anything about, you’re not stuck with your current level of motivation for change. Here’s how you can increase it, by working on the three elements of motivation: Ready, Willing and Able.
Ready
Readiness to change is about priority. If the need to change isn’t taking up a big slice of your mental landscape compared to everything else that’s going on, it’s not going to get the resources it requires. This is why it’s almost impossible to sell prevention, but easy to sell rescue: People in need of rescue are highly focussed.
photo credit: Tim Green aka atoach
One of the most successful methods of stopping smoking is to be told by a cardiologist, when you have just had a heart attack, that you are definitely going to die if you don’t. Being told exactly the same thing when you’re feeling perfectly healthy just doesn’t have the same impact.
It’s sad but true that you often won’t be ready to change until the need for change looms in your view like an elephant you’re about to hit with your car.
How to be more ready: Start to make your desired change more prominent in your life. Leave pictures lying around, or pin them on a bulletin board, that remind you about it. Subscribe to (and read or listen to) blogs, podcasts and mailing lists that talk about it. Get books about it.
Sit down for a few minutes, close your eyes to screen out distractions, and think about it for a few minutes. Bring the most vivid sensory imagination and the most intense emotion you can into play and attach them to the change you want to make. Picture yourself after the change.
photo credit: Valerie Everett
Willing
Willingness to change is about importance, which is different from priority. A change can be important without being high-priority. It’s important that I get my tax done soon, but it’s not high priority, which means it keeps getting bumped by other things that are.
“It’s not really that bad.” Those are the words that stifle the impulse to change. Even if we don’t like our current life, we may put up with it rather than change, because change can be uncomfortable and require energy.
How to be more willing: The question to ask is: What are your highest goals, and how does this change serve them?
Think about the benefits of the change. How does it take you closer to being the person you want to be?
Think about the benefits of the benefits.
Keep thinking (and write them down) until you get to the heart of the matter: If you make this change your life will be better than it is now. The change will be worth it.
Or maybe you’ll conclude that it won’t. If the shoe don’t fit, it ain’t your shoe.
photo credit: chaosinjune
Able
Finally, you can be convinced that change is important, you can have it as a high priority – but if you don’t have a basic confidence that it’s possible, you’re unlikely to start.
The thing is, too, you can actually have the potential to change without realising it. If you think you can’t change, you’re right. But if you think you can change – and have a realistic plan and possibly some support to do so, because hope is not a strategy – you’re probably right about that, as well.
This is the part of the motivation process that most people find hardest, and it feeds back into the other two. If you don’t think you can do something, trying is not going to be a priority, and you’re going to convince yourself it’s not that important.
How to be more able: Having a plan – any plan – is better than having no plan. Even if you abandon the plan for a better one once you’re underway. You can’t steer if you’re not moving.
photo credit: Andre Charland
And there are very simple, very accessible skills that anyone can master which put change within your reach (and help you to focus on it and make it important and a priority).
Here’s my suggestion. If you don’t have a plan yet, sign up for my free course, Seven Steps to a Personal Change Plan.
And if you’ve already done that course, or you know what change you want to make but aren’t sure how to get moving, get focussed and succeed, sign up for my cheap course, Change Your Mind. It shows you a simple, step-by-step process for achieving your goals – and I’ve just added a new bonus: an ebook which reveals seven top techniques and tells you exactly how to use them to work on 12 very common real-life issues. It’s still just $29, though (NZD, so even less in the rest of the world).
You can increase your motivation and change your life for the better by working on these three elements: becoming ready, willing and able.
Technorati Tags: motivation, personal change, self-efficacy, confidence
Sign up below to get early notification and a discount on my forthcoming book, How Not to Change Your Life.
May
4
Today I was going to begin a series on motivation – and I kind of am. I want to talk about the recently-announced tobacco tax increases in Australia and New Zealand, what they mean for motivation to stop smoking, and how that relates to motivation to change in general.
To give you the background, Australia has announced a tax increase on cigarettes of 25%, effective last Friday (30 April 2010), while New Zealand has put in the first of three 10% rises effective 29 April 2010, with the other two to follow in January 2011 and early 2012.
photo credit: namestartswithj89
There’s been some predictable political posturing from the neoconservative ACT party in NZ, three of whose four members were the only ones to vote against the bill in the multi-party parliament. One of them, Sir Roger Douglas, brought out the rhetoric of “individual responsibility” and “individual freedom”, pointed out that it would disproportionately impact the poor (not usually a consideration for ACT, most of whose proposals would disproportionately advantage the rich), and referred to what he called an “‘I know what’s best for you’ mentality”. The Libertarianz, a political party not in Parliament, went further:
The taxes on tobacco already cover the costs of health care caused by smoking related illness, so this is simply an extraordinarily urgent sin tax – a punishment for doing things that don’t hurt anyone but which Nanny State doesn’t like you doing.
The Libertarianz Party believes it is not the government’s job to moralise about what people do in their spare time. The government’s job is to defend and uphold individual rights – including the right for New Zealanders to make choices that may be unhealthy for them, but which they should have the freedom to make all the same.
I tend to agree with the Libertarianz in their basic philosophical idea, that when it comes to government less is generally more. It’s only when they start making thick-headed applications of it (which happens almost immediately) that I part company with them.
What this talk about “individual choice” and “freedom” doesn’t take into account is that nicotine, the addictive component of tobacco, has a direct effect on the human brain’s motivational pathways. It’s one of the most addictive of all drugs – only methamphetamines addict a higher proportion of first-time users, and the failure rate for quitting without help is 95%. Most people who smoke start when they are teenagers, when their capacity for good judgement is not yet fully developed (brain areas which deal with judgement and principled choice continue to develop until the mid-twenties). Smoking is not the unconstrained free choice for mostly harmless pleasure that neoconservative and libertarian political thinkers depict.
photo credit: goldsardine
Smokers are highly motivated to keep smoking. Not only does nicotine reinforce the behaviour directly, but stopping is difficult and unpleasant for many people (particularly without help). On the other hand, there is motivational power in increasing the cost of cigarettes – and more motivational power for those for whom the cost of cigarettes represents a larger proportion of their disposable income, that is, young people and low-income adults. If anyone still doubts that raising prices “doesn’t really work”, there’s statistical evidence in an increase in calls to the Quitline – a bigger increase than when graphic advertisements about the harm of smoking were introduced in 2008, and comparable to the response to the last major price rise, in 2000.
As the Action on Smoking and Health director Ben Youdan pointed out (some time before the 10% increase was announced), there is positive economic justification also:
Half of smokers die from tobacco use, many in middle age. Combined with debilitating illness, these people lose the ability to earn and this has far greater economic impact. Based on a 20 percent increase the additional cost to non-quitters would be around $200m per annum. The economic value of the health gains from people quitting and not dying is $3bn.
photo credit: pfala
Now, I’ve mentioned the flaws in the conservative posture that people’s choices should be unconstrained by government policy because they are completely free to choose to behave healthily, and it should be their right to behave unhealthily if they want to. Health choices are complex and not at all unconditioned, especially for those with few resources. I personally don’t have a problem with the government adding a counterbalancing condition to move people in a direction which is advantageous for them and for society as a whole (which pays the cost of ill health in multiple ways besides the obvious direct costs of health care).
For the sake of balance, though, I should mention that from the rhetoric of some liberal thinkers and policymakers, you would think that people’s choices are wholly conditioned (and therefore they are complete victims of their environment). I don’t believe that’s the case either. If it were so, instead of 36% of people in the most deprived tenth of NZ society smoking, it would be 100% (and for that matter, presumably it would be 0%, rather than 11%, in the least deprived tenth). Clearly, people’s resources and their social environment do strongly influence and condition their choices, and one of the tasks of government, I believe, is to change that situation for the better so that people are genuinely more free. But it’s not solely, or even mainly, up to the government; people are capable of making some free choices even in a very conditioned environment (read Man’s Search for Meaning, by concentration camp survivor Victor Frankl, if you think otherwise).
photo credit: left-hand
I’ve gone unusually political there, and I’m sure pushed some people’s buttons. Politics, after all, is usually conducted by emotions. Rant at me in the comments, I don’t mind. But the point I’m coming to is this: If anyone could just stop smoking any time they liked, there’d be no need for stop-smoking services, and 300,000 New Zealanders wouldn’t fail in their attempts to stop smoking every year. (Fail twice in the year, on average.) And 235,000 smoking New Zealanders wouldn’t say that, if they had their lives over again, they would not choose to smoke.
On the other hand, if individuals have no power at all to choose and change, then there’d be no point in stop-smoking services, and they wouldn’t double, triple or quadruple the chance of success (which they do).
I don’t believe either of those extremes, which is why I created my free ebook, How to Stop Smoking. Download it if you want to get started on some tax avoidance.
photo credit: Hamed Saber
Basically I’ll be taking the findings of a recent study on smoking cessation and other things I know about motivation, change and the challenges smokers face in stopping, and packaging it into an accessible online course called Smokefree Life. Part of the accessibility will be the price – I’m going to sell it at about the price of two packets of cigarettes, with a promise: If you follow my system and don’t save more money on cigarettes than you spent on the course, I’ll give you a full refund.
Next week, I’ll talk about being ready, willing and able to change. The week after, I plan to discuss ambivalence. (I think. Probably.) And I’ll round out the series at the end of May with a post on how to increase your motivation for positive change.
(If you’re on my mailing list, by the way, your monthly free resource this week is an online decision analyzer – so motivation, decision and change is the big theme for May.)
Technorati Tags: smoking, government policy, motivation, personal change
Sign up below to get early notification and a discount on my forthcoming book, How Not to Change Your Life.
Nov
29
Around a million people in New Zealand, almost 24% of the population, currently smoke at least once a month. Let’s say a million to make it easier to translate the percentages into numbers.
The Ministry of Health has just released a report into a 2008 survey around stopping smoking, and while I don’t find the content particularly surprising, the sheer numbers involved are startlingly large.
photo credit: mborowick
So, of those million smokers, about 600,000 have tried to stop smoking in the past 5 years. About 300,000 of these have deliberately stopped smoking for at least 24 hours in the past 12 months, and on average they have tried this twice in those 12 months. Asian smokers were about twice as likely as others to have tried to stop, for some reason, and European people less likely than average. Around 200,000 people stopped smoking for at least a week in the past 12 months.
Of the 300,000 people who tried to stop smoking in the past 12 months, 225,000 did so for their own health, 111,000 because of the cost of smoking, more than 100,000 because they were sick of smoking, and 80,000 because of someone else’s health. Obviously, some people had more than one reason. Significantly more women than men tried to stop smoking because of someone else’s health, which makes sense, since women often try to stop smoking while pregnant or because of their children. This matches pretty closely to the reasons that my stop-smoking clients give me when I ask.
So, how many actually succeeded? Of the 300,000 people who tried to stop smoking, about 19,600 actually did stop and remained smokefree for the 6-12 months prior to the survey. Of these, other research indicates that around 15,000 will never return to smoking. That’s about a 5% successful quit rate in a year.
photo credit: marfis75
Here’s an interesting part to the survey. Current and past smokers were asked about their beliefs and attitudes as well as their behaviours. Based on the results, about 235,000 people in New Zealand are smokers but, if they had their lives over again, they say they would not choose to smoke. And yet, when asked if they agreed with the statement that “Smokers who fail to quit do not really want to quit”, 138,000 agreed and only 120,000 disagreed. They want to stop, they fail to stop, and yet they believe it’s because they don’t really want to. Whatever “really” means.
So what did people do to try to stop smoking? Almost 60,000 used nicotine replacement therapy (NRT). You can get this from the Quitline, from smoking cessation providers like me, from doctors or practice nurses, or over the counter at the supermarket or pharmacy. Through Quitline, smoking cessation providers and doctors, it’s Government-subsidised (it costs $3 to have the prescription filled at a pharmacy); otherwise it costs, I believe, about 10 times that much. About two-thirds of the NRT used was subsidised, indicating that people had had some interaction with a trained provider of some kind, even if only a volunteer on the Quitline. Around 47,000 NZ smokers still believe that NRT is more harmful than smoking cigarettes, though, and about 44,000 believe that it doesn’t improve smokers’ chances of quitting (significantly more women than men believe this). In case you’re wondering, the weight of the evidence is that these people are misinformed.
photo credit: Penningtron
About 36,000 people in their most recent quit attempt used Quitline, more than any other service. Almost 17,000 went to their GP, 14,000 sought help or advice from a friend or family member, over 9,000 from some other healthcare worker apart from their doctor, and 4,500 from a Maori community health worker. (Around 4000 used hypnotherapy, if you look into the spreadsheets that give more detail – more women than men, and almost all in the older agegroups, which fits with my experience, although I have seen some younger women.) About 9,500 used Allen Carr’s book. But about two-thirds of the people who made a recent attempt to stop smoking used no products or advice at all.
Why is this? Well, when asked if they agreed with the statement “People should be able to quit without the help of programmes or products”, a third agreed and half disagreed. Significantly more men than women agreed with the statement, which surprises me not at all. There’s a mismatch between beliefs and behaviour, though. Half of smokers don’t agree that people should be able to stop without help, but two-thirds try to stop without help anyway. That means that at least 10% of smokers are trying to stop without help, even though they say they believe it won’t work.
photo credit: Bibi
They’re probably right, too. All the evidence shows that getting help, advice and support does increase the likelihood that smokers will be successful in stopping. Something which the survey fails to tell us (even in the detailed spreadsheets) is which methods were more successful for those who did stop and remain smokefree, but there’s other research on this: NRT about doubles your chances on average, being in a group is also good, and behavioural advice helps too. According to a 2008 study which I’ve blogged about before (Hypnosis for smoking cessation: A randomized trial), hypnotherapy, well-applied, also increases your chances of a successful outcome.
Hundreds of thousands of people in New Zealand alone try to stop smoking every year. Most of them don’t succeed, and this has to be frustrating, quite apart from the continued expense, the continued health risks and the increasing social isolation that smokers experience. That’s why I created my ebook, How to Stop Smoking. It’s a free download (it does lead on to an inexpensive online course with audio tracks). If you’re struggling to stop smoking, give it a read – it offers advice which is likely to be helpful whatever stop-smoking method you are using.
Technorati Tags: smoking, smoking cessation, quitting, New Zealand, statistics
Sign up below to get early notification and a discount on my forthcoming book, How Not to Change Your Life.
|
