University Times

You’ve resolved to extinguish that pack-a-day smoking habit. And to lose that extra 15 pounds. You want to be more organized, efficient, fiscally restrained and pleasant…all at the same time. Although it’s common knowledge that most of us will break our New Year’s resolutions, several Pitt researchers say you should direct your motivation wisely instead of squandering it on the implausible.

“These are the sorts of things we think about all year,” said Saul Shiffman, a professor of psychology who heads up Pitt’s smoking research group. “This is an occasion to be motivated or focused and that’s a good thing.”

Just wanting to make a change isn’t good enough. “Even though you have a will, you still need a way,” said Shiffman, quoting a colleague. Behavioral change is difficult, requiring more than a Band-Aid, demanding a permanent lifestyle change.

Mark Twain explains the process of willful change in “The Tragedy of Puddin’Head Wilson” as: “Habit is habit, and not to be flung out the window by any man, but coaxed downstairs a step at a time.”

According to Frank Ghinassi, chief of adult services at Western Psychiatric Institute and Clinci, “There is a cognitive dissonance between what we would like to think we would like to do as opposed to what we are prepared to actually deliver – therein lies the fundamental flaw.”

Say, a cheese-filled crust pizza tempts someone who is counting calories. Unable to resist the Italian pie, the dieter bargains with himself or herself and decides it’s okay to eat it and then proceeds to eat a lot since the resolution to cut calories has been broken. Known as the “abstinence violation effect,” people dichotomize their behavior – either they’re perfect or a failure, according to Ghinassi. “This accounts for the fact that what is a small, stoppable return to an old behavior gets interpreted as complete relapse,” he said. And because of the defeat, some people don’t come back.

We like our habits.

According to Ghinassi, “Habits are comforting, especially in the middle of a frustrating week or a difficult time.” And when indulging in unhealthy habits, people are comfortable and aren’t thinking at the moment what’s happening to, say, their pulmonary system, he said. A person’s long familiarity with the immediate rewards of a bad behavior can seem quite distant from the negative consequences.

Ghinassi suggests that people looking to alter a behavior should keep change limited. “Don’t take on 11 things at once. Pick reasonable goals attainable day to day. ‘I’m going to exercise and eat moderately today and when I get up tomorrow, I’ll decide to do it tomorrow.'” It also helps when you join forces with a friend. “Find other people who struggle with the same things you do – put together a ‘healthy’ lunch group.”

The same philosophy holds for weight loss and exercise programs. “The reason people fail at weight loss is that their expectations are high – they want to lose way more weight faster than what is possible,” said John Jakicic, chair of the Department of Health and Physical Activity in the School of Education. “It’s the American way: We want it quick, easy and in big quantities. It takes years to put on weight and takes some time to take it off.”

For example, if someone wants to shed some pounds, Jakicic suggests reducing food intake by 20 percent. “You can have a plate with 20 percent less food, you can eat one less slice of pizza and a mini Snickers candy bar can be substituted for a larger one – those are sustainable behaviors you can live with.” The same credo applies to exercise. A gym isn’t necessary for a half hour of daily activity. “Give me three 10-minute walks a day. Find opportunities for activity that adds that activity to your life.”

A shift in eating behavior is not a diet – it’s a lifestyle change, according to Jakicic. “Weight loss has to be maintained,” he said. “You have to have the mentality that you’re not going back. Once you get yourself outside of that size 16 dress, get rid of it. Then move on to doing the same with the size 14 wardrobe.”

Jakicic also recommends self-empowerment. “No one will change your bad behaviors for you. If you take this to heart, you will be successful. It’s all about ownership.”

To quit smoking, a series of changes with lots of planning are necessary – in addition to the discomfort of giving up the cigs, according to Frank Vitale, director of Pitt’s international smoking cessation specialists program. “Just like learning anything else, you need the right knowledge, skills, a plan and a good teacher,” he said.

Smoking is a learned behavior. “Smokers smoke more than anything they’ve done in their life – it’s connected to situations,” Vitale said. Breaking the connections permanently requires new behaviors such as brushing one’s teeth after a meal instead of lighting up or drawing deep breathes, he said. The coping methods taught in Vitale’s program either change how people think about a habit or change what they do.

Shiffman and Vitale suggest that smokers quit through behavior change AND a medication, such as nicotine patch, gum or lozenges. “The drugs cut down on withdrawal – it keeps you calm enough to make the behavioral changes,” Vitale said.

Whether it’s eating less, exercising more, quitting smoking or peeling back an irritating habit, Shiffman recommends a six-step program:

-It’s good to solidify your motivation by reminding yourself why you want to make a change. Think about how bad smoking is for you and how much better you’ll look or feel. Support your motivation – think about the change you want to make, write it down or re-read that news article that inspired you.

-Turn your aspirations into specific goals with time limitations. For example, if you want to be more organized, you want to more organized THIS YEAR. Smokers looking to quit have to pick a target date for quitting. Smokers can cut down how much they smoke, but ultimately they want to set a goal to quit so they don’t wander in the wilderness of reduction too long.

-Develop a plan. “How am I going to do this?” With smoking cessation, quitters should build medications into the plan.

-Prepare yourself. If you plan to use medications to stop smoking, buy them in advance. Changing your eating habits? Then stock your home with the foods that you need.

-Get support. We all do better when we have people helping us. For a weight loss program, a Weight Watchers program may be good for support. A less formal approach includes just talking about your plan to family and friends.

-Stick with it. New year’s resolutions capitalize on a peak in motivation — that’s good. But any behavioral change takes time to work.

-Mary Ann Thomas