[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.67,0:00:03.55,Default,,0000,0000,0000,,>> Hi, I'm Dr. Mike Evans and I\Nthink quitting smoking is a journey.
Dialogue: 0,0:00:04.11,0:00:06.74,Default,,0000,0000,0000,,For some, it's a short journey\Nfull of resilience.
Dialogue: 0,0:00:06.74,0:00:11.12,Default,,0000,0000,0000,,But I think for most it's a long journey, a long\Naffair, if you will, of quitting and relapse.
Dialogue: 0,0:00:11.64,0:00:14.86,Default,,0000,0000,0000,,A complicated relationship that can have\Nas much to do with a person's relationship
Dialogue: 0,0:00:14.86,0:00:16.48,Default,,0000,0000,0000,,with themselves, as with the cigarettes.
Dialogue: 0,0:00:17.39,0:00:21.28,Default,,0000,0000,0000,,What starts as a pleasant sensation, an\Nopportunity to rebel or even to belong,
Dialogue: 0,0:00:21.97,0:00:24.27,Default,,0000,0000,0000,,is replaced by less pleasure\Nand a feeling of being trapped.
Dialogue: 0,0:00:24.88,0:00:29.02,Default,,0000,0000,0000,,A daily or hourly ride of nicotine withdrawal\Nand then another cigarette, which brings relief.
Dialogue: 0,0:00:29.81,0:00:33.36,Default,,0000,0000,0000,,Most teens who smoke, think they will in their\Ntwenties and actually don't until their forties.
Dialogue: 0,0:00:34.27,0:00:38.52,Default,,0000,0000,0000,,Stopping smoking is about making a change\Nand that is something we're not too good at.
Dialogue: 0,0:00:38.52,0:00:40.51,Default,,0000,0000,0000,,When I think of change, I think of two concepts.
Dialogue: 0,0:00:40.63,0:00:43.71,Default,,0000,0000,0000,,Where you are at and the\Nmechanics of how we change.
Dialogue: 0,0:00:44.30,0:00:46.11,Default,,0000,0000,0000,,So, we should start where you are at.
Dialogue: 0,0:00:46.31,0:00:49.66,Default,,0000,0000,0000,,When I started medical school, I thought I\Ncould take somebody who smoked and convert them
Dialogue: 0,0:00:49.66,0:00:51.39,Default,,0000,0000,0000,,into a non-smoker in one fell swoop.
Dialogue: 0,0:00:51.84,0:00:52.89,Default,,0000,0000,0000,,Now I see it differently.
Dialogue: 0,0:00:53.10,0:00:55.23,Default,,0000,0000,0000,,I focus on where the person is at.
Dialogue: 0,0:00:55.35,0:00:57.25,Default,,0000,0000,0000,,You may be in what we call pre-contemplation,
Dialogue: 0,0:00:57.85,0:01:00.37,Default,,0000,0000,0000,,where you're not really even\Nthinking about change.
Dialogue: 0,0:01:00.88,0:01:03.17,Default,,0000,0000,0000,,Approximately 75% of smokers want to quit.
Dialogue: 0,0:01:03.59,0:01:05.35,Default,,0000,0000,0000,,But 25% are not interested.
Dialogue: 0,0:01:06.13,0:01:09.34,Default,,0000,0000,0000,,Maybe you're at the contemplation stage,\Nthinking about it, but not quite ready to act.
Dialogue: 0,0:01:10.10,0:01:11.22,Default,,0000,0000,0000,,Next is preparation.
Dialogue: 0,0:01:11.69,0:01:16.01,Default,,0000,0000,0000,,This is critical with smoking, especially in the\Nlikely event that you've tried to quit before.
Dialogue: 0,0:01:16.15,0:01:17.87,Default,,0000,0000,0000,,What has worked in the past and what hasn't?
Dialogue: 0,0:01:17.98,0:01:19.12,Default,,0000,0000,0000,,What caused the relapse?
Dialogue: 0,0:01:19.75,0:01:21.15,Default,,0000,0000,0000,,Maybe you're at the action stage.
Dialogue: 0,0:01:21.69,0:01:23.42,Default,,0000,0000,0000,,This is when you're ready to make your move.
Dialogue: 0,0:01:24.35,0:01:25.63,Default,,0000,0000,0000,,There's never a perfect time to quit.
Dialogue: 0,0:01:25.63,0:01:27.09,Default,,0000,0000,0000,,And at one point you just have to jump.
Dialogue: 0,0:01:27.32,0:01:29.91,Default,,0000,0000,0000,,I'll tell my patients, "Hey,\Nit's going to be a challenge now
Dialogue: 0,0:01:29.91,0:01:31.34,Default,,0000,0000,0000,,and it's going to be a challenge in five years.
Dialogue: 0,0:01:31.34,0:01:32.33,Default,,0000,0000,0000,,So, why not do it now?"
Dialogue: 0,0:01:32.57,0:01:34.74,Default,,0000,0000,0000,,And then finally, there's the maintenance stage,
Dialogue: 0,0:01:34.74,0:01:37.18,Default,,0000,0000,0000,,where you become a non-smoker\Nand are trying to stay that way.
Dialogue: 0,0:01:38.53,0:01:41.02,Default,,0000,0000,0000,,[cheers]. When we make changes\Nit's critical to stop and think,
Dialogue: 0,0:01:41.13,0:01:42.72,Default,,0000,0000,0000,,how important is this change to me?
Dialogue: 0,0:01:42.72,0:01:45.22,Default,,0000,0000,0000,,And how confident am I in making this change?
Dialogue: 0,0:01:45.60,0:01:47.19,Default,,0000,0000,0000,,What we call your self-efficacy.
Dialogue: 0,0:01:47.61,0:01:48.72,Default,,0000,0000,0000,,Your job is to be honest.
Dialogue: 0,0:01:48.72,0:01:51.24,Default,,0000,0000,0000,,My job is to see if I can\Nmove your score towards ten.
Dialogue: 0,0:01:53.88,0:01:56.47,Default,,0000,0000,0000,,The second concept is about\Nthe different parts of change.
Dialogue: 0,0:01:56.47,0:01:58.08,Default,,0000,0000,0000,,So, there's the what.
Dialogue: 0,0:01:58.58,0:01:59.31,Default,,0000,0000,0000,,What are we changing?
Dialogue: 0,0:01:59.51,0:02:01.85,Default,,0000,0000,0000,,With smoking, I suppose it is\Nstraight forward, stopping.
Dialogue: 0,0:02:02.59,0:02:04.87,Default,,0000,0000,0000,,But if you think about it, you\Nmight be changing lots of things.
Dialogue: 0,0:02:04.87,0:02:06.90,Default,,0000,0000,0000,,And I think it is like a relationship breakup.
Dialogue: 0,0:02:06.90,0:02:09.20,Default,,0000,0000,0000,,You start by just keeping\Nthings simple and low risk.
Dialogue: 0,0:02:09.20,0:02:11.09,Default,,0000,0000,0000,,You might breakup your routine a little bit.
Dialogue: 0,0:02:11.40,0:02:12.77,Default,,0000,0000,0000,,Avoid certain places.
Dialogue: 0,0:02:13.28,0:02:15.62,Default,,0000,0000,0000,,Maybe use that juicer every\Nmorning to distract yourself.
Dialogue: 0,0:02:15.87,0:02:19.16,Default,,0000,0000,0000,,But you will need to change more than\Nyour smoking, to stop your smoking.
Dialogue: 0,0:02:21.31,0:02:22.34,Default,,0000,0000,0000,,The next is the why.
Dialogue: 0,0:02:22.77,0:02:23.43,Default,,0000,0000,0000,,Why change?
Dialogue: 0,0:02:23.94,0:02:26.38,Default,,0000,0000,0000,,I feel like I could do a ten-minute video just
Dialogue: 0,0:02:26.38,0:02:28.82,Default,,0000,0000,0000,,on all the medical reasons why\Nnot to smoke and they are legion.
Dialogue: 0,0:02:28.82,0:02:29.83,Default,,0000,0000,0000,,But I'm going to spare you.
Dialogue: 0,0:02:30.06,0:02:31.52,Default,,0000,0000,0000,,Partly because you already know.
Dialogue: 0,0:02:31.71,0:02:33.25,Default,,0000,0000,0000,,Partly because you don't need anymore guilt.
Dialogue: 0,0:02:33.25,0:02:36.78,Default,,0000,0000,0000,,And partly because in clinic, I actually\Nspend more time asking people what they
Dialogue: 0,0:02:36.78,0:02:37.84,Default,,0000,0000,0000,,like about smoking.
Dialogue: 0,0:02:38.10,0:02:39.64,Default,,0000,0000,0000,,Which sounds funny, but I think we have
Dialogue: 0,0:02:39.64,0:02:42.48,Default,,0000,0000,0000,,to recognize there are positives\Nor at least perceived positives.
Dialogue: 0,0:02:42.48,0:02:46.05,Default,,0000,0000,0000,,And I think it's important to reframe these\Nperceptions, if we are to make a change.
Dialogue: 0,0:02:46.05,0:02:47.97,Default,,0000,0000,0000,,So, let's run through a few of the common ones.
Dialogue: 0,0:02:48.75,0:02:49.95,Default,,0000,0000,0000,,Cigarettes are my friend.
Dialogue: 0,0:02:50.16,0:02:51.09,Default,,0000,0000,0000,,They destress me.
Dialogue: 0,0:02:51.31,0:02:52.12,Default,,0000,0000,0000,,They relax me.
Dialogue: 0,0:02:52.12,0:02:55.58,Default,,0000,0000,0000,,Hmm, I'm not going to deny that\Nyou may feel a sense of relief
Dialogue: 0,0:02:55.58,0:02:57.32,Default,,0000,0000,0000,,and satisfaction, when you have a cigarette.
Dialogue: 0,0:02:57.74,0:02:58.90,Default,,0000,0000,0000,,But I see it a bit differently.
Dialogue: 0,0:02:59.09,0:03:00.33,Default,,0000,0000,0000,,You have a nicotine addiction.
Dialogue: 0,0:03:00.72,0:03:02.78,Default,,0000,0000,0000,,The nicotine in tobacco is highly addictive.
Dialogue: 0,0:03:02.94,0:03:06.95,Default,,0000,0000,0000,,Within a few seconds of inhaling, it travels to\Nyour brain causing you to have a temporary high.
Dialogue: 0,0:03:07.76,0:03:12.79,Default,,0000,0000,0000,,Over time, your brain changes, causing\Nyou to smoke more to get the same effect.
Dialogue: 0,0:03:12.82,0:03:15.49,Default,,0000,0000,0000,,We rate your addiction to nicotine\Nwith a few simple questions.
Dialogue: 0,0:03:15.52,0:03:17.44,Default,,0000,0000,0000,,Do you smoke more than 15 cigarettes a day?
Dialogue: 0,0:03:17.58,0:03:20.17,Default,,0000,0000,0000,,Or smoke within 30 minutes\Nof getting up in the morning?
Dialogue: 0,0:03:20.30,0:03:23.58,Default,,0000,0000,0000,,Do you find it difficult to go more\Nthan four hours without a smoke?
Dialogue: 0,0:03:24.35,0:03:28.23,Default,,0000,0000,0000,,The power of nicotine comes from the repeated\Nsmall doses you give yourself when you smoke.
Dialogue: 0,0:03:28.90,0:03:33.58,Default,,0000,0000,0000,,It may seem innocent at first, but if you\Ntake 15 puffs from a cigarette and smoke, say,
Dialogue: 0,0:03:33.58,0:03:36.38,Default,,0000,0000,0000,,20 cigarettes a day, that's\N300 drug doses a day.
Dialogue: 0,0:03:37.13,0:03:39.44,Default,,0000,0000,0000,,You think smoking relieves\Nyour stress or is satisfying.
Dialogue: 0,0:03:39.44,0:03:40.38,Default,,0000,0000,0000,,But it actually isn't.
Dialogue: 0,0:03:40.38,0:03:43.06,Default,,0000,0000,0000,,The cigarette is just making\Nyour nicotine addiction go away.
Dialogue: 0,0:03:43.67,0:03:45.62,Default,,0000,0000,0000,,Smoking doesn't make your concentration better.
Dialogue: 0,0:03:46.11,0:03:48.58,Default,,0000,0000,0000,,It just calms your nicotine\Nreceptors cry for more.
Dialogue: 0,0:03:49.62,0:03:51.36,Default,,0000,0000,0000,,Smoking makes your heart beat faster.
Dialogue: 0,0:03:51.46,0:03:53.64,Default,,0000,0000,0000,,Increases blood pressure and breathing.
Dialogue: 0,0:03:53.86,0:03:56.45,Default,,0000,0000,0000,,These are all symptoms of\Nstress, not stress reduction.
Dialogue: 0,0:03:56.92,0:03:57.77,Default,,0000,0000,0000,,Let me repeat that.
Dialogue: 0,0:03:58.42,0:04:00.95,Default,,0000,0000,0000,,The cigarette just reduces your\Nnicotine stress, not your real stress.
Dialogue: 0,0:04:05.93,0:04:07.40,Default,,0000,0000,0000,,I've got a lot of trigger times.
Dialogue: 0,0:04:07.94,0:04:10.89,Default,,0000,0000,0000,,Coffee, sex, meals, certain people.
Dialogue: 0,0:04:11.01,0:04:13.48,Default,,0000,0000,0000,,Break times, telephone calls, the car.
Dialogue: 0,0:04:13.73,0:04:16.09,Default,,0000,0000,0000,,There are a lot of triggers you're\Ngoing to have to prepare for.
Dialogue: 0,0:04:17.02,0:04:18.88,Default,,0000,0000,0000,,You got to change your coffee routine.
Dialogue: 0,0:04:18.88,0:04:21.00,Default,,0000,0000,0000,,Plan something to do right after meals.
Dialogue: 0,0:04:21.08,0:04:22.45,Default,,0000,0000,0000,,Throw out your car ashtray.
Dialogue: 0,0:04:23.11,0:04:25.98,Default,,0000,0000,0000,,I have no advice on sex,\Nbut make a plan for breaks
Dialogue: 0,0:04:26.03,0:04:28.14,Default,,0000,0000,0000,,or the telephone, with lots of distractions.
Dialogue: 0,0:04:29.34,0:04:32.59,Default,,0000,0000,0000,,Know that when you have a hunger or\Ncaffeine or other types of pangs,
Dialogue: 0,0:04:32.59,0:04:35.15,Default,,0000,0000,0000,,you also have a nicotine pang\Nthat needs to be satisfied.
Dialogue: 0,0:04:35.51,0:04:37.78,Default,,0000,0000,0000,,You have associated these,\Nbut they're actually separate.
Dialogue: 0,0:04:38.53,0:04:42.51,Default,,0000,0000,0000,,Alcohol and parties double the\Nrisk, as you have the association.
Dialogue: 0,0:04:42.51,0:04:45.09,Default,,0000,0000,0000,,Plus, you're imbibing something\Nthat intends to lower your resolve.
Dialogue: 0,0:04:46.76,0:04:47.100,Default,,0000,0000,0000,,I want something in my hand.
Dialogue: 0,0:04:49.15,0:04:52.13,Default,,0000,0000,0000,,Yes, you are making maybe\N300 hand motions a day.
Dialogue: 0,0:04:52.59,0:04:57.01,Default,,0000,0000,0000,,You may need to replace this by chewing gum\Nor chewing on a straw or a cinnamon stick.
Dialogue: 0,0:04:57.01,0:05:01.12,Default,,0000,0000,0000,,Or playing on your cellphone, to keep your\Nhands busy, to replace this daily habit.
Dialogue: 0,0:05:02.60,0:05:03.38,Default,,0000,0000,0000,,I will gain weight.
Dialogue: 0,0:05:04.95,0:05:05.62,Default,,0000,0000,0000,,Yes, you might.
Dialogue: 0,0:05:05.69,0:05:08.11,Default,,0000,0000,0000,,But I think this is actually\Nmore marketing than reality.
Dialogue: 0,0:05:08.11,0:05:09.88,Default,,0000,0000,0000,,What I call the Virginia Slims effect.
Dialogue: 0,0:05:10.50,0:05:14.16,Default,,0000,0000,0000,,On average, people who quit, gain\Nabout 2.5 kilograms or five pounds.
Dialogue: 0,0:05:14.70,0:05:15.87,Default,,0000,0000,0000,,So, two thoughts on this.
Dialogue: 0,0:05:16.27,0:05:19.62,Default,,0000,0000,0000,,Firstly, if this is a concern for you,\Nyou might want to focus on strategies
Dialogue: 0,0:05:19.62,0:05:21.42,Default,,0000,0000,0000,,that affect calories in and calories out.
Dialogue: 0,0:05:21.42,0:05:24.01,Default,,0000,0000,0000,,Such as your new daily routines\Nmight focus on walking.
Dialogue: 0,0:05:24.49,0:05:27.13,Default,,0000,0000,0000,,A special emphasis on being\Nmindful of emotional eating.
Dialogue: 0,0:05:27.67,0:05:30.55,Default,,0000,0000,0000,,Or that your hand mouth routine\Nincludes carrots or celery sticks.
Dialogue: 0,0:05:31.10,0:05:32.68,Default,,0000,0000,0000,,My second point is about perspective.
Dialogue: 0,0:05:32.84,0:05:35.91,Default,,0000,0000,0000,,A possible five pounds may be\Nimportant from a vanity perspective.
Dialogue: 0,0:05:36.34,0:05:37.87,Default,,0000,0000,0000,,But from my doctor perspective,
Dialogue: 0,0:05:38.08,0:05:41.19,Default,,0000,0000,0000,,the health return is spectacularly\Nhigher, when you stop smoking.
Dialogue: 0,0:05:41.99,0:05:43.95,Default,,0000,0000,0000,,Remember, we said smoking was a relationship.
Dialogue: 0,0:05:44.15,0:05:46.65,Default,,0000,0000,0000,,Part of the healing of stopping\Na damaging relationship,
Dialogue: 0,0:05:46.65,0:05:48.22,Default,,0000,0000,0000,,is start a new healthy relationship.
Dialogue: 0,0:05:48.77,0:05:52.71,Default,,0000,0000,0000,,So, now it's the time to start a deeper\Nrelationship with your bicycle or salads
Dialogue: 0,0:05:52.71,0:05:55.59,Default,,0000,0000,0000,,or walking or gardening or\Nyour support of friends.
Dialogue: 0,0:05:56.96,0:05:58.03,Default,,0000,0000,0000,,Next is the how.
Dialogue: 0,0:05:58.28,0:06:00.21,Default,,0000,0000,0000,,What do the skills require to change?
Dialogue: 0,0:06:00.21,0:06:02.29,Default,,0000,0000,0000,,How do I change, with the emphasis on I?
Dialogue: 0,0:06:03.31,0:06:04.09,Default,,0000,0000,0000,,So, what works?
Dialogue: 0,0:06:04.09,0:06:05.60,Default,,0000,0000,0000,,Well, let's start with willpower.
Dialogue: 0,0:06:05.91,0:06:06.90,Default,,0000,0000,0000,,It's a strange word.
Dialogue: 0,0:06:06.90,0:06:11.02,Default,,0000,0000,0000,,On the one hand, it permeates behavior change\Nand all of the interventions we talked about.
Dialogue: 0,0:06:11.52,0:06:14.03,Default,,0000,0000,0000,,It's also a word I don't love, as\Npeople see it as black and white.
Dialogue: 0,0:06:14.03,0:06:17.51,Default,,0000,0000,0000,,If a person succeeds, they have willpower\Nand if they fail, they have no willpower.
Dialogue: 0,0:06:18.08,0:06:20.57,Default,,0000,0000,0000,,The science of willpower and\Nsmoking gives a mixed message.
Dialogue: 0,0:06:20.57,0:06:23.49,Default,,0000,0000,0000,,Approximately 5% of smokers\Nwho try to quit cold turkey,
Dialogue: 0,0:06:23.49,0:06:26.03,Default,,0000,0000,0000,,achieve prolonged abstinence\Nfor six to 12 months.
Dialogue: 0,0:06:26.70,0:06:29.49,Default,,0000,0000,0000,,With most relapsing in the first\Neight days of attempting to quit.
Dialogue: 0,0:06:29.49,0:06:32.71,Default,,0000,0000,0000,,And the other hand, most people\Nwho quit, do so unassisted.
Dialogue: 0,0:06:32.74,0:06:35.95,Default,,0000,0000,0000,,Maybe 2/3 to 3/4 of people do so by themselves.
Dialogue: 0,0:06:36.79,0:06:41.28,Default,,0000,0000,0000,,Reconciling these two stats reveal the natural\Nhistory of smoking cessation, that quote,
Dialogue: 0,0:06:41.53,0:06:43.99,Default,,0000,0000,0000,,"failures" are part of this process.
Dialogue: 0,0:06:43.99,0:06:46.92,Default,,0000,0000,0000,,And can be seen as dress\Nrehearsals for the eventual success.
Dialogue: 0,0:06:48.69,0:06:51.54,Default,,0000,0000,0000,,Another key pearl here is the data\Nwhich tells us that a perception
Dialogue: 0,0:06:51.54,0:06:54.71,Default,,0000,0000,0000,,of the quitting smoking experience\Nis often much darker than reality.
Dialogue: 0,0:06:55.67,0:06:58.70,Default,,0000,0000,0000,,In a British study of people who were\Nsurveyed about their quit experience,
Dialogue: 0,0:06:59.05,0:07:02.39,Default,,0000,0000,0000,,53% said that it was not\Nat all difficult to stop.
Dialogue: 0,0:07:02.100,0:07:05.29,Default,,0000,0000,0000,,Twenty seven percent said\Nit was fairly difficult.
Dialogue: 0,0:07:05.29,0:07:07.32,Default,,0000,0000,0000,,And the remainder found it very difficult.
Dialogue: 0,0:07:07.61,0:07:10.24,Default,,0000,0000,0000,,So, to summarize, you can do it by yourself.
Dialogue: 0,0:07:10.24,0:07:12.02,Default,,0000,0000,0000,,And it may be less difficult than you think.
Dialogue: 0,0:07:12.36,0:07:16.32,Default,,0000,0000,0000,,On the other hand, it looks like your chances\Nare better if you layer on some other tactics.
Dialogue: 0,0:07:16.32,0:07:17.56,Default,,0000,0000,0000,,So, if you fail, try again.
Dialogue: 0,0:07:17.56,0:07:19.23,Default,,0000,0000,0000,,And think about adding another strategy.
Dialogue: 0,0:07:20.48,0:07:22.28,Default,,0000,0000,0000,,Some say there are two types of cigarettes.
Dialogue: 0,0:07:22.28,0:07:24.75,Default,,0000,0000,0000,,Those that are dealing with your\Nnicotine addiction and those
Dialogue: 0,0:07:24.75,0:07:26.08,Default,,0000,0000,0000,,that have become part of a routine.
Dialogue: 0,0:07:26.74,0:07:28.100,Default,,0000,0000,0000,,So, let's see what works for\Nboth these types of cigarettes.
Dialogue: 0,0:07:30.76,0:07:33.23,Default,,0000,0000,0000,,Let's start with treatments that\Nhave not been proven affective.
Dialogue: 0,0:07:33.68,0:07:35.28,Default,,0000,0000,0000,,And where you may be wasting your money.
Dialogue: 0,0:07:35.47,0:07:37.74,Default,,0000,0000,0000,,Now, some of my patients have found they help.
Dialogue: 0,0:07:37.74,0:07:41.21,Default,,0000,0000,0000,,And to be honest, if they stop your\Nsmoking, I suppose I don't really care.
Dialogue: 0,0:07:41.65,0:07:45.16,Default,,0000,0000,0000,,But under this category I put laser\Ntherapy, acupuncture and hypnosis.
Dialogue: 0,0:07:45.62,0:07:49.28,Default,,0000,0000,0000,,When we compare these treatments to a placebo\Nor just compare them to the quit rates
Dialogue: 0,0:07:49.28,0:07:51.54,Default,,0000,0000,0000,,on waiting lists, the rates\Ndon't appear to be improved.
Dialogue: 0,0:07:52.27,0:07:54.40,Default,,0000,0000,0000,,Next is medications to help stop smoking.
Dialogue: 0,0:07:55.16,0:07:58.67,Default,,0000,0000,0000,,The data shows that medications, especially\Nwhen combined with behavioral support,
Dialogue: 0,0:07:58.67,0:08:00.31,Default,,0000,0000,0000,,can double your chance of success.
Dialogue: 0,0:08:01.21,0:08:03.25,Default,,0000,0000,0000,,Many patients are resistant, which I get.
Dialogue: 0,0:08:03.67,0:08:05.78,Default,,0000,0000,0000,,But I also see an irony in the\Nfact that people are willing
Dialogue: 0,0:08:05.78,0:08:07.88,Default,,0000,0000,0000,,to inhale chemicals much, much worse for them.
Dialogue: 0,0:08:08.28,0:08:10.71,Default,,0000,0000,0000,,But they won't take a medication\Nfor a few weeks or months
Dialogue: 0,0:08:10.71,0:08:12.45,Default,,0000,0000,0000,,to stop smoking for the rest of their life.
Dialogue: 0,0:08:13.41,0:08:16.80,Default,,0000,0000,0000,,If we use nicotine replacement therapy\Nas an example, it allows people to deal
Dialogue: 0,0:08:16.85,0:08:18.51,Default,,0000,0000,0000,,with the addiction of nicotine, without having
Dialogue: 0,0:08:18.51,0:08:22.37,Default,,0000,0000,0000,,to inhale the other 7,537\Nchemicals in cigarettes.
Dialogue: 0,0:08:22.91,0:08:24.11,Default,,0000,0000,0000,,And that's what I worry about.
Dialogue: 0,0:08:24.27,0:08:29.57,Default,,0000,0000,0000,,People die, two full 747's of people a\Nweek in Canada, from smoking, not nicotine.
Dialogue: 0,0:08:30.91,0:08:33.13,Default,,0000,0000,0000,,Nicotine replacement therapy\Ncomes in multiple forms.
Dialogue: 0,0:08:33.13,0:08:35.64,Default,,0000,0000,0000,,And there is usually less nicotine\Nthen what you get in a cigarette.
Dialogue: 0,0:08:36.30,0:08:38.31,Default,,0000,0000,0000,,You can put on a patch, which\Nis easy and discreet.
Dialogue: 0,0:08:38.31,0:08:41.13,Default,,0000,0000,0000,,You can chew gum, although in a\Ndifferent way than you usually chew gum.
Dialogue: 0,0:08:41.67,0:08:43.87,Default,,0000,0000,0000,,You can suck on a lozenge\Nor you can use an inhaler.
Dialogue: 0,0:08:44.28,0:08:47.40,Default,,0000,0000,0000,,The patch gives you a nice baseline\Nnicotine level to lower your cravings.
Dialogue: 0,0:08:47.68,0:08:50.15,Default,,0000,0000,0000,,The latter three, offer the\Nadvantage of flexible dosing,
Dialogue: 0,0:08:50.15,0:08:51.43,Default,,0000,0000,0000,,when you have a nicotine craving.
Dialogue: 0,0:08:51.83,0:08:55.04,Default,,0000,0000,0000,,And a familiar routine of opening packages\Nand putting something in your mouth.
Dialogue: 0,0:08:55.55,0:08:59.74,Default,,0000,0000,0000,,The important thing people need to know about\Nnicotine replacement therapy are, firstly,
Dialogue: 0,0:08:59.74,0:09:01.44,Default,,0000,0000,0000,,you can design your own nicotine program.
Dialogue: 0,0:09:01.79,0:09:03.02,Default,,0000,0000,0000,,You do not need a prescription.
Dialogue: 0,0:09:03.48,0:09:07.17,Default,,0000,0000,0000,,Prefer the patch and then the gum or lozenge\Nor inhaler for breakthrough cravings?
Dialogue: 0,0:09:07.17,0:09:09.71,Default,,0000,0000,0000,,Great. Maybe you smoke under\Nten cigarettes a day
Dialogue: 0,0:09:09.71,0:09:11.26,Default,,0000,0000,0000,,and just want to use the gum when you need it.
Dialogue: 0,0:09:11.85,0:09:13.61,Default,,0000,0000,0000,,Your pharmacist can really help here.
Dialogue: 0,0:09:14.29,0:09:16.04,Default,,0000,0000,0000,,People get a bit confused with the cost.
Dialogue: 0,0:09:16.04,0:09:19.69,Default,,0000,0000,0000,,NRT is generally cheaper than smoking,\Nbut you might be buying a month at once.
Dialogue: 0,0:09:20.53,0:09:22.23,Default,,0000,0000,0000,,Moneywise, of course, it's a no brainer.
Dialogue: 0,0:09:22.23,0:09:24.71,Default,,0000,0000,0000,,A pack a day is maybe $3,600 a year.
Dialogue: 0,0:09:25.37,0:09:26.89,Default,,0000,0000,0000,,imagine what you would do with that money.
Dialogue: 0,0:09:26.89,0:09:29.53,Default,,0000,0000,0000,,Imagine what you would do with\Nten years of that savings.
Dialogue: 0,0:09:30.40,0:09:34.06,Default,,0000,0000,0000,,Secondly, with nicotine replacement,\Nyou can stop cold turkey
Dialogue: 0,0:09:34.06,0:09:35.77,Default,,0000,0000,0000,,or you can wean down your smoking.
Dialogue: 0,0:09:36.33,0:09:37.88,Default,,0000,0000,0000,,Taking nicotine and smoking together,
Dialogue: 0,0:09:37.88,0:09:40.74,Default,,0000,0000,0000,,does not increase your risk of\Nheart attacks, smoking does.
Dialogue: 0,0:09:40.74,0:09:43.22,Default,,0000,0000,0000,,You probably started smoking gradually.
Dialogue: 0,0:09:43.22,0:09:45.18,Default,,0000,0000,0000,,And I guess the same can be true of stopping.
Dialogue: 0,0:09:45.62,0:09:48.13,Default,,0000,0000,0000,,If you feel you need another\Nmonth of NRT, then that's fine.
Dialogue: 0,0:09:48.13,0:09:51.38,Default,,0000,0000,0000,,I'm not going to go into details\Nof pills for smoking cessation.
Dialogue: 0,0:09:51.38,0:09:53.91,Default,,0000,0000,0000,,But I will give you a quick\Noverview of the two most known ones.
Dialogue: 0,0:09:54.30,0:09:56.13,Default,,0000,0000,0000,,The first is Zyban or bupropion.
Dialogue: 0,0:09:56.80,0:09:58.44,Default,,0000,0000,0000,,This started just as an antidepressant.
Dialogue: 0,0:09:58.44,0:10:01.90,Default,,0000,0000,0000,,And then users found their desire for smoking\Ndropped and they were able to quit more easily.
Dialogue: 0,0:10:02.49,0:10:06.05,Default,,0000,0000,0000,,Champix or Chantix, in the U.S., is varenicline.
Dialogue: 0,0:10:06.05,0:10:10.30,Default,,0000,0000,0000,,It is a newer option that may be even more\Neffective, but also has some side effects
Dialogue: 0,0:10:10.30,0:10:11.87,Default,,0000,0000,0000,,that may make it not for everyone.
Dialogue: 0,0:10:12.57,0:10:15.39,Default,,0000,0000,0000,,You can discuss these options with your\Ndoctor or other healthcare providers.
Dialogue: 0,0:10:15.39,0:10:17.08,Default,,0000,0000,0000,,The counseling needs to be individualized.
Dialogue: 0,0:10:17.93,0:10:20.07,Default,,0000,0000,0000,,The final approach is the\Nbehavioral interventions.
Dialogue: 0,0:10:20.07,0:10:24.86,Default,,0000,0000,0000,,I covered some of this ground, but I don't think\Npeople realize how many fantastic resources are
Dialogue: 0,0:10:24.86,0:10:25.54,Default,,0000,0000,0000,,out there for them.
Dialogue: 0,0:10:26.19,0:10:28.57,Default,,0000,0000,0000,,Governments make a lot of\Nmoney from people who smoke.
Dialogue: 0,0:10:28.57,0:10:30.36,Default,,0000,0000,0000,,And they fell into superb programs.
Dialogue: 0,0:10:30.60,0:10:32.62,Default,,0000,0000,0000,,You want a text message, a supportive e-mail?
Dialogue: 0,0:10:32.96,0:10:35.49,Default,,0000,0000,0000,,You want expert counseling, want to\Nbe connected with other people going
Dialogue: 0,0:10:35.49,0:10:37.76,Default,,0000,0000,0000,,through the same thing or\Nwho have just been there?
Dialogue: 0,0:10:38.50,0:10:39.92,Default,,0000,0000,0000,,Or maybe you just want to talk to someone?
Dialogue: 0,0:10:40.27,0:10:40.93,Default,,0000,0000,0000,,Go online.
Dialogue: 0,0:10:41.09,0:10:41.94,Default,,0000,0000,0000,,Call the help line.
Dialogue: 0,0:10:42.04,0:10:42.61,Default,,0000,0000,0000,,Buy the book.
Dialogue: 0,0:10:42.65,0:10:43.46,Default,,0000,0000,0000,,Get the message.
Dialogue: 0,0:10:44.02,0:10:46.68,Default,,0000,0000,0000,,In the first months following\Nquitting, I want you to prepare
Dialogue: 0,0:10:46.68,0:10:48.55,Default,,0000,0000,0000,,for the roadblocks of risk and stress.
Dialogue: 0,0:10:49.21,0:10:51.06,Default,,0000,0000,0000,,So, avoid high-risk situations.
Dialogue: 0,0:10:51.21,0:10:51.96,Default,,0000,0000,0000,,You know what they are.
Dialogue: 0,0:10:52.28,0:10:54.60,Default,,0000,0000,0000,,You might want to tell the\Npeople involved in advance.
Dialogue: 0,0:10:54.98,0:10:57.03,Default,,0000,0000,0000,,And then I want you to focus\Non stress reduction.
Dialogue: 0,0:10:57.63,0:11:00.46,Default,,0000,0000,0000,,Stressful things are going to happen\Nto you, but you create the stress.
Dialogue: 0,0:11:01.08,0:11:03.55,Default,,0000,0000,0000,,Tell people, "Hey, I'm quitting\Nsmoking this month."
Dialogue: 0,0:11:03.55,0:11:05.73,Default,,0000,0000,0000,,So, what's the least stressful\Nstrategy that works.
Dialogue: 0,0:11:06.11,0:11:08.42,Default,,0000,0000,0000,,I also get people to think about the three A's.
Dialogue: 0,0:11:08.99,0:11:11.14,Default,,0000,0000,0000,,Avoid situations you know are stressful for you.
Dialogue: 0,0:11:12.14,0:11:13.48,Default,,0000,0000,0000,,Alter expectations.
Dialogue: 0,0:11:13.59,0:11:15.72,Default,,0000,0000,0000,,So, when you look at your\Nto do list, be realistic.
Dialogue: 0,0:11:15.99,0:11:18.42,Default,,0000,0000,0000,,Manage the expectations up\Nfront before it's stressful.
Dialogue: 0,0:11:18.72,0:11:20.51,Default,,0000,0000,0000,,And the final A is acceptance.
Dialogue: 0,0:11:21.39,0:11:26.32,Default,,0000,0000,0000,,If we use driving as an example, traffic\Njams, bad drivers and flat tires happen.
Dialogue: 0,0:11:26.32,0:11:26.95,Default,,0000,0000,0000,,Take a deep breath.
Dialogue: 0,0:11:27.47,0:11:28.80,Default,,0000,0000,0000,,Focus on what you can control.
Dialogue: 0,0:11:28.80,0:11:30.81,Default,,0000,0000,0000,,And accept what you can't.
Dialogue: 0,0:11:31.22,0:11:33.89,Default,,0000,0000,0000,,Now, let's say you quit smoking,\Nthat's excellent.
Dialogue: 0,0:11:34.26,0:11:34.89,Default,,0000,0000,0000,,You've broken up.
Dialogue: 0,0:11:34.89,0:11:36.25,Default,,0000,0000,0000,,So, what now?
Dialogue: 0,0:11:36.71,0:11:38.09,Default,,0000,0000,0000,,Well, first of all, you're great.
Dialogue: 0,0:11:38.66,0:11:41.30,Default,,0000,0000,0000,,Secondly, there's going to\Nbe some ups and downs.
Dialogue: 0,0:11:41.30,0:11:43.45,Default,,0000,0000,0000,,More ups, especially after you\Nget through the first month.
Dialogue: 0,0:11:43.52,0:11:46.72,Default,,0000,0000,0000,,But some of the things to expect with\Nnicotine withdrawal are cravings.
Dialogue: 0,0:11:46.72,0:11:48.63,Default,,0000,0000,0000,,And these don't follow a perfect line.
Dialogue: 0,0:11:49.34,0:11:52.25,Default,,0000,0000,0000,,Headaches, nervousness, irritability,\Ntrouble sleeping.
Dialogue: 0,0:11:52.25,0:11:53.55,Default,,0000,0000,0000,,And you may want to eat more.
Dialogue: 0,0:11:53.55,0:11:54.92,Default,,0000,0000,0000,,So, have some healthy foods ready.
Dialogue: 0,0:11:54.92,0:11:58.69,Default,,0000,0000,0000,,And then also people tend to have more\Nof a cough, as their lungs self-clean.
Dialogue: 0,0:11:59.57,0:12:03.58,Default,,0000,0000,0000,,Finally, the Japanese have a\Nproverb that success is falling
Dialogue: 0,0:12:03.58,0:12:05.50,Default,,0000,0000,0000,,down seven times and getting up eight times.
Dialogue: 0,0:12:06.19,0:12:07.83,Default,,0000,0000,0000,,If you get derailed, don't feel guilty.
Dialogue: 0,0:12:08.40,0:12:10.44,Default,,0000,0000,0000,,As I said in the beginning, this is a journey.
Dialogue: 0,0:12:10.66,0:12:11.67,Default,,0000,0000,0000,,Come back and see us.
Dialogue: 0,0:12:11.82,0:12:13.47,Default,,0000,0000,0000,,This is the best thing I can do for you.
Dialogue: 0,0:12:13.100,0:12:15.02,Default,,0000,0000,0000,,Don't learn helplessness.
Dialogue: 0,0:12:15.02,0:12:17.01,Default,,0000,0000,0000,,Learn about yourself and get\Nready for the next round.
Dialogue: 0,0:12:17.98,0:12:18.82,Default,,0000,0000,0000,,And thanks for listening.