Let me tell you about my mom.
My mom was 42 years old when I was born,
and she started exercising for the first time in her life.
She started by running around the block,
and then she started doing 5K races, and then she started doing 10K races.
And after that, she ran a marathon,
and after that, my mom did a triathlon.
By the time she was 57 years old,
my mom was trekking uphill to the base camp of Mt. Everest.
(Laughter)
And let me tell you about my dad.
(Laughter)
When I was a kid, my dad used to take me to science classes.
He was also my calculus teacher in high school.
(Laughter)
I wanted to crawl under the desk.
(Laughter)
I learned something important from my mom:
The value of health.
And I learned something important from my dad:
the value of science.
And these two values have guided me on my trek through life,
and they've helped me appreciate an epidemic that we are all facing.
And it's not Ebola.
Instead, it is the epidemic of unhealthy living.
A half billion people worldwide are obese.
And you would think that 50 years after the first U.S. Surgeon General's report
on the dangers of tobacco was published we'd be beyond the problem of smoking.
Today, a billion people worldwide use tobacco.
Tobacco and obesity are two of the most preventable causes
of premature death.
Solving these problems is like trying to solve a jigsaw puzzle.
We engage in unhealthy behaviors because of our genetics,
because of brain neurotransmitters,
because of environmental influences such as peers and the media.
Each of those pieces of the puzzle
are not things that you and I can solve on our own.
But there is one piece of this puzzle that may hold the key:
Our choices about what we do with our cravings to engage
in addictive behaviors like smoking or overeating.
Our choices.
There is a new science of self-control
that may hold the key to reversing these epidemics.
It's called willingness.
Willingness means allowing your cravings to come and to go,
while not acting on them by smoking or eating unhealthy.
But actually, I'm not talking about willpower, and I'm not talking about
"power through your cravings."
Instead, I'm talking about a different notion of cravings
that looks like this:
dropping the struggle with your cravings.
Opening up to them, letting them be there,
and making peace with them.
Now at this point you may be very skeptical.
(Laughter)
I was when I first heard about it years ago.
A friend of mine came to me with a book on willingness.
He said, "Jonathan,
this book will change your life forever!"
And I said "Oh, OK... Yeah... yeah, I'll check it out."
So I went through it and thought, "Nah, this is a bunch of psycho-babble,"
and tossed it aside.
Until some years later when my wife
brought me to a workshop on willingness at the University of Washington,
and I was blown away.
So then I read the book,
and then I read a lot of books on willingness,
and I got trained in it,
and what I learned was that willingness is part of acceptance
in the Acceptance and Commitment Therapy approach to behavior change.
It's a broad approach to behavior change
that's being used to help people with anxiety disorders, with addictions
even some innovative companies
are now using it to help improve their employees' performance
and reduce their stress.
Now, to understand why I was blown away,
you have to understand the world I live in.
In my research world,
a common way you help people quit smoking and lose weight
is you teach them to avoid their cravings.
Avoid thinking about smoking, distract yourself from food cravings.
There's a song from a Broadway show that captures this perfectly.
It goes like this:
(Singing) When you start to get confused because of thoughts in your head,
don't feel those feelings,
hold them in instead.
Turn it off like a light switch just go click.
We do it all the time
when you're feeling certain feelings that just don't seem right.
Treat those pesky feelings like a reading light and turn them off.
(Laughter)
(Applause)
We all live in this world,
where the song we keep hearing is "turn off the bad feelings."
Now, let's take a look at these cookies.
(Laughter)
They just came out of the oven ooh, they are so good!
Ah, they're so delicious.
Mm-mm, just feel that craving to eat those cookies.
Ooh, they're lovely, they're so good.
Now, turn it off!
(Laughter)
Turn it off!
You want those cookies even more now, right?
You see the futility of trying to turn it off.
You can't turn it off!
And maybe you don't have to.
Maybe, you can leave the light on.
Here is how:
My research lab at the Fred Hutchinson Cancer Research Center, here in Seattle,
is conducting randomized clinical trials
to see if showing people how to be willing to have their cravings
is effective for quitting smoking.
We are conducting trials and face-to-face interventions
and a telephone quit smoking hotline and a website called webquit.org
and in an app called SmartQuit.
These technologies have the potential to reach millions of people
with interventions that could save their lives.
That's pretty amazing.
And let me tell you about the data.
When you pool together the results from six clinical trials,
all six that have been published to date,
including trials conducted by our colleagues,
what we see is that for the people who were assigned
to the avoidance approach - avoiding your cravings -
some of them quit smoking,
and it varied depending on the study.
However, for the people who were randomly assigned to the willingness condition,
twice as many quit smoking.
Very, very encouraging.
Now, of course, the data only tell us one small part of the story.
So, to help you see willingness in action,
I'm going to weave together experiences I've had
in counseling people for quitting smoking.
And I'll together refer to them as one person
that we'll just call Jane.
So, as is typical of people who come in to want help for quitting smoking,
Jane was a 45-year-old person
who started smoking when she was a teenager.
She tried to quit smoking several times and was not successful.
So, she was very skeptical that anything "new"
was going to be helpful to her for quitting,
and yet she was really hopeful that this time would be different.
So, the first thing that I showed Jane was to be willing,
that is to be aware, of her cravings in her body.
So to notice where she felt cravings in her body.
And what I did was I asked her
to journal that, and just to track the intensity over time,
and to see if she'd smoke afterwards.
So in the middle of explaining this, she stops me and says,
"What are you talking about? I don't have cravings, I just smoke!"
So I said, "Well, why don't you try it, and we'll see what happens,
and if it doesn't work, we'll try something else."
So she came back a week later and she said,
"You know, I've been tracking my cravings,
I've been tracking them all the time.
And now I can't stop thinking about smoking!
(Laughter)
What am I supposed to do?"
Well, before I tell you my answer, let's look behind the scenes.
Now, what was probably going on here
was that Jane was having cravings all along,
and like a lot of us, she was living on autopilot.
(Laughter)
You wake up in the morning, you smoke a cigarette,
you have a cup of coffee, you smoke a cigarette,
you get in the car, you smoke a cigarette.
We're often just not aware of what we think, what we feel before we act.
So, my answer to Jane was to be willing,
and one of the ways I showed her to do that
was with an exercise called "I am having the thought".
So, one of Jane's thoughts before she had a cigarette was,
"I'm feeling a lot of stress right now, I really need a cigarette."
So I asked her to add the phrase
"I'm having the thought" like this.
"I'm having the thought
that I'm feeling a lot of stress right now I really need a cigarette."
Then I asked her to add the phrase "I'm noticing I'm having the thought,"
so "I'm noticing that I'm having the thought
that I'm feeling a lot of stress right now,
I really need a cigarette."
Now, we can all do an exercise like this when we have any kind of negative thought.
Like for my thought that "I'm boring all of you with my talk"
(Laughter)
and I'm having the thought that I'm boring all of you with my talk.
So, what this exercise did is it gave me a little bit of space
between me and my thoughts.
And it's in that space
that I can choose not to run off the stage in front of 1,500 people.
(Laughter)
And the fact is we don't act on every thought we have,
because if we did, we'd all be in a whole lot of trouble.
(Laughter)
So, this was helpful to Jane, but there was something else
that was really difficult for Jane.
I felt a lot of compassion for her about it.
That was the judgment that she felt
from people when she would be outside smoking a cigarette.
The criticism from her husband for being a smoker,
and the self-loathing that she developed about smoking.
And she dealt with this shame by having a cigarette,
which gave her relief temporarily until the shame came back.
So, I said to Jane,
"What would it be like if we tried to honor this feeling of shame
as part of the human experience?
If you had a close friend who is feeling shame about smoking,
I said to Jane,
what would you offer this friend as words of caring and kindness,
and could you then offer those words to yourself, Jane?"
And she looked up,
and she had this look of this temporary respite from the shame,
which made it just a little bit easier next time
not to act on the craving.
So, here is the secret to self-control:
the secret to self-control is to give up control.
Because otherwise,
we get into a tug-of-war with a monster, a craving monster.
And the craving monster says,
"Come on, smoke a cigarette. Come on, have that cookie. Come on!"
And you're on the other side saying,
"No craving monster, I'm going to distract myself from you,
I'm going to ignore you, no, no, no, no."
And the craving monster says, "No, no, come on, you know you want it!"
And you're just back here
and you're going back and forth and back and forth
and pretty soon the craving monster overpowers you
you have that cookie, you have that cigarette,
until the craving monster comes back.
And then you're in the tug-of-war again doing what we've learned how to do.
Unless -
unless you drop the rope.
And what you discover
is that if you just allow the monster to be,
to occupy a space in your body,
you discover in a few minutes
that the craving monster is not as threatening as he appears.
And sometimes, he even goes away.
As we break for lunch, we're going to have choices of what to eat.
(Laughter)
When you see them, try to be aware of the cravings in your body,
try to be willing to have those cravings.
See if they pass on their own.
Whatever choice you make, try to bring a spirit of caring
and kindness to yourself,
for that is the mountain that we are all climbing.
Thank you very much.
(Applause)