Physical exercise is like smoking cessation because they both require a lifestyle change process before they can become a new habit that is integrated seamlessly into daily life. Regular physical exercise is often viewed as one of many components of lifestyle change, including eating a balanced and nutritious diet, reducing stress, stopping smoking, and limiting alcohol.
However, addressing physical exercise like a habit to be changed, such as stopping smoking, may result in better success rates for people wishing to initiate or increase physical exercise. Changing from sedentary lifestyle to moderate activity may be a simple thing to agree to, but a difficult goal to achieve. According to Harvard Health Publications, even people who are highly motivated to make a change, whether it is adopting a new habit, like exercise, or breaking an old habit, like smoking, can find making the change extremely difficult.
Behavior experts agree that changes motivated by regret, guilt, or fear do not achieve lasting results, while positive thinking and self-motivation can and do create lasting change. Other keys to successfully managing change include setting only a few specific goals, defining practical ways to reach those goals and building in a mechanism to account for success and failure. A 2009 study in the European Journal of Social Psychology found that it took an average of 66 days to form a new habit. The study indicated that there is a wide range of individual variation, from 18-254 days, and that persistence is necessary to form a new habit even if a day or two of the new behavior is missed before reaching the goal.
Physical exercise and smoking cessation are both well-studied areas of health. Recent meta-analyses compiling the results of large numbers of exercise studies have concluded that aerobic physical activity improves cardiorespiratory fitness and enhances cognitive performance in sedentary older adults. Studies of smoking cessation in health care and behavioral psychology literature have revealed successful behavior modification results using the Trans Theoretical Model of change (TTM).
Interestingly, exercise can actually be used as a support strategy to make a stop-smoking effort more effective. According to the NCBI, regular exercise may help people stop smoking by helping to manage weight gain as well as moderating nicotine withdrawal symptoms and food cravings.
While a number of different change models are used successfully in health care, TTM is the most widely studied. TTM was developed in the late 1970’s by James O. Prochaska and Carlo C. DiClemente for their research on alcoholism. The idea behind the TTM model is that a person moves through five different stages during the process of making a change: precontemplation, contemplation, preparation, action, and maintenance. In this model, each stage prepares the person for moving to the next, so a failure to follow the progression of stages can result in lack of success in meeting the goal. An example would be a person with a completely sedentary lifestyle, who is not currently thinking about starting to exercise, is at the precontemplation stage, and is probably not ready to make a list of practical ways to take more walking steps each day. Most of the scientific evidence for the success of TTM in creating behavior change comes from studies of alcohol, drug abuse, and smoking cessation, but the model has been used successfully to help people implement exercise and diet programs.
When clinicians use the TTM to counsel patients, its effectiveness may be limited in the context of a short office visit. The approach may be used by individuals on their own also, but often with somewhat limited effectiveness because an individual operating independently find it difficult to build in the accountability that is necessary for meeting milestones toward a long-term goal. Counselors, and nurse coaches may be able to meet this need for accountability through the change process. Nurse coaches represent a new emerging role in health care and are specially trained to assist individuals to find meaning within their health experience while co-creating a collaborative, therapeutic, and caring environment in which change can occur and health can flourish.
Physical exercise, like smoking cessation, requires a whole-person lifestyle change. The experts at Harvard Health publication suggests that it may helpful to think of lifestyle change as a process that can be planned and managed successfully with the right tools, not an event to be accomplished and then forgotten.
By Lane Therrell