Today’s New York Times ran a story by reporter Lizette Alvarez on “The Holdouts” – professionals who, in defiance of increasingly menacing health warnings, spend their breaks dashing to an elevator, descending to the concrete canyon below, trudging to an area that meets the minimum requirement of being at least 25 feet from the skyscraper where they work, however inclement the weather, in order to have their smoke.
One of the people interviewed by Alvarez was Linda Greene, an executive assistant for a large financial services organization. Her story is all too familiar: At age 15, she filched an unfiltered Pall Mall from her sister’s cigarette pack, smoked it – and promptly threw up. Undeterred by her discomfort, not to mention a $100 bribe offered by her father, she persisted. “Everyone was doing it, advertising it, glamorizing it.” Sadly, 47 years later, she’s still smoking.
What keeps her doing it? Also a familiar story: “I don’t want to gain weight.”
Although weight concerns were not central to the article, a few clues are provided about the tradeoff Ms. Greene makes not just in terms of her long-term health but also, ironically, of social acceptability and of how she looks and feels on a daily basis.
She knows she should quit and she wants to quit – someday. “I have to decide I’m going to quit,” said Ms. Greene. “It can’t be someone else who decides.” Once again, a familiar story – it’s a control issue. And she’s absolutely right; unless she’s ready to quit, she probably will not succeed.
I wrote Life After Cigarettes for Linda Greene, and for women like her. I wanted to tell her about the control she’ll regain when she quits smoking. I wanted to offer a new perspective on her weight concerns and give her some ideas for managing her weight so that it maxes out within a dress size or a unit on the Body Mass Index. I wanted to share with her the gift of those ordinary moments she can enjoy relaxing with her colleagues when she’s not spending her breaks rushing out for a furtive cigarette. This is what I’d tell Linda Greene if I had the chance.
I recently had an e-mail from my old friend Lynn about our upcoming high school reunion (okay, I’ll ‘fess up, it’s our 50th): “Now if I could just drop 15 lbs without giving anything up… And the reunion is a few days after we get back from our September vacation so I don’t see dropping a few last minute pounds then. MOST of the time I’m very accepting of myself the way I am. Wonder what reunion anxiety comes under in the DSM.”
I’m attending not only that reunion but also the reunion of high school I’d have graduated from had my family not moved away just before I entered the 9th grade. So I have a double dose of it.
In fact, this is the second time I’ve written about an upcoming reunion. The first time was thirty years ago, when I wrote an article about my 20th high school reunion for a newspaper Sunday supplement (remember newspapers?) that started off with the statement that I’d bought a new outfit and dieted off 5 pounds for the occasion.
Some things never change.
As I recall, the lines after the one about dieting went something like: “Burst your buttons, teachers. Eat you hearts out, boys.” That’s the impression most of us want to make on the people we knew back then (and who still, in our minds, look like nubile, fresh-faced cheerleaders and lean, muscular quarterbacks – not like the face we see in the mirror, and possibly not like “they” looked even back then). And that hope, I think, gets at the root of Lynn’s implicit question about the source of the anxiety that so many of us suffer in connection with our upcoming reunions: We’ve set a standard for ourselves that will be difficult for anyone more than a few years past graduation to meet, especially if we’ve calibrated that standard to our high school ideas about beauty.
If you’re a former smoker and concerns about weight were part of your smoking dynamic, the thought of seeing the prom queen or your old boyfriend may spark second thoughts about the decision to quit. Don’t go there! If you’ve read Life After Cigarettes or followed this blog, you know that even if you gained the typical few pounds when you quit smoking, you’ve still come way out ahead in the appearance sweepstakes: No more cigarette burns on your clothes, no smell of tobacco smoke in your hair, no nicotine-stained nails and fingertips, whiter teeth, and fresher breath. If you’re a longer-term quitter and this is your twentieth or thirtieth reunion, not your first or fifth, you’ll have fewer wrinkles, less gray hair, a less gravelly voice, and a more feminine body shape than the prom queen who continued to smoke. If it’s your fortieth or fiftieth reunion, you’ll probably have noticeably more energy and you’re less likely to be stooped over from osteoporosis.
You may also be thinking: How will I feel when I’m thrown back in with the crowd I always smoked with? Will I be tempted? Am I in danger of relapse?
Studies of smoking relapse crises have identified a variety of circumstances in which relapse may occur. Although many are associated with negative states like depression or anger, a substantial number are triggered by social situations involving other smokers, eating, and especially alcohol consumption. So your intuition that temptation lurks in social events like reunions – or weddings or anniversary celebrations or holiday parties – is indeed correct.
How you confront that challenge turns out to be even more important than whether you actually experience withdrawal symptoms. There are three types of response you can make to ward off the danger of relapse. First, there are behavioral strategies. For starters, try to go easy on the food and alcohol. Sit at a nonsmoking table. A little exercise is a good distractor so be the first one to hit the dance floor. Second, talk to yourself. Stay focused. Enjoy the sensation, unavailable to smokers, of being able to hone in on a conversation without having your attention frayed at the edges by the niggling urge to smoke. Think about how much better you’ll feel tomorrow morning if your first waking thought isn’t, “oh, no!“ Impress your old schoolmates and teachers by radiating the beauty and confidence that comes with being in charge of your own life, not by falling back into those old destructive patterns. Finally, if like my friend Lynn, who has been smoke-free for many years but not completely nicotine free, this may be a Nicorette moment. Forewarned is forearmed, so go prepared.
In Life After Cigarettes, I mentioned my one-time wish to create a website to which a woman smoker could upload a current photograph. The idea was to use age-progression software—what the police use to visualize how someone who has been missing for several years might look now—to project two different outcomes: how she would look in ten or twenty years if she continued to smoke, vs how she would look if she quit smoking today. “The keep-on-smoking version would have more wrinkles, grayer hair, and other signs of more rapid aging than the stop-smoking version. The smoker would probably be slightly thinner but also—the flip side of thinner—more haggard and less shapely.”
I never had the chance to carry out this project, but here's a website that will allow you – not to visualize yourself in ten years, but at least to get an idea of your body shape in a few weeks or months if you quit smoking now and gain a few pounds as a result. You can either upload a photo of yourself or modify the model in the picture to reflect your current body shape by entering your weight and height. Note: I have no connection with this site or with Redbook. For all I know, there are many similar sites out there. Redbook created the site to show how you’d look if you lost a few (or many) pounds, but it works in reverse as well. I have no idea what algorithm they used to accomplish the morph nor how accurate it is, but it’s good enough for the present purpose.
Once you’ve entered your current weight and height, go ahead and dial it up ten pounds; or add a unit of BMI (5-7 pounds, depending on your height), which the site also allows you to do. I think you’ll be surprised. I think you’ll see it’s not all that big a deal, compared with the myriad improvements in your appearance and health that you’ll gain along with that handful of pounds.
Because this website fouses solely on weight, what it doesn’t show you is the beauty bonuses you’ll see as soon as you quit smoking: no more cigarette burns on your clothes, no smell of tobacco smoke in your hair, no nicotine-stained nails and fingertips, whiter teeth, fresher breath – the list goes on and on.
It also doesn’t show you the longer-term benefits for how you look and feel – fewer wrinkles, less gray hair, clearer voice, more feminine body shape, more energy, less stooped posture – marks of aging that happen earlier if you smoke than if you don’t.
But wait, what if you gain more than ten pounds? Please remember, the odds are very good that you, like the majority of quitters, will end up within the ten-pound window, particularly if you follow the suggestions I’ve made in Life After Cigarettes and elsewhere in this blog. Even a blip of two or three pounds the first week after quitting doesn’t presage out-of-control weight gain; it’s just your body readjusting to the loss of nicotine’s effects on appetite and blood volume. A few women may need some additional help in managing or adjusting to their new weight, but most of you just need to concentrate on growing into your virtual body, the one you see on your computer screen, and enjoying it.
I recently noticed that my son-in-law had lost the “baby weight” he’d put on a few years ago when my daughter was pregnant and regained his sleek rock musician physique. So when I saw him serving his own meals on the salad-size plates used by their nine-year-old son and a four-year-old daughter, I suspected there might be a connection. Sure enough, he told me he was on the “small plate diet” and had lost 15 pounds. (Full disclosure – he also started working out at his local gym.)
The Small Plate Movement, as its proponents prefer to call it, was launched in 2008 at the annual meeting of the American Public Health Association. It’s a collaborative effort by representatives of academia, government, media, and industry and includes two initiatives, one aimed at families, the other at restaurants. The underlying premise is simple: The standard diameter of our dinner plates has crept up to a baronial 12”, making servings that look generous on plates of more modest proportions seem downright stingy. If we downsize our plates to 10”, we tend to serve ourselves and eat around 20% fewer calories – a reduction most people can tolerate without even noticing, much less experiencing serious hunger pangs.
Another way you can use your plate to facilitate portion control, and at the same time promote nutritional balance, is to visualize that plate as a “pie” divided into 4 quarters. Reserve one of the four slices for protein (e.g., meat, beans, tofu), one for carbs (pasta, rice, potatoes), and the remaining two for veggies – say, a garden salad and a serving of broccoli or peas. To be true to the spirit of the thing, no heaping helpings and no overlapping!
This is all good news for anyone who struggles with her weight, but especially for someone who recently stopped smoking and could use a few simple tricks for managing the extra pounds that typically accompany quitting. Whoever thought the humble dinner plate could be such a good friend to former smokers?
Cynthia S. Pomerleau, Ph.D., is currently research professor emerita in the University of Michigan Department of Psychiatry. From 1985 to 2009 she served as director of the Nicotine Research Laboratory, where much of her research focused on the impact of smoking on women. She is the author of more than a hundred articles and book chapters on smoking and a contributor to the 2001 Surgeon General’s Report on Women and Smoking.