Are YOU addicted? My confession

As a college student, I fell prey to a cigarette addiction. Many years later, I'm still not certain how the habit took hold, though it probably involved stress, friends who smoked, and lack of information about the dangers. Regardless, I soon realized this behavior's power over me. My efforts to stop proved to be ultimately successful (whew) but certainly very challenging.

Conquering the smoking habit gave me first-hand insight into the process of breaking addiction. Now, when I help patients with their own smoking cessation or other dependency issues, I explain that it takes commitment, vision, and a solid plan to resolve the problem for the long term. But it's a worthy goal: Health and life often depend on breaking free of the damage wrought by addiction.

The majority of people I know both personally and professionally have at one time or another experienced a physical or mental dependence on a behavior or substance. Compulsive or habitual preoccupations might revolve around food, cigarettes, alcohol, shopping, gambling...almost anything.

Your takeaway: You're not alone.
Your call to action: Start NOW. Don't wait for those New Year's resolutions.

Dr. James Prochaska, Director of the Cancer Prevention Research Center at the University of Rhode Island and co-author of the book "Changing for Good," writes about the 6 steps it takes to truly gain control over whatever might be controlling you. In my practice, here's how I recognize those first three steps, the ones that prepare a patient for successful change.

Stage 1: Pre-contemplation
Patients at this stage don't see a problem. They are in denial, not recognizing the need for change. Or perhaps they blame the issue on other people or circumstances.

Some patients come into my practice saying things like "My girlfriend wants me to quit smoking" (not a decisive "I want to"), or they seem to believe that, despite warnings from doctors, friends, and the media, they are immune to the dire effects of nicotine. Although these individuals often feel discouraged, they don't attempt change because their current state is, if not actually comfortable, at least familiar. Another trait typical of this stage is a fear of failure so intense that even thinking about trying to change (or trying again) triggers panic.

Interestingly, I've observed a bright side to aging when it comes to addiction. Maturity seems to ignite awareness that it's time to face changes, even difficult ones. People of forty or more years old are especially motivated to move from Pre-contemplation into Stage 2.

Stage 2: Contemplation
In this stage, clients let go of denial, face problems, and transition to a new awareness of the negative effects dependence has on their lives. This stage is characterized by hopefulness for solutions.

Monitoring is advised during this stage. For example, I ask people who are in the Contemplation stage of weight loss to keep a food diary to see what their present habits and choices are. Used this way, the diary is an awareness tool that helps patients identify triggers and troublesome habits as well as point out eating patterns in general. (Journaling is also an effective tool in later stages for continuing support, accountability, and guidance.)

Some people stay in Contemplation for a very long time--even years. In those cases, this stage becomes a type of procrastination in which continual thinking and planning are substituted for real action.

When individuals finally make the decision to move toward an achievable goal, they often experience anticipation, anxiety, and excitement--feelings that signal the beginning of the next stage of behavioral change.

Stage 3: Preparation
Preparation translates into your typical New Year's Resolution. Patients who are in this stage plan to act in the very near future even if they might express some skepticism about taking the plunge. This stage is important because it helps set up success: Small changes instituted according to a larger plan are less shocking than a sudden "cold turkey" approach, which can backfire. For smokers, for example, the plan of action might include setting a date to quit, telling others about the decision, and taking other small steps at reasonable intervals.

November is both the month for the Great American Smokeout (Nov. 17) and National Lung Cancer Awareness Month. NOW is the perfect opportunity to make this life-changing good-health decision. (Psst! If you don't smoke, I still encourage you to take advantage of this invitation. The dependence-breaking stages above apply to all problem habits!)

Have these first three steps gotten your wheels turning? That's good! Think through what you want to achieve, and try to determine where you are. Then commit to learning more about the process and how to get from here to your true goal: real, lasting, and ultimately beneficial change.