Better ways to call it quits

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You likely know the reasons why you should quit smoking.

If you didn’t, here’s a fact sheet from the World Health Organization. You’re probably aware that stopping smoking reduces your risk of lung cancer, heart disease, and chronic obstructive pulmonary disease more commonly referred to as COPD (more facts here). A recent study has further shown that long-term smoking causes your brain’s cortex to thin. The good news is that stopping smoking will restore part of your cortex.

You probably also know that you can receive support from the Health Promotion Board on the Quit Smoking Helpline (1800 438 2000) and the I Quit mobile app. But you may not be aware that some ways to quit are better than others. Here’s what the experts say:

1. Cut back on nicotine slowly
A 2015 study shows that brain oxygen uptake and blood flow decreases up to 17% just 12 hours after people stop smoking. This nauseatingly unpleasant sensation is a likely obstacle for many aiming to stop smoking entirely. So actually, it seems that quitting gradually may be better in the long run than going cold turkey.

2. E-cigarettes are one way to quit smoking
recent study found that as many as a fifth of participants had quit smoking and were smoke-free 8 months after a 2-month study, during which they could use e-cigarettes. In another recent study involving randomized trials, more participants were smoke-free by the end of the year with e-cigarettes (9% quit smoking) than a placebo (4% quit smoking). It also turns out that the kind of e-cigarette you use and how often you use them may be more important than you thought. Recent reports suggest that e-cigarettes are effective if used regularly and if you use the refillable tank versions. The jury’s still out though, according to a 2015 meta-analysis of research: This analysis says that on the whole, e-cigarettes helped people stay smoke-free for a month but not 3 or 6 months after quitting.

3. Use concrete rewards
Give yourself an incentive to stop smoking. Don’t laugh. It works. Participants who earned a $20 gift card on their quit date and additional $5 each week for the following 12 weeks after the quit date, were much more likely to stay smoke-free than those who didn’t have a financial incentive to do so. In this 2014 study, about half were smoke-free a month after their quit date, and a third remained smoke-free 2 months after they stopped receiving any financial incentive.

A 2015 study found that adding a financial disincentive further improved quit rates. More people stayed smoke-free for 6 months if they received US$800 than if they had counselling or nicotine-replacement therapy (gum, medication, patches). But even more people stayed smoke-free if they not only received US$650 but also had to forfeit a US$150 deposit for not staying smoke-free 6 months after the quit date. So here’s a way for your supporters to do something concrete to up your chance of success. It’s better, of course, if your friends and family have deep pockets.

4. Consider coaching and counselling options
Getting help and support from an stop smoking specialist advisor has been shown to be one of the most effective strategies for helping smokers stay smoke-free. But not everyone wants or has time for one-to-one sessions. A 2014 study found that providing smokers with support through a virtual stop-smoking advisor via the interactive “StopAdvisor” website doubled quit rates among those from lower income groups. Unfortunately, that’s not an option here.

You can however receive support from smoking cessation programmes at the polyclinics — both the National Healthcare Group and SingHealth polyclinics offer them. Smoking cessation advisors can also help at the Department of Pharmacy at Changi General Hospital, Khoo Teck Puat Hospital, and National University Hospital, as well as at Singapore General Hospital (Department of Respiratory & Critical Care Medicine), Tan Tock Seng Hospital (Clinic 4A), and the National Skin Centre.

And everyone can get involved. Family and friends can getting involved too. Anyone can learn the basics of smoking cessation counselling — HPB provides Level 1 and Level 2 training, and continuing education Level 3 workshops.

There may also be a smoking cessation programme at your workplace: Check with your HR to find out more. And if there isn’t, consider seeking support from a professional counsellor — the Employee Assistance Programme or EAP at your workplace may be a good place to start.

5. Watch out for your cravings
A 2015 study found that brain areas associated with smoking cravings were much less activated for women during the ovulation period than a later part of the menstrual cycle. Even if you’re not planning to time your exit from nicotine, you could be mentally more prepared to do battle with your cravings before you get to that time of the month.

You can have all resources about how to best quit, but it’s the emotional support that’s most crucial to staying smoke-free. Just remember, there’s no one-size-fits-all solution to quitting. Have a happy smoke-free No Tobacco Day!

Are you eating to live? Or living to eat?

Raspberry Pancakes

Eating is one of our national hobbies. So says the Rough Guide. It has to be true.

This guide in the Guardian introduces our top 10 street foods. Wonder how many UK tourists would come to Singapore just for chilli crab. Or does the guide aim to make homesick Singaporean undergrads dream about char kway teow?

There are over 250 local food blogs and a food blog to compile all food blogs. The handmade coffee hipster cafe scene is ‘shrooming pretty much one new cafe every other month. We have more than a few apps dedicated to food locations and reviews.

There’s a food festival pretty much all the time. There are two food fairs coming up: the Food and Beverage Fair 2015 on 19 to 22 March and Savour on 26 to 29 March 2015. As if there wasn’t enough lo hei and pineapple tarts at the recent Lunar New Year celebrations to nudge your BMI to the next level. And if you wait a bit longer, there’s the Singapore Food Festival from 10 to 19 July 2015 and the World Food Fair from 10 to 13 September 2015. And between Oktoberfest and log cakes at the year end, there’s the Asia Pacific Food Expo 2015.

It’s pretty clear that we love our food.

In fact, getting us to reduce our risk of colorectal cancer by eating less bacon, canned sausages, ham, spam, corned beef, and salted fish (more about that here) will be a walk in the park. Compared to getting us to eat less. That’s an uphill task. But a task that the Health Promotion Board (HPB) has to accomplish all the same. They’re going all out to help us get with the healthy programme. They have a National Healthy Lifestyle campaign, a Scratch and Win contest for drinks ordered siew dai (with less sugar), and even exciting prizes for worthy individuals able to shed 3 kg on HPB’s Million kg Challenge.

Recent research however does have things to say about how we can help ourselves stay on track with our food choices, portion sizes, and BMIs. Here are some ways to tip the scales in the right direction:

1. Drink water before your meal
Drinking water before a meal can be the key to sticking to a meal plan or portion size. A 2010 study showed that drinking 2 cups of water before a meal resulted in individuals losing 4.5 pounds more on average than the control group.

But water may not be for everyone. A recent randomized trial showed that consuming diet drinks produced more weight loss than consuming water. Those who drank water while following a 12 week weight management programme lost on average 9 pounds, while those who drank diet drinks on the same programme lost 13 pounds.

But before you start your water parade, know that drinking water without an accompanying plan to eat a healthy portion of veggies and fruits isn’t going to get you very far. Not convinced? Read this article.

2. Manage your stress
Are all calories equal? Not quite. As it turns out, it’s easier to lose weight by cutting down on carbs than fat. But cake, ice cream, and cupcakes are the things we crave when we’re feeling stressed. So it’s important to manage your stress (and to read our earlier blog on stress management and emotional eating).

3. Don’t snack with your favourite TV programme 
A 2014 study found that viewers ate more M&Ms, cookies, grapes, and carrots while watching the film, The Island, on TV than when watching an interview programme. Apparently, we eat more when we’re distracted. So watch your K dramas without the snacks. Or swap out the cookies for apples and pears to save on unnecessary calories.

4. Focus on the fun stuff and lose weight
If you think “exercise”, you may find yourself eating more than you should later on. But think that you’re having fun, and you’ll won’t. Just getting people to think that they were going on a scenic walk rather than an exercise walk made them eat fewer M&Ms after the walk. Thinking that you’ve “exercised” may lead you to consume more calories than if you weren’t so focused on the fact that you were exercising. Instead, concentrate on having a fun experience (read our earlier blog post about having fun)!

5. Get the right kind of social support
When our family and friends provide reassuring comments about our size, we’re likely to maintain our weight or even lose weight. When they don’t, we put on weight. That’s what a 2014 study of women participants found. Pressure to lose weight from concerned friends and family, didn’t bring about the desired effect. In fact, it did the opposite. Participants put on weight, even when they weren’t concerned about their size to start with. So don’t let your loved ones nag you. Instead, get them to support your healthy food choices.

6. Assess your hunger before the meal
It appears that we’re less likely to stick to our health goals when we’re dining with someone who has an unhealthy BMI. In a recent study, participants ate more pasta when dining with someone wearing a prosthesis (adding 50 pounds to his/her weight). It didn’t matter whether that person ate more salad or pasta. But if that person did have more salad, participants themselves ate less salad! It turns out that it’s important to decide on our meal choices and portion size before the meal so that we’re not distracted into eating more food than what we would otherwise consume.

7. Choose wisely from the menu
It turns out that we tend to order anything on the menu that attracts our attention. Menu items in a different colour font, bold and italics, probably set apart in a box, are precisely what we’ll order. They’re likely to be the tastiest thing on the menu. But you need to ask yourself if it’s healthy choice…

8. Don’t automatically finish everything on your plate
On average, children only finish almost 60% of what’s on their plate. In contrast, adults typically finish over 90% of what’s on their plate, according to recent study published in the International Journal of Obesity. Researchers of this study suggest that children eat according to how full they feel and whether they like the foods on their plate. It appears that we, on the other hand, eat whatever we’ve put on our plate. We may therefore need to be wise about how much food we pile on our plate!

9. Distract yourself at night
recent study of participants on a weight management programme found that people were most tempted to cheat at night and when there were other people around. When you have those late night cravings, try meditation or relaxation techniques. Getting into the routine of regular physical activity could also reduce food cravings (here’s why).

When should you tell your colleague to “take a holiday”?

workplace stress

Going by the elevated stress levels reported by employees in Singapore (read our earlier post) and lack of job satisfaction bemoaned by many in the local workplace (discussed in an earlier post too), it would appear that for some employees, the answer may be now!

According to a recent workplace survey, as many as 94% of bosses held the view that employees shouldnot bring work home. It doesn’t add up. Or bosses say “have work-life balance”. But they hand their employees more work than that which can be completed within working hours. Clearly, there are going to be instances where bosses say one thing and do another. It also doesn’t help when bosses continue working outside office hours. 

Numerous studies have highlighted the effects of chronic stress on employees’ emotional and physical well-being. Prolonged exposure to stress weakens the immune system, causing employees to be absent from work and less productive when working with a stuffy head and sniffy nose at work (read this Fortune article). Burnout leads to higher staff turnover and elevated business costs. More crucially, it may mean losing valuable employees. It’s the reason why some companies have started to insist on employees taking their annual leave.  

Depression is explained as a condition in which an individual experiences “a persistent and pervasive low mood that is not affected by external circumstances”, with the individual losing interest in activities which once interested them. And it may escape the notice of most bosses, but the fact is that employees who are experiencing burnout, may be actually experiencing symptoms of depression (here’s an explanation of the two terms). 

But what can you do about it?

Here are some steps you can take:

1. Find out if you and/or your colleagues are experiencing burnout.
Complete this self-assessment questionnaire.

2. Recognise signs and symptoms of depression.
Mayo Clinic has a fact sheet on burnout. Understand that someone with depression cannot “cheer up” and “get over it“. It’s not just about feeling “sad“. One in 17 has depression in Singapore (find out more). 

3. Raise awareness about burnout at your workplace.
This article on Understanding and Avoiding Burnout has tips for managers. 

4. Provide a supportive environment for preventing burnout at your workplace.
Here’s a systematic list of things you and your organization can do to help.

5. Reach out to your colleagues.
Find the right words, but don’t forget to take care of your own emotional well-being.

World Mental Health Day. It’s two months and 19 days away. What are you doing on World Mental Health Day?

Raising awareness for mental health

The burden of planning activities to raise awareness about mental health issues, improving employees’ mental health literacy, and reducing stigma for seeking professional, confidential psychological support for personal and/or job-related problems generally falls somewhat squarely on someone’s shoulders in the human resource department.

Apart from the run-of-the-mill talks and workshops which typically aim to train up emotional resilience and emotional intelligence among employees, it’s not always easy to know what other mental wellbeing activities could be organized for the benefit of employees, as well as stakeholders. The Health Promotion Board‘s “Enrich Your Mind Learning Festival” organized for the 27th of October 2013, Sunday, at Max Atria, Singapore Expo, is an example of how mental wellbeing can be enhanced and awareness raising can be achieved at the workplace. In addition, this free-admission whole-day affair, which starts at 10am and ends at 6pm, offers expertise from professionals who will dispense advice freely about creating the power of attorney and goodie bags for the early birds.

If not to benefit personally from the mindfulness and relaxation training for coping with day-to-day stress and for guarding against dementia through engaging in mentally stimulating activities, it’s fertile ground for social engagement and for building one’s social network – another protective factor against dementia. It’s not a replacement of a good ol’ walk in the park – yet another protective factor against dementia (Fratiglioni et al., 2004) – but it’s a good place to start. Happy learning!

Working towards a healthy workplace

The World Health Organisation (WHO) supports a healthy workplace to prevent non-communicable diseases and reduce the burden of mental ill health – health priorities highlighted by the United Nations.

Advocating a comprehensive model to promote healthy behaviours among workers in their job and lifestyle, and minimize their exposure to psychosocial and physical risks, WHO recommends re-allocating work to reduce workloads and respecting work-family balance  for mental wellness, and implementing safety measures in the physical environment.

The responsibility of achieving a healthy workplace also falls on the organization. This means providing employees with personal health resources. Fitness facilities and programmes, healthy food choices, smoking cessation programme support, and employee assistance counselling are among the list of activities recommended by WHO.

The work of promoting healthy workplaces sits in the purview of the Health Promotion Board (HPB). Their Workplace Health Promotion Programme is guided by Sept 2000 recommendations from the Tripartite Committee on Workplace Health Promotion. As well as easy access to HR resources for implementing corporate wellness programmes, organizations can apply to HPB for funding from the Workplace Health Promotion Grant.

The rationale for promoting a healthy workplace is not limited to ethical-legal considerations: Healthy employees are key to staff retention and sustainability. In other words, organizations have a corporate social responsibility to provide a safe and healthy environment for employees, but it also makes good business sense.