Up next on "Cycle of Health."

Our fanl of experts explores nicotine addiction and how programs like MINDOnline help us quit smoking, vaping and chewing tobacco and we'll visit teens combating big tobacco sea deduction of their peers into a life lifetime of craving and illness.

♪ ♪ ♪ ♪ HELLO AND WELCOME TO A BRAND NEW SEASON OF CYCLE OF HEALTH.

I'M YOUR HOST, DR. RICH O'NEILL.

TONIGHT'S TOPIC: "KICK THE NIC."

NICOTINE, A HIGHLY ADDICTIVE SUBSTANCE, HAS SIGNIFICANT HEALTH RISKS, ESPECIALLY FOR ADOLESCENTS AND YOUNG ADULTS WHOSE BRAIN DEVELOPMENT IS PARTICULARLY VULNERABLE.

JOINING US TONIGHT ARE FRED HINTZ, TRAINER WITH THE MOTIVATIONAL INTERVIEWING NETWORK OF TRAINERS AND DR. ZSUZSA MESZAROS.

Fun fact, the Hollywood actress zsag aabrr was the same until she came to the United States and changed I.

AND DR. SUSAN SPERRY CO-DIRECTORS OF MIND ONLINE AT SUNY UPSTATE MEDICAL UNIVERSITY.

so, folks, why is it so hard to quit smoking and vaping?

>> Well, nick seen is a very addictive substance, as you said.

And it has a lot to do with the fact that it reaches the brain very quickly.

Within 20 seconds, it's in the brain and releases dopamine, which helps attention, concentration, causes relaxation and euphoria.

And of adjust one or two minutes of pleasure, it quickly wears off, the nicotine effect.

>> So you need another hit?

>> Absolutely.

And our leader attention Waynes and dysphoria sets in, anxiety, restlessness, irritability.

The smoker craves the next cigarette.

>> So then have you a craving to deal with which is like a psychological effect?

>> Exactly.

>> So you are psychologically addicted, too.

What do you do about the psychological addiction?

>> It's not just the craving that comes from withdrawal.

Any kind of change is difficult.

And people feel ambivalent about it.

They have reasons they want to change, and they have some reasons they would rather stay the same.

>> So mixed feelings.

>> Mixed feelings and that applies to health behavior change, like deciding to quit smoking.

People are simply ambivalent.

Part of them wants to change.

Part of them doesn't.

>> You know,ambivalence is something that motivational interview is wag created for.

>> To deal with ambivalence.

>> Yeah it basically started with a grad student working in an alcohol substance abuse recovery place.

And he noticed something that I think we all probably have encountered.

People are there to deal with alcohol.

And so the counselors try to help them.

Would help them by trying to tell them these are the bad things about alcohol.

>> Don't do this.

>> Don't do this.

>> Stop that.

>> And here are all the reasons you ought to quit and why are you doing it anyway?

>> Exorting them to quit.

>> Exorting, persuading.

And he noticed that that didn't really have the desired effect.

And he decided he was going to try something a little different.

And he decided he would actually try to listen to people.

>> No?

Not listen to people.

It's a radical concept.

And not just try to talk people into making changes, but really join with them where they were and, you know, see if that would work.

And he found out that the people he worked with, with that approach, actually had better outcomes.

>> So-- go ahead, Fred.

>> They had longer retention in treatment, they had better success at staying abstinent.

And they wondered if it was a quirk and they did a research study and motivational interviewing is the most, I think it's the most researched intervention used for, you know, for a lot of-- >> Behavior change.

>> Yes, behavior change.

It's expanded well beyond alcohol now.

You may have noticed any time you try to-- you really want to help somebody, and you think the way to do that is to tell them here is how you can change.

Here is why you should change.

Instead,... >> Yeah, what do do you?

What kind of things do you ask people or listen?

>> Well, we try to elicit their own reasons for making the change rather than us giving them all the reasons and giving them the desire and giving them the felt need.

You better do this or.

>> So what do you want to accomplish in your life by quitting smoking or vaping or drugs, yeah?

>> Yeah what benefit would you get out of it if you were to choose to do it.

>> And so the motivational interviewing for nicotine dependence, the mind part of MINDOnline.

>> Motivational interviewing for nicotine dependence.

>> Absolutely.

Is really designed to apply the techniques that Fred has been talking about, motivational interviewing, building a person's own intrinsic motivation for change.

Working with individuals in the community who might want to at least think about changing their tobacco or nicotine habits.

It's not necessary to be at the point you are like I definitely want to change this, but you are just starting to think about it.

>> So let me get that.

So if I'm somebody who vapes or smokes and I'm not committed to changing, right, I'm just starting to weigh the possibilities of changing, I can still go to MINDOnline.

>> That's exactly what motivational interviewing is for, for people who are in the process of should I?

Can I?

>> And hoping to tip the scale some towards, let's give this a try.

>> Well, motivational interviewing really prizes individual autonomy.

So if you come to be part of our program, we are not going to tell you what to do.

We are going to talk to you about what you want for yourself Your desire, ability, reason and feed for change.

And that's up to you to decide what you want.

Individuals attend eight sessions-- >> In your program.

Just eight.

>> Tuesdays and Thursdays for half an hour each session.

>> You are just committing a half hour a week-- >> A full hour, two half hour sessions.

One on Tuesday, one on Thursday, for four weeks in a row.

That's your full commitment.

You are working one on one with a therapist who is really trying to tailor make a program just for you.

>> For what you have in mind, what you are hoping to do in your life.

>> Absolutely.

And then we are so convinced that this is beneficial to people from a health perspective.

We also want to provide some financial incentives for people to get on board.

>> You mean you are going to pay me to go to your program?

>> You will get $20 for coming to the first session.

>> I'm going to start vaping so can I get the 20 bucks.

Okay, all right.

>> And then so that is Session 1.

Session 2, 3, 4, 5, 6, 7, 8, you get entered into a raffle in which you could win a $200 Amazon gift card.

>> Cool.

>> It's important to know that our sessions are billed through insurance, so co-pays and deductibles would apply.

And we can answer questions about that whether you contact our program.

>> Great.

You were going to say something, Fred.

>> Not that I know of.

>> I'm mind reading again.

>> Don't encourage me to speak more.

I'll go on.

>> So as part of the program, I've heard that people often use medication to help them quit smoking or vaping.

Is that part of your program?

>> Absolutely.

We offer the option to start medications both nick seen replacement and non-nicotine options.

The most effective one is chantix.

It can triple the chances of success of smoking cessation.

>> Triple the chances.

>> It takes away the cravings for nick seen.

But also they offer some other ones which help with the craving and improves mood.

And also nicotine replacement options which provide a steady prolonged level of nicotine in their body so people don't go through the withdrawals.

>> That's what I hear about the patch or people chewing gum.

What about these vapes, vapes you can get at the smoke shop, right?

Without a prescription.

They're marketed to help people quit smoking, right?

What is the reality about these?

Is that just marketing?

>> I'm afraid these are not very effective tools of becoming nicotine-free because actually vaping devices contain more nicotine addictive substance than a cigarette.

So it's harder to quit vaping than to quit smoking.

>> You are increasing your addiction actually if you use one of these things.

>> That's correct.

>> Real strong nicotine hit.

Just without a tar, but hey, you are getting the nicotine.

>> So you guys provide medication and maybe the patch and other things.

And do those help people quit-- what is the success rate from your program?

How many people actually quit?

>> We are very happy to see that a third of the people, like 33% quit during the first month and then another 14% decreases smoking or vaping more than 50%.

So the majority of people cut back.

>> So just like the first month, a third of the people actually quit and then the benefits of the program continue after that.

That's wonderful.

So one of things that's extremely distressing to me is that the tobacco industry, they bought up the vaping companies right?

And they market these things so that so many kids have become addicted, who were never addicted before these things existed.

And that is horrible, from my point of view that that's happened.

And there are millions of kids now.

Tell us about that.

>> This is very concerning that approximately a third of high school students tried once in their lifetime vaping and 10% currently vaping, use vape in the past 30 days.

And this notion that vape is harmless, many people don't even know that vape contains nicotine, this addictive substance.

And some flavorings and additives which stabilize them, the nicotine vape are very harmful if inhaled and can cause a very dangerous pneumonia.

>> Pneumonia.

And dozens of people have died.

>> These things are not harmless.

>> Not harmless.

>> There is no real danger.

You can damage your lungs and you get highly addicted to them.

>> Of course.

>> And 10% of kids, that's really astonishing.

And what a horrible thing.

Let's take a moment to see how teens themselves are taking action to join the fight against nicotine.

>> Reality check is a portion of our grant, which is the advancing tobacco free communities grant from New York State Department of Health.

I am a Program Coordinator for tobacco-free CNY a program with the Onondaga county health department that covers Onondaga, Oswego and Cayuga Counties.

We have a youth engagement coordinator that goes to the schools, recruits youth that are passionate about tobacco use and trained to become our youth voice when we are working on policy work or doing education to the community or to youth.

I think we were on a good path before vaping showed up.

The E-cigarettes have really taken a toll with all the flavors.

>> Tobacco companies market vapes like candy, like with bright colored packaging and they are like, these flavors taste so good.

Even though you have to be 21 to buy them, they still do market them towards children.

When you are young like that, you don't know that much about addiction and you don't know it's going to have a long lasting effect on you because you just see it and it's like fun and flavored because that's how tobacco companies market it.

>> What is special about reality check, it is centered around youth advocacy and I'm a passionate person about leadership and being a leader in my community.

So being part of reality check for the past three years have taught me about leadership skills and how to go out in our community and reach tout people who are in power and that can make a change in our community.

We traveled to Albany thanks to the reality check and WCNY group and we were able to talk to Pamela hunter and recently able to talk to Assemblyman William Magnarelli and they told us about their experience with tobacco in the community and how they're on our side about advocating against it.

>> The idea behind the use sum is that we have different reality check groups from every place across the state.

Everybody brings their reality check group youth to a central location to have the summit where they learn all these skills like advocacy skills, public speaking, leadership skills, we work closely with the City of Syracuse when we were doing our tobacco reach out policy and some of them wrote letters to the editor and did some, you know, sent letters in the Common Council to educate them on why this was important to the youth.

>> One of the most recent events we did was at the palace theater on James street.

We watched the movie "The little mermaid" and picked that movie because it's not rated r and it doesn't have smoking on screen, which is what we are trying to advocate is that we want to make sure that movies that have smoking on screen are rated r so children who are below that age will not be seeing those actions on TV.

>> There is so much research that shows that modeling is a huge impact on whether the youth decides to pick up that cigarette or pick up that E-cigarette.

So the modeling is huge and you know, if the parents don't want their kids to smoke, cessation is a great avenue for them to take.

>> Reality check would be good for younger people and people who feel the need to make a change and make sure things don't just keep trickling down from generations.

When you can come at it yourself in a school, and we have pizza.

>> It's amazing to see what they're able to do.

They're able to go in front of a legislature and, you know, educate on things.

At my age when I was their age, I would never have been able to do that.

These are impressive youth, have learned a lot and helped us a lot.

>> So how can parents help their kids keep from starting smoking or keep from starting vaping?

How can parents do that?

>> Well, one idea that comes to my mind is what message we give them and I don't know if other parents have experienced this, but I've noticed that kids don't listen to what parents say.

They listen to what parents do.

>> Right.

>> And if we say don't smoke, that's bad.

That's wrong.

>> And then you are smoking.

>> Don't do that.

You are a kid.

I'm an adult.

The message we can give is all the fun stuff happens when you are an adult.

And if you really want, you know, sometimes we can get the fun stuff even though they say not to do it.

What is the message we are giving?

>> By doing it, talking a different language.

>> And forbidding them and say, framing it as this is an adult thing you can do.

>> Just wait.

So model it by not smoking yourself or not vaping.

>> I think that would have a much stronger impact than whatever words come out of our mouth.

>> What if you smoke what if you are a smoker or a vapor yourself as a parent?

>> We would encourage people to contact our program and make an effort to cut down or quit.

It's hard to quit smoking and he was talking about the addictive properties and we tend to weave smoking into our daily life.

We wake up and we have a cigarette with our cup of coffee or we might always smoke as we are driving into work.

>> So it's connected to those events and they're like a cue to -- you get in the car and your brain says oh great time for a cigarette.

Or you have your morning cup of coffee, great time for a cigarette.

It's got a psychological connection.

>> And the important thing is, as we make an effort to change our behaviors towards health, we are also telling our kids, this is difficult.

Once you start smoking, it's really hard to quit.

Much better to never pick up the habit than to have to go through the difficult process of changing a habit.

And so parents can really roll model moving towards health, making health behavior changes.

At the same time they're engaging their kids in conversations about overall health.

So we would encourage parents to talk about tobacco and nicotine use as part of broader conversations about things that promote healthy living, diet, exercise, habits to avoid to avoid health harms.

And also talk a little bit about how you might be able to resist peer pressure and other challenges where 3R50E78 are trying to get to you adopt behaviors that perhaps are not healthy for you.

>> Maybe engage in a little role play with your kids so like if Susie says here, how about trying this vape, what would you say?

And your kid would say, thank you very much but I'm not interested.

So you role play that so they have an immediate response rather than taking the thing and Huffing away.

>> Right.

>> As you are saying that, I'm remembering, I think probably the only thing I remember from health class in ninth or tenth grade was the teacher gave us an example.

He said we were talking about smoking.

And how bad it was for you.

And he said, you know, think about how much they cost.

Now back then, many, many years ago, right, I think cigarettes were like 50 cents a pack, something like that.

And he did the math.

He said look, so if you are addicted, most people smoke one to two packs a day.

He did the math.

He said if you did smoke for like five years,-- if you didn't smoke, you would have enough money to buy yourself a new Cadillac.

Cadillacs were the big thing back then.

And in ninth grade, you know, wow!

Buy a Cadillac, right?

And that was a thing.

I never forego the that-- I never forgot that.

He gave us a real world example of the impact of smoking beyond all the health stuff, you know?

He linked it to something positive, like you want to be cool and drive around in a Cadillac or-- I actually wanted an mg.

I didn't want a Cadillac, but that kind of thing.

So your parents could have that kind of discussion with your kids what are the benefits of quitting smoking and quitting vaping?

Or smoking.

What are the benefits of quitting smoking?

>> A lot of people get focused on the harms of smoking.

But really know less about the benefits of quitting.

What most people are surprised about how quickly your body begins to heal itself after you stop smoking.

So within 20 minutes, blood pressure and heart rate starts to drop.

>> 20 minutes.

>> Within the first week or two, your carbon monoxide levels that we get through tobacco smoke begin to drop.

>> Oh wow.

>> Within the first month to a year, your circulation improves and your lung function improves.

>> So you are breathing better, you can get up the stairs a little easier.

>> After 15 years, the overall mortality drops back to the level of a non-smoker.

>> All reasons in that sort of a period of time.

That's wonderful.

THAT'S JUST ABOUT ALL THE TIME WE HAVE, I WANT TO THANK OUR GUESTS: FRED HINTZ, MENTAL HEALTH COUNSELOR AND TRAINER With the motivational interviewing network of trainers.

DR. ZSUZSA MESZAROS AND DR. SUSAN SPERRY CO-DIRECTORS OF MINDONLINE AT SUNY UPSTATE Motivational interviewing for nicotine dependence at SUNY Upstate.

Finally science shows that laughter has a lot of health benefits.

WE HAVE A TRADITION HERE - IT'S CALLED 'LAUGHTER IS THE BEST MEDICINE.'

AND LET'S SEE IF THAT WORKS TODAY!

VIEWERS, AS SOME OF YOU HAVE NOTICED THAT I HAVE A PONYTAIL.

AND SO DO TWO OF MY GUESTS.

Looking at us, see if you can guess who has the longest pony tail.

Big reveal, 3, 2, 1.

Ta-dah!

I HAVE A CONTEST GOING WITH THEM TO SEE WHO CAN GROW THEIRS THE LONGEST.

I got a long way to go.

You can join the contest, too.

If you quit smoking, you will likely live six to seven years longer.

Quit going to the barber shop and the beauty shop.

Join our contest to grow the longest pony tail and we'll see you in about six to seven years.

So now, to hear our new companion community fm radio show, checkup from the neck up, visit WCNY.ORG/COMMUNITYFM.

AND FOR ONLINE EXTRAS, VISIT WCNY.ORG/CYCLEOFHEALTH for more information about MINDOnline.

FOR 'CYCLE OF HEALTH,' I'M PSYCHOLOGIST DR. RICH O'NEILL.

THANK YOU FOR CHECKING IN AND GOOD LUCK QUITTINg Next week on "Cycle of Health..." >> Tonight's topic, protecting and improving our hearing.

Join our experts discussing how hearing loss can affect us, how to protect our hearing and the latest in high tech diagnosis and devices to help us keep sensing, super lative.