Most cardiovascular disease is preventable. Most heart attacks and strokes can be prevented, and even after they have occurred there is little doubt that with doctor and patient working together we can stop the progress of cardiovascular disease and prevent future events, dramatically reducing the risk of death or disability. But to do this requires altering those risks that led to disease or risk of disease in the first place. What those risks are is well known: smoking, high cholesterol, high blood pressure, diabetes, obesity, sedentary lifestyle, poor diet, and excessive stress. What is common to altering each of these risks is that they are each related to behavior and therefore require changes in behavior. Physicians often think that behavior change is hard, and prescribe more pills instead, thinking that taking pills is easy. But we know that many patients do not take medications as prescribed, and that the ability to stick with taking pills day in and day out for the long-term is also a behavior that is sometimes difficult to achieve.
So how do we change behavior? People often see this as a very difficult task and it can be for some. We can be "fixed in our ways", and we are used to the way we live and find it comfortable. It is important to know that behavior can be changed. Here is an overview of some of the basic principles and steps of behavior change. We will use smoking as a model but the same principles apply to all behavior change.