Update on Tobacco Use and Health Disparities in the US: A New Surgeon General’s Report By Tom Horvath, PhD On 11/19/24, the Surgeon General released Eliminating Tobacco-Related Disease and Death, Addressing Health Disparities. This report updates the report issued in 1998, Tobacco Use Among U.S. Racial Ethnic Minority Groups. Below are some key points of the current report (the 35th on smoking and health since the landmark 1964 report), and observations about them. Not included in the report is the fact that tobacco use has ironies that often get overlooked. Tobacco use is not a leading cause of individuals attending addiction treatment or mutual help groups, but it remains according to this report the leading cause of preventable death and disease (with over 480,000 premature ...

By Tom Horvath, PhD, ABPP Although many of us have warm memories about Thanksgiving spent with family and friends, there may be some painful memories as well. If you're looking for tips on coping with Thanksgiving, and the problems that might arise, consider the following goals: If avoiding squabbles is your goal, can you sit on your own opinions for one day? Say nothing, or say “I don’t agree with these ideas, but this isn’t the time or place to discuss them.” Repeat “this isn’t the time or place” as needed. If your goal is not drinking, or drinking less, you might need some preparation. Will a family member or two be “in the know” and support you? If you are likely to be asked questions (“why are you not drinking?”) do you have an honest but not necessarily revealing ans...

By Tom Horvath, PhD “If we have our own why, we shall get along with almost any how.” -Friedrich Nietzsche, Twilight of the Idols, Maxims and Arrows, #12, translated (1954) by Walter Kaufman, originally published 1889. Our Own Why There is a range of “whys” that explain how we behave. We have in-the-moment behaviors like eating (why? “I’m hungry”). As we mature, we also have much longer-term timeframes, such as multi-year educational plans (why? “I want to be an X”), and multi-decade parenting plans (why? “I want to give my children opportunities and an upbringing that I did not get to have”). You can probably recall many examples of how you tolerated discomfort or pain for the sake of a longer-term outcome. I suggest that it is helpful to make a list of these experiences in you...

By Tom Horvath, PhD I was recently contacted by a website putting together a list of 50 very brief accounts, including before and after pictures, about individuals resolving addictive problems. I was pleased that they included a few quotes from me, about the process of change. https://www.boredpanda.com/best-all-times-before-after-addicts-transformation/ Perhaps the most important fact to know about significant addictive problems is that most individuals fully or mostly resolve them. So often the stories we see are focused on problems, not success. The process of change often takes more effort and more time than we would like, but nevertheless it happens! The results of the change process are quite different from individual to individual. The lengthy time needed to change ca...

Progressive Muscle Relaxation: Using My Muscles to Relax My Mind By Tom Horvath, PhD Have you had moments when you believed “I cannot relax” or “I cannot relax unless I use?” Have you then used or drank because it was your best method to relax? Sometimes we do need to relax! The good news is that progressive muscle relaxation is one effective method that can work as well (with some practice) and does not have side effects. Progressive muscle relaxation (PMR) is over100 years old! There is strong scientific evidence of its effectiveness. It has been applied to anxiety, stress, insomnia, depression, sports performance, and other areas. Edmund Jacobson, a physician, developed the technique and wrote several books about it. You can easily find YouTube videos and other sources (such a...

What are your sources of pleasure? By Tom Horvath, PhD If you’ve had addictive problems, you may easily recall experiences (with substances or activities) that you found intensely pleasurable. Addictive behavior can provide that! However, regardless of how much you are still having that type of experience, you can understand and appreciate yourself much better by examining the other sources of pleasure in your life. A daily review of them is useful. That review could happen at any time, but doing so as you fall asleep is a good way to end the day with a sense of pride and gratitude. What experiences from your day stand out to you? You may be surprised at what you discover. Here are some questions to consider in that review. How much did you enjoy sensory experience today? S...

Amanda Eversmann of Life Process Program, on Radical Acceptance in Addiction, Recovery, and Parenting I entered on a ten-year addiction because my mother didn’t radically accept me and I accordingly didn’t accept myself.  I had to first learn to accept myself, and also my children. Then I radically accepted my mom. 1. My Upbringing I remember my childhood fondly. My mom was an 8th grade teacher and taught at the public school next to the Catholic school I attended K-12. My dad worked hard at the Ford motor factory. We were comfortably middle class. My mom was involved in every activity I did.  She was a Girl Scout leader, Sunday school teacher, classroom volunteer. But she and I have different personalities. We butted heads frequently. She can be pretty intense and I am more lai...

By Tom Horvath, PhD Whether we think about them or not, our lives are an ongoing answer to “big questions:” What is important to me? Who is important to me? How important is my health and longevity? What is fun? What is most satisfying? What contribution (if any) do I want to make to the world (or some part of it)? What would I like to be remembered for, and by whom? Identifying Big Life questions The list of questions just stated is not definitive. You get to choose your own questions! It is often helpful, however, to learn about the big questions (the “God, man, and the universe” questions) that others have. For many of us much of the time, it is very easy to get caught up in short-term answers to these questions. We can focus on what and who is important right now, what is fu...

By Tom Horvath, PhD I expect that you know everything I am about to write about. However, I hope this blog will be a useful reminder about life and values. A well-lived life is based on values. We act on values we are not even aware of. However, we know many of them. Becoming even clearer about them is worth the effort. Some ways to accomplish that effort is what I am proposing here. If you find yourself, in some part of your life, uncertain about what to do next, it’s time to think ahead. What is a value you want to be acting on? To help identify this value, ask yourself “big picture” questions. What would I ultimately like to accomplish? How would I like to be remembered? What change seems most important to make? If I could be completely in charge, what would I do? What I ...

By Tom Horvath, PhD How well can I calm myself or energize myself using my own abilities? How much do I need to use a substance for help? Although at times a mild sedative (one drink) or mild stimulant (a cup of coffee) can be a helpful tool, the more we rely on such tools the more our internal abilities diminish (atrophy). Daily low doses of sedatives or stimulants can be helpful. As the doses get higher, problems can emerge. In cases of substantial addictive problems, it is common to see someone bouncing between “downers” and “uppers,” sometimes even multiple times per day. At that level of substance use we can lose all sense that self-regulation can be accomplished by ourselves. None of us may reach the ideal of regulating ourselves entirely from our own resources. However, ...