NAGGING

Three times a week or more, 30-year-old Mary Rietta of Azusa gets a lecture.

“Mom, you shouldn’t smoke,” her three children--ages 7, 9 and 11--warn one after the other. If her kids aren’t on her case about smoking, it might be Rietta’s mother, who’s been known to count her daughter’s beers.

No less subtle is the boyfriend of a 25-year-old businesswoman, who asked not to be identified. The boyfriend, an exercise enthusiast who eats a spartan diet, called her recently when she was in the middle of eating some Haagen-Dazs. “Vanilla with Swiss chocolate almond,” she recalls, savoring the description. “Oh, well, that’s good for you,” he said sarcastically.

Alison Schooley of Burbank, mother of a 6-year-old girl, knows how to eat wisely during pregnancy. But now that the 35-year-old insurance claims adjuster is expecting twins, her mother in Philadelphia often can’t resist dispensing long-distance advice: “Make sure you don’t gain too much weight.”

Nag, nag, nag.

When it comes to your health, everyone else seems to know what’s best for you. And they’re quick to tell you, point-blank, which habits you need to lose. How else to explain perfect strangers who tsk-tsk smokers and hot fudge sundae eaters in public?

But true nagging, the kind of day-after-day criticism delivered broken-record style, is usually more up close and personal and lobbied by someone near and dear: a spouse, a partner, a parent, an offspring, a best friend.

“You’re ordering dessert? I thought you were on a diet.”

“You’re smoking again? You must hate your lungs.”

“Is your butt glued to that couch? I thought you were going out for a walk.”

The closer you are to someone, the greater license to nag.

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“You wouldn’t nag a new boyfriend,” volunteers a 26-year-old West Los Angeles office manager, after describing how she has been urging her longtime beau to go to the doctor about a strange growth (she’s guessing fungus) between his fingers.

But whether a relationship is at the honeymoon or golden anniversary stage, nagging can get old, for the nagger and the nagged.

And often lost in the push-pull for power, control and action is an unanswered question: Does nagging really help change unhealthy behaviors?

Does it ever inspire the less-than-perfect to eat fewer Big Macs, pass up that last beer, give up cigarette smoking or take up exercise?

Or should naggers just save their breath? The experts are divided.

“I can’t think of too many instances when nagging would be helpful,” says Jamie Ostroff, a clinical psychologist and chief of behavioral science services at Memorial Sloan Kettering Cancer Center in New York. She works with smokers who have had recent diagnoses of tobacco-related cancers (lung, bladder, head and neck), trying to convince them to give up the habit and enlisting the help of family members. In her ongoing study of what works, so far unpublished, she has found no role for nagging.

“Nagging states the obvious,” she says. “It is also not a role that in most adult relationships you would allow a partner to engage in. Nagging is often not good for the relationship.”

Even worse, she adds, comments such as “You have no willpower” can erode the self-esteem of the person trying to make a change.

Then there’s the danger of the nagger stepping over the line--from helper to enabler. Citing reports from the medical literature about the best ways to help alcoholics stop drinking, Ostroff says, “Partners who take on more than their share of responsibility lower the responsibility level of the drinker.”

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Nagging can definitely backfire, according to a report published in 1995 in the Addiction Letter. Strategies such as trying to persuade a spouse to drink less when out partying may worsen the problem by provoking arguments, the authors say, and that in turn might lead to even more drinking or drug taking.

“A lot of people will tell you that nagging is what they need,” says Nancy Pierce, a health educator at the Cooper Institute for Aerobics Research in Dallas who helps figure out how to turn sedentary people into regular exercisers. “I think it probably works with a certain personality. Some people want someone on their backs. . . .”

But for most others trying to become more active, what is most helpful, she says, is the buddy system and information. “Offer to exercise with them. Get them something to read, such as Walking magazine or American Health, that has information about the benefits of regular exercise.”

Skip the subscription, counters Richard Cotton of the American Council on Exercise. That’s like buying someone a self-help book for their birthday.” He does think support such as the buddy system motivates people to exercise, however.

In the long run, Pierce finds, sticking with workouts depends more on personal commitment and readiness to make the change, not on the amount of nagging.

Not everyone agrees. Nagging may have a role--although a limited one--in changing unhealthy behavior, says Virginia Hill Rice, professor of nursing at Wayne State University, Detroit, who has studied strategies to help people stop smoking.

“Chronically nagging is probably not a good approach,” she says. “Over the long haul, it is probably demoralizing. But all positive [comments] may not work either. There may be a critical balance.”

In her study published in 1996 in the journal Tobacco Control, Rice and her colleagues evaluated 137 smokers trying to quit, analyzing what effects their partners’ positive social support and negative social support (what most call nagging) had on their efforts.

“For some people, nagging seems to have a positive effect. But not nagging alone,” Rice says.

“As the smoker moves along the quitting trajectory, it may be that more ‘nagging’ or negative interactions are needed at some point to get smokers to quit, if positive support has not worked or is not working.”

Based on her study and others, Rice says that the optimal time to nag smokers trying to quit may be at the seven-month mark. “After six months,” she says, “people get a little tired of being the supportive person.”

That might be the time, she says, to let loose with comments that remind the person how bad the habit is, such as, “Smoking is a dirty habit” or “The house smells.”

This strategy might apply to other behaviors as well, Rice speculates.

Even the nagged who say they try to ignore comments can’t tune them out entirely. Says Rietta, the nagged mother of three: “The nagging from my kids does get me to thinking. I have a box of NicoDerm CQ at home that’s collected a little dust. But it’s there.”

A subtler form of nagging was used by Cotton, of ACE, when he was trying to persuade his father, now deceased, to quit smoking. “I wrote him a letter pleading with him to stop smoking,” he says. His father had smoked two or three packs a day for more than 50 years and had been found to have emphysema. In his letter, Cotton talked about how he wished his dad would be around to meet the grandchildren he hoped to produce.

The letter worked. “He quit smoking on the spot and carried that letter around,” Cotton recalls. His father lived another decade after he stopped smoking. He died in 1993, four years after Cotton’s daughter was born.

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So how to become a subtler nag, or at least a nag who can give a compliment now and then?

Nagging can be turned into motivation with just a bit of rephrasing, contends Dr. Michael Goldstein, associate professor of human behavior at Brown University School of Medicine, Providence, R.I.

A nag would say: “You have to stop overeating.”

A motivator would say: “I know it’s hard to stay on a diet. But I’m really concerned about the impact on your health. What can I do to help you?”

Of course, says Goldstein, you can’t be Pollyanna all the time. “You need to become more direct when the behavior is dangerous.” Such as? “I can’t accept the fact that you are drinking and driving. I’m taking the keys.”

Naggers are often angry and frustrated, finds Ostroff, of Memorial Sloan Kettering. That’s especially true if the unhealthy habit has resulted in serious consequences such as heart disease or cancer. “I try to point out that it is understandable to be angry. Then I try to defuse the anger.”

The spouse of a heart attack patient might really want to say: “If you hadn’t smoked all those years, you probably wouldn’t have had the heart attack.”

Ostroff tells the potential nagger: “The situation is going to require you to team up to prevent this from happening [again].” Then she gives specific examples of how to do that--congratulate the person on making the decision to stop smoking; celebrate big and small successes.

This also helps the partner feel constructive, Ostroff says, and “[naggers] don’t feel like they are watching a train wreck.”

Naggers have gotten a bad reputation that might not be deserved. Says Ostroff: “They’re just misguided. Behind the most critical nagger is a sincere desire to help.”