Med Clin North Am. 2004 Nov;88(6):1607-21.
Alternative therapies for tobacco dependence.
Villano
LM, White
AR.
For both hypnotherapy and acupuncture, the evidence of
any effect is anecdotal. There are insufficient rigorous studies that are
homogeneous in design or results to allow a reliable conclusion on whether or
not these therapies are effective. At best, individual smokers who choose one of
these interventions for preference should not be discouraged provided that they
are informed about the state of the evidence.
Clinical hypnosis for smoking cessation:
preliminary results of a three-session intervention.
Elkins GR, Rajab MH.
This study presents preliminary data regarding hypnosis treatment for smoking
cessation in a clinical setting. An individualized, 3-session hypnosis
treatment is described. Thirty smokers enrolled in an HMO were referred
by their primary physician for treatment. Twenty-one patients returned
after an initial consultation and received hypnosis for smoking cessation.
At the end of treatment, 81% of those patients reported that they had stopped
smoking, and 48% reported abstinence at 12 months posttreatment. Most patients
(95%) were satisfied with the treatment they received. Recommendations
for future research to empirically evaluate this hypnosis treatment are
discussed.
BACKGROUND: Hypnotherapy is widely promoted as a method for aiding smoking
cessation. It is proposed to act on underlying impulses to weaken the desire
to smoke or strengthen the will to stop. OBJECTIVES: The objective of this
review was to evaluate the effects of hypnotherapy for smoking cessation.
SEARCH STRATEGY: We searched the Cochrane Tobacco Addiction Group trials
register. SELECTION CRITERIA: We considered randomised trials of hypnotherapy
which reported smoking cessation rates at least six months after the beginning
of treatment. DATA COLLECTION AND ANALYSIS: Two reviewers extracted data
on the type of subjects, the type and duration of the hypnotherapy, the
nature of the control group,the outcome measures, method of randomisation,
and completeness of follow-up. The main outcome measure was abstinence
from smoking after at least six months follow-up in patients smoking at
baseline. We used the most rigorous definition of abstinence in each trial,
and biochemically validated rates where available. Subjects lost to follow-up
were counted as smokers. Where possible, we performed meta-analysis using
a fixed effects model. MAIN RESULTS: Nine studies compared hypnotherapy
with 14 different control interventions. There was significant heterogeneity
between the results of the individual studies, with conflicting results
for the effectiveness of hypnotherapy compared to no treatment or to advice.
We therefore did not attempt to calculate pooled odds ratios for the overall
effect of hypnotherapy. There was no evidence of an effect of hypnotherapy
compared to rapid smoking or psychological treatment. REVIEWER'S CONCLUSIONS:
We have not shown that hypnotherapy has a greater effect on six month quit
rates than other interventions or no treatment. The effects of hypnotherapy
on smoking cessation claimed by uncontrolled studies were not confirmed
by analysis of randomised controlled trials.
J Clin Exp Hypn. 2000 Oct;48(4):374-87. Descriptive outcomes of the American Lung
Association of Ohio hypnotherapy smoking cessation
program.
Ahijevych K, Yerardi R, Nedilsky
N.
Hypnosis smoking cessation treatment is one type of program available to
smokers. This paper describes a large randomly selected sample from such
a program, which has not been previously reported. During 1997, 2,810 smokers
participated in single-session, group hypnotherapy smoking cessation programs
sponsored by the American Lung Association of Ohio. A randomly selected
sample of 452 participants completed telephone interviews 5 to 15 months
after attending a treatment session. Twenty-two percent of participants
(n = 101) reported not smoking during the month prior to the interview.
Use of other smoking cessation strategies since the treatment session were
assessed. Interestingly, only 20% of participants who used pharmaceutical
products to assist with smoking cessation took them for the recommended
treatment duration. Hypnotherapy smoking cessation treatment offers an
alternative cessation method, which may meet the unique needs of certain
individuals
J Clin Exp Hypn. 2000 Apr;48(2):195-224. Hypnosis and suggestion-based approaches
to smoking cessation: an examination of the evidence.
Green
JP, Lynn SJ.
This article reviews 59 studies of hypnosis and smoking cessation as to
whether the research empirically supports hypnosis as a treatment. Whereas
hypnotic procedures generally yield higher rates of abstinence relative
to wait-list and no-treatment conditions, hypnotic interventions are generally
comparable to a variety of nonhypnotic treatments. The evidence for whether
hypnosis yields outcomes superior to placebos is mixed. In short, hypnosis
cannot be considered a specific and efficacious treatment for smoking cessation.
Furthermore, in many cases, it is impossible to rule out cognitive/behavioral
and educational interventions as the source of positive treatment gains
associated with hypnotic treatments. Hypnosis cannot, as yet, be regarded
as a well-established treatment for smoking cessation. Nevertheless, it
seems justified to classify hypnosis as a "possibly efficacious"
treatment for smoking cessation.
Alaska Med. 1996 Apr-Jun;38(2):65-8. Smoking cessation products and
programs.
Lando HA.
Behavioral treatment techniques have facilitated smoking cessation, with
intensive multicomponent interventions sometimes producing long-term abstinence
rates approaching 50%. There is little evidence that either hypnosis or
acupuncture are effective. Both nicotine gum and nicotine patch significantly
improve treatment outcomes, although patch is easier for patients to use
correctly. Self-help programs may be of benefit, however, smoking cessation
products other than nicotine replacement show little evidence of effectiveness.
Health professionals should be informed consumers and should be skeptical
in evaluating claims for commercial programs or products. Additional information
and materials are available from a number of sources including the National
Cancer Institute, the U.S. Office on Smoking and Health, and the voluntary
health organizations.
Addict Behav. 1996 Jan-Feb;21(1):29-35. Smoking cessation in pregnancy: the effect
of hypnosis in a randomized study.
Valbo A, Eide
T.
At Buskerud Central Hospital in Norway, a county hospital with 2000 deliveries
per year, an intervention study, using hypnosis, aimed at smoking cessation
and reduction among pregnant women still smoking around 18th week of pregnancy
was carried out during the period 1992-1993. Two sessions (each lasting
45 minutes) using conventional induction into a superficial nonsomnabulistic
stage of trance were performed. A tape was played, encouraging the pregnant
woman's wish to quit smoking and her capacity to do so. Relaxation techniques
together with self-hypnotic methods were introduced to combat craving.
Changes in smoking pattern were investigated at delivery time. No significant
effect on smoking cessation or smoking reduction was obtained (p > 0.05).
We recorded a 10% quit rate in both intervention group and control group,
and 42% and 31% reduced their smoking in the intervention group and control
group, respectively.
Arch Intern Med. 1995 Oct 9;155(18):1933-41. An analysis of the effectiveness of interventions intended to help
people stop smoking.
Law M, Tang JL.
In a systematic review of the efficacy of interventions intended to help
people stop smoking, data have been analyzed from 188 randomized controlled
trials. Following personal advice and encouragement to stop smoking given
by physicians during a single routine consultation, an estimated 2% (95%
confidence limits, 1%, 3%; P < .001) of all smokers stopped smoking
and did not relapse up to 1 year as a direct consequence of the advice.
The effect is modest but cost-effective: the cost of saving a life is about
$1500. Supplementary interventions (follow-up letters or visits, demonstration
of spirometry, etc) have an additional effect--variable in extent. Advice
and encouragement are particularly effective for smokers at special risk--pregnant
women (efficacy; 8%) and patients with ischemic heart disease. Behavior
modification techniques (relaxation, rewards and punishment, avoiding "trigger"
situations, etc), in group or individual sessions led by a psychologist,
have an effect that is statistically significant (P = .05) but no greater
than simple advice by a physician (2%); yet, these techniques are several
times more expensive. The effect of hypnosis is unproved (no trials have
used biochemical markers). Nicotine replacement therapy is effective in
an estimated 13% of smokers who seek help in cessation; the effect is greater
in those who are nicotine-dependent. Other pharmacological treatments are
not of proven efficacy, and acupuncture is ineffective. Sudden cessation
or gradual reduction in smoking are similar in their efficacy on average.
Physicians should take time to advise all their patients who smoke to quit.
Smokers who are intent on stopping should be given additional support and
encouraged to use nicotine replacement therapy.
J Clin Exp Hypn. 1991 Apr;39(2):93-102. The uncertain relationship between
hypnotizability and smoking treatment outcome.
Holroyd
J.
Literature on the relationship between hypnotizability and smoking
treatment outcome was reviewed. 91 private patients treated for smoking with
hypnotherapy participated in an investigation designed to correct problems in
some of the earlier research. 43% quit smoking by the end of treatment but only
16% abstained at least 6 months. Neither immediate quitting nor continued
abstinence correlated with hypnotizability. Other variables hypothesized to
predict smoking cessation also were not correlated with outcome: number of
treatment sessions, need to smoke, motivation to quit, and gender. The low
abstention rate may have impeded verification of a relationship between
hypnotizability and treatment outcome.
J Fam Pract. 1986 Jan;22(1):61-5. A randomized controlled trial of
hypnotherapy for smoking cessation.
Lambe R, Osier C,
Franks P.
A randomized controlled study in a family practice setting
was conducted on the use of hypnosis in helping people quit smoking. In the
hypnosis group 21 percent of patients quit smoking by the three month follow-up
compared with 6 percent in the control group. By six months there were no
significant differences between the two groups, and at one year 22 percent in
the hypnosis group and 20 percent in the control group had quit. The only
significant predictor of success with quitting was having a college
education.