Hypnosis and Smoking Cessation


Stop Smoking

As Stoptober has now started, the NHS Stop Smoking campaign, I am posting my research findings regarding hypnosis as a tool for Smoking Cessation. he research papers covered a variety of session types and formats and the overall consensus is that hypnosis is a highly effective treatment method for smoking cessation.

I have seen may clients for smoking cessation and it has varied from one to six sessions and although there is an element of physical addiction, the physical aspect lasts for a maximum of 72 hours, after this any cravings are purely psychological and linked to a variety of associations and beliefs about the connection to smoking in those associated environments and situations.

core beliefs

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Study 1: Hypnosis for Smoking Most Effective Technique; Three Times More Effective than Nicotine Gum and Five Times More Effective than Willpower Alone
Smoking cessation A Meta-Analytic Comparison of the Effectiveness of Smoking Cessation Methods.
http://www.ncbi.nlm.nih.gov/pubmed/1387394
http://psycnet.apa.org/journals/apl/77/4/554/

Results: They found that among of all of the techniques used, hypnosis was the most effective. They found that a single session of hypnosis was three times more effective than the nicotine gum and five times more effective then willpower alone (willpower was 6%; nicotine gum was 10% and a single hypnosis session was 30%).

Notes: The Institute of Actuaries (in the US) commissioned the largest study ever done on smoking cessation. It statistically analysed the results of 633 smoking cessation studies involving 71,806 participants.

Journal of Applied Psychology. Vol 77(4), Aug 1992, 554-561
By: C. Viswesvaran, F. L. Schmidt, Department of Management and Organisations, University of Iowa, Iowa City 52242

Study 2: Hypnosis and NLP to Quit Smoking
Freedom From Smoking: Integrating Hypnotic Methods and Rapid Smoking to Facilitate Smoking Cessation.
http://bscw.rediris.es/pub/bscw.cgi/d4584046/Barber-Freedom_from_smoking.pdf

Results: The researchers combined hypnosis with with NLP smoking cessation techniques and found that 39 subjects (90%) reported that they remained smoke-free 6 months after the treatment.. The 4 subjects that resumed smoking reported doing so in response to intolerable anxiety.

Notes: This study recruited 43 subjects who wished to quit smoking. The researchers combined hypnosis with with NLP smoking cessation techniques and found that 39 subjects (90%) reported that they remained smoke-free 6 months after the treatment. The following reasons are given for using hypnosis:

  • clarify and heighten patient’s awareness of his/her motivation to stop smoking
  • ego-strengthening to inspire new behaviour
  • ease the physical and mental effects of smoking withdrawal
  • encourage a general increase in daily activity
  • helping if smoking constitutes self-medication as a distraction from some unpleasant emotions.

Hypnotic suggestions were given that encourage the patient’s freedom to determine his/her behaviour rather than be compelled by smoking addiction. Also, just some of the hypnotic suggestions that were given:

  1. If you have any ambivalence at this time about stopping smoking, we will discuss it now and take the opportunity to meet any objections you might have to stopping smoking
  2. You are someone who used to smoke; there is no reason on earth that is sufficient to justify you ever picking up a cigarette again
  3. If your child or someone else you love has for some reason a really strong craving to eat poison, you wouldn’t let your child eat that poison, would you?
  4. You may be delighted by the creativity you may show in developing really interesting rationalisations to smoke, but you won’t take them seriously
  5. You may have a very brief, very peculiar, but interesting experience over the next several hours or days or even weeks – an image of looking back over your shoulder at the walls of a kind of prison that held you for some reason – a reason perhaps now forgotten – you are no longer a prisoner there. You may be able to hear or even feel the discomfort of other prisoners who are still there and you will feel compassion for them, but you also enjoy the clear air of your freedom
  6. You may be surprised at pride you feel having chosen to take care of yourself – to stand by what you know is right – and pride at having chosen to let this experience be calmer and more comfortable than you may have once expected
  7. You can enjoy the process of learning to live freely
  8. You no longer have to do something because someone else once convinced you that you must
  9. You can discover that any time you want to feel more comfortable, all you have to do is sit back in a chair or take a deep breath
  10. You can take comfort in knowing that if any feelings were bothering you, they no longer need to
  11. If you have cravings, that is natural – to miss the old habit – the difference now is that the craving will not be responded to in the old way – new responses will be discovered that will lead to more satisfying results
  12. Increased activity levels will be noticed – parking your car a little further away than usual and walking the extra distance – a renewed dedication to your favourite sport, etc
  13. This is not a short- term change – but for the rest of your life
  14. Increased fluid intake in response to any cravings – a pleasant full glass of water – you might be surprised how satisfying that can be

Int J Clin Exp Hypn. 2001 Jul;49(3):257-66
By: J. Baber, University of Washington School of Medicine, Seattle, Washington

Study 3: Smoking Cessation and Hypnosis: Three Sessions
Clinical Hypnosis for Smoking Cessation: Preliminary Results of a Three-Session Intervention.
http://bscw.rediris.es/pub/bscw.cgi/d4431440/Elkins-Clinical_hypnosis_smoking_cessation.pdf
http://www.belleruthnaparstek.com/smoking-cessation/clinical-hypnosis-for-smoking-cessation-preliminary-results-of-a-three-session-intervention.html

Results: At the end of the program 17 subjects (81%) reported that they had stopped smoking. A 12-month follow-up revealed that 10 of them (48%) remained smoke-free.

Notes: Twenty-one smokers who were referred to this study by their physicians for medical reasons, received three smoking cessation hypnosis sessions. All patients reported having failed in previous unassisted attempts to stop smoking. The clinical-treatment protocol included three sessions. The first session was the initial consultation and did not include a hypnotic induction. Sessions 2 and 3 involved individually adapted hypnotic suggestions and an individual therapeutic relationship with each patient. Each patient was also provided with a cassette tape recording of a hypnotic induction with direct suggestions for relaxation and a feeling of comfort. The patients were seen biweekly for treatment.

Hypnotic Suggestions: Absorption in relaxing imagery, a commitment to stop smoking, decreased craving for nicotine, posthypnotic suggestions, practice of self-hypnosis, and to visualise the positive benefits of smoking cessation. The induction was standardised, but the specific imagery for relaxation and the positive benefits for smoking cessation were individualised based upon the patient’s preference regarding such imagery. The suggestions may be summarised as follows:

1. Eye-focus induction. “Begin by focusing your attention on a spot on the wall. As you concentrate, begin to feel more relaxed. Concentrate intensely so that other things begin to fade into the background. As this occurs, noticing a relaxed and heavy feeling and allowing your eye-lids to close.”

2. Relaxation. “Noticing a ‘wave of relaxation” that begins at the top of your head and spreads across your forehead, face, neck, and shoulders. Every muscle and every fibre of your body is becoming more and more completely relaxed. More and more noticing a feeling of ‘letting go’ and becoming so deeply relaxed.”

3. Comfort. “. . . and as you become and remain more relaxed, finding a feeling of comfort. Feeling safe and secure. A peaceful feeling, calm and secure. Feeling so calm that nothing bothers or interferes with this feeling of comfort.”

4. Mental imagery for relaxation. “As you can hear my voice with a part of your mind, with another part going to a place where you feel safe and secure. A place where you become so deeply relaxed that you are able to respond to each suggestion just as you would like to, feeling everything you need to feel and to experience.” (Here individualised imagery is suggested, for example, suggestions for walking down a mountain path or along the beach, depending on the patients preference.)

5. Commitment for smoking cessation. “. . . and today becoming a nonsmoker, becoming free from nicotine and free from cigarettes. . . . You will not smoke cigarettes or use tobacco again. With each day that passes, your commitment to remain free from cigarettes will become stronger and each time you enter this relaxed state you will remember the reasons you want to stop smoking.” (Here individualised imagery is suggested consistent with the patient’s individual reasons for wanting to stop smoking, i.e., health, family, financial, etc.)

6. Dissociation from cravings. “As you enter an even deeper level of hypnosis, you may notice a floating sensation, less aware of your body, just floating in space. Your body floating in a feeling of comfort and your mind, just so aware of being in that pleasant place [individualised imagery for a pleasant place]. As your body floats, you will not be bothered by craving nicotine. Your mind blocks from conscious awareness any cravings and you can feel more detached from your body as you become more relaxed.”

7. Posthypnotic suggestions. “. . . and as you become and as you remain free from nicotine and free from cigarettes, you will find a sense of satisfaction and accomplishment. You will find that, more and more, you are able to sleep very well, your sense of smell will improve, and your sense of taste will improve. You will not eat excessively and you will find an appropriate amount of food to be satisfying to you.”

8. Self-hypnosis. “Each time you practice self-hypnosis or listen to the tape recording that I will provide to you today, you will be able to enter a very deep state of relaxation, just as deep as you are today . . . and within this relaxed state, you will find a feeling of control. You will be able to become so deeply relaxed that you will become very comfortable, and you will be able to have a feeling of dissociation that keeps from conscious awareness any excessive craving for nicotine. Within this relaxed state, your commitment to remain free from cigarettes will become even stronger and you will find a kind of strength from your practice of self-hypnosis.”

9. Positive imagery for benefits of smoking cessation. “. . . now, seeing yourself in the future as a nonsmoker, free from nicotine and cigarettes. Notice all of the good things going on around you, how healthy you feel, and . . . [here, individualised imagery was introduced, depending on the patient’s perceived benefits from smoking cessation]. Seeing how well you are able to feel and you will not smoke, no matter if times become stressful or difficult. You will be able to remain calm and relaxed, both now and in the future.”

10. Alerting. “Returning to conscious alertness as a nonsmoker. Returning to conscious alertness in your own time and your own pace, in a way that just feels about right for you today. Feeling very good, normal, with good and normal sensations in every way as you return to full conscious alertness.”

Int J Clin Exp Hypn. 2004 , Jan;52(1):73-81
By: G. R. Elkins, M. H. Rajab, Texas A&M University’s Health Science Center

Study 4: Hypnosis to Quit Smoking for Medical Reasons
The Use of Hypnosis in Controlling Cigarette Smoking.
http://journals.lww.com/smajournalonline/Abstract/1968/09000/The_Use_of_Hypnosis_in_Controlling_Cigarette.23.aspx

Results: This early study (1968) found that the majority of people who want to quit smoking for medical reasons, were able to do so after having four hypnosis sessions.
Southern Medical Journal, 1968 Sep;61(9):999-1002
By: Crasilneck HB, (Ph.D.) , Hall JA. (Ph.D.)

Study 5: Hypnosis to Quit Smoking – One Session (Compared to Placebo and No Treatment)
Use of Single Session Hypnosis for Smoking Cessation.
http://www.ncbi.nlm.nih.gov/pubmed/3369332

Results: When they were followed-up at 4, 12, 24 and 48 weeks, the researchers found that significantly more members of the hypnosis group had quit smoking than the other two groups. They also found that among those still smoking, those who were in the hypnosis group were smoking significantly less than those in the other two groups.

Notes: This study involved 60 participants who were randomly assigned to one of three groups: one that received a placebo, one that received a single hypnosis session and one that received no treatment.

Addictive Behaviours, 1988, Vol. 13(2):205-208
By: J. M. Williams, D. Hall, Dept. of Human Resources, University of Scranton, PA

Study 6: Hypnosis to Quit Smoking – Hospitalised Patients (Compared to Nicotine Replacement Therapy and Going “Cold Turkey”)
Hypnotherapy For Smoking Cessation Sees Strong Results
http://www.sciencedaily.com/releases/2007/10/071022124741.htm

Results: Hospitalised patients who smoke may be more likely to quit smoking through the use of hypnotherapy than patients using other smoking cessation methods. This study shows that smoking patients who participated in one hypnotherapy session were more likely to be nonsmokers at 6 months compared with patients using nicotine replacement therapy (NRT) alone or patients who quit “cold turkey.”

Notes: This study compared the quit rates of 67 smoking patients hospitalised with a cardiopulmonary diagnosis. All patients were approached about smoking cessation and all included in the study were patients who expressed a desire to quit smoking. At discharge, patients were divided into four groups based on their preferred method of smoking cessation treatment: hypnotherapy (n=14), NRT (n=19), NRT and hypnotherapy (n=18), and a group of controls who preferred to quit “cold turkey” (n=16). All patients received self-help brochures. The control group received brief counselling, but other groups received intensive counselling, free supply of NRT and/or a free hypnotherapy session within 7 days of discharge, as well as follow up telephone calls at 1, 2, 4, 8, 12, and 26 weeks after discharge. Patients receiving hypnotherapy also were taught to do self-hypnosis and were given tapes to play at the end of the session.

At 26 weeks after discharge, 50 percent of patients treated with hypnotherapy alone were nonsmokers, compared with 50 percent in the NRT/hypnotherapy group, 25 percent in the control group, and 15.78 percent in the NRT group. Patients admitted with a cardiac diagnosis were more likely to quit smoking at 26 weeks (45.5 percent) than patients admitted with a pulmonary diagnosis (15.63 percent).

The researchers note that hospitalisation is an important opportunity to intervene among patients who smoke.

This study as presented at Chest 2007, the 73rd annual international scientific assembly of the American College of Chest Physicians.
http://www.sciencedaily.com/releases/2007/10/071022124741.htm Oct. 24, 2007
By: Faysal Hasan, MD, FCCP, North Shore Medical Centre, Salem, MADr. Hasan and colleagues from North Shore Medical Centre and Massachusetts General Hospital

Study 7: Hypnosis and Smoking Cessation in the Workplace – Hypnotherapy Accompanying a Smoke-Free Work Policy
Reducing smoking at the workplace: implementing a smoking ban and hypnotherapy.
http://www.ncbi.nlm.nih.gov/pubmed/7670901?dopt=Abstract

Results: Fifteen percent of survey respondents quit and remained continuously abstinent. A survey to assess attitudes toward the policy was conducted 1 year after policy implementation (n = 1256; response rate = 64%). Satisfaction was especially high among those reporting high compliance with the policy. These results suggest that hypnotherapy may be an attractive alternative smoking cessation method, particularly when used in conjunction with a smoke-free worksite policy that offers added incentive for smokers to think about quitting.

Notes: This study examines the impact of a smoke-free policy and the effectiveness of an accompanying hypnotherapy smoking cessation program. Participants in the 90-minute smoking cessation seminar were surveyed 12 months after the program was implemented (n = 2642; response rate = 76%). Seventy-one percent of the smokers participated in the hypnotherapy program.

J Occup Environ Med. 1995 Apr;37(4):453-60
By: G. Sorensen, B. Beder, C. R. Prible, J. Pinney, Dana Farber Cancer Institute, Boston, Massachusetts

Study 8: Smoking and Suggestions Given During Anaesthesia for Surgery
Reducing smoking. The effect of suggestion during general anaesthesia on postoperative smoking habits.
http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2044.1994.tb03368.x/abstract

Results: In a double-blind randomised trial, 122 female smokers undergoing elective surgery were allocated to receive one of two prerecorded messages while fully anaesthetised. The active message was designed to encourage them to give up smoking whilst the control message was the same voice counting numbers. No patient could recall hearing the tape. Patients were asked about their postoperative smoking behaviour one month later. Significantly more of those who had received the active tape had stopped or reduced their smoking (p < 0.01). This would suggest a level of preconscious processing of information.

Anaesthesia. 1994 Feb;49(2):126-8
Comment in: Anaesthesia. 1994 Oct;49(10):917-8
By: J. A. Hughes, L. D. Sanders, J. A. Dunne, J. Tarpey, M. D. Vickers, Department of Anaesthesia, Morriston Hospital, Swansea, West Glamorgan

Study 9: Smoking and Hypnosis: Single Session with Self-Hypnosis
Predictors of smoking abstinence following a single session restructuring intervention with self hypnosis.
http://bscw.rediris.es/pub/bscw.cgi/d4465008/Spiegel-Predictors_smoking_abstinence_self_hypnosis.pdf

Results: Fifty-two percent of the study group achieved complete smoking abstinence 1 week after the intervention; 23% maintained their abstinence for 2 years. Hypnotisability and having been previously able to quit smoking for at least a month significantly predicted the initiation of abstinence. Hypnotisability and living with a significant other person predicted 2- year maintenance of treatment response.

Notes: A consecutive series of 226 smokers referred for the smoking cessation program were treated with a single-session habit restructuring intervention involving self-hypnosis. They were then followed up for 2 years. Total abstinence from smoking after the intervention was the criterion for successful outcome.

Am J Psychiatry. 1993 Jul;150(7):1090-7
By: D. Spiegel, E. J. Frischholz, J. L. Fleiss, H. Spiegel, Department of Psychiatry and Behavioural Sciences, Stanford University School of Medicine, CA

Study 10: Smoking and Hypnosis: Factors for Success – Patient’s Own Reason to Quit, Maintaining Contact with Patient, Self-Hypnosis
Smoking and hypnosis: A systematic clinical approach
http://www.tandfonline.com/doi/abs/10.1080/00207147008415930#preview

Results: 2 methods of helping cigarette smokers stop smoking were compared in treating a total of 181 patients. After 6 months, 60% of those treated with an active, personalised approach were not smoking. This approach emphasised: (a) the feedback, under hypnosis, of the patient’s own reasons for quitting, (b) maintaining contact with the patient by telephone, (c) use of meditation during hypnosis to obtain individualised motives, and (d) Sell-hypnosis. Only 25% of smokers were successfully treated by an earlier hypnotic procedure that did not systematically employ these features.

International Journal of Clinical and Experimental Hypnosis, Volume 18, Issue 4, 1970
By: William Nulanda, Morton Prince Clinic for Hypnotherapy and Peter B. Field, Veterans Administration Hospital, Brooklyn & Morton Prince Clinic for Hypnotherapy

Study 11: Smoking and Hypnosis: Which Suggestions Work
Hypnotic Treatment of Smoking.
http://www.eric.ed.gov/ERICWebPortal/search/detailmini.jsp?_nfpb=true&_&ERICExtSearch_SearchValue_0=ED240439&ERICExtSearch_SearchType_0=no&accno=ED240439

Results: Results indicated that positive suggestions were more efficacious than negative. Treatment was most successful for subjects who did not see themselves as habitual smokers.

Notes: Prior studies of hypnotic treatment of smoking have reported abstinence rates of between 17 and 88 percent at six months, but few have investigated procedures or forms of suggestions. To compare the effectiveness of positive and negative hypnotic suggestions and self-hypnosis for cessation of smoking, 32 subjects were assigned to one of four treatment groups: (1) negative suggestions alone; (2) negative suggestions plus self-hypnosis; (3) positive suggestions alone; and (4) positive suggestions plus self-hypnosis. Subjects also completed a series of smoking history questionnaires; the Self-Efficacy for Smoking Avoidance Questionnaire, to assess expectations for smoking cessation; and the Horn-Waingrow Scale, used to delineate types of smokers. Treatment involved three 1-hour sessions, with those not abstinent at post-treatment or follow-up receiving three additional sessions. Outcome was assessed at post-treatment and 1, 2, 3, and 6 months following the final treatment session. Results indicated that positive suggestions were more efficacious than negative. Treatment was most successful for subjects who did not see themselves as habitual smokers. While ratings of self-efficacy at pre-test and following treatment were not predictive of later self-efficacy, subjects’ ratings at 1 month post-treatment were predictive of later self-efficacy ratings.

Summary of research presented at the Annual Convention of the American Psychological Association (91st, Anaheim, CA, August 26-30, 1983)
By: Samuel A. Bastien, IV; Marc Kessler

Additional References:

NHS Stoptober Campaign

https://cnhcregister.org.uk/newsearch/index.cfm

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