RESEARCH

Summary of Findings:

After 1 session, 95% of those who received ‘advanced therapy’ had quit smoking. The remaining 5% received a second session of treatment, leading to a further 1.3% of the group quitting smoking. In total, therefore, at 6 months, 97% of those who received ‘advanced therapy’ had quit smoking. 

Excerpts from “Smoking Cessation and Hypnosis”

A comparative review of the effectiveness of hypnosis, an advanced method of hypnosis, and other interventions used for the cessation of smoking.

by Michael O’ Driscoll B.Sc., M.Sc. (Oxon)

This paper presents some of the findings from a study looking at all methods of smoking cessation, including standard hypnotherapy techniques and compares those to a specially developed advanced method of hypnotherapy for smoking cessation.

High quit rates for hypnosis compared to other methods

A larger meta-analysis of research into hypnosis to aid smoking cessation (Chockalingam and Schmidt 1992) (48 studies, 6,020 subjects) found that the average quit rate for those using hypnosis was 36%, making hypnosis the most effective method found in this review with the exception of a program which encouraged pulmonary and cardiac patients to quit smoking using advice from their doctor (such subjects are obviously atypical as they have life-threatening illnesses which are aggravated by smoking and therefore these people have very strong incentives to quit).

Table 1. Effectiveness of different types of intervention to achieve smoking cessation adapted from data in Chockalingam and Schmidt (1992)
Type of intervention% who quit smokingno. of subjectsno. of trials
Advice (cardiac patients)42455334
Hypnosis36602048
Miscellaneous35140010
Advice (pulmonary patients)34166117
Smoke aversion312557103
Group withdrawal clinics301158046
Acupuncture30299219
5-day plans3097613
Other aversive techniques273926178
5 day plans26782825
Aversive methods in25104126
Educational (health promotion initiatives)24335227
Medication18681029
Physician interventions (more than advice)18348616
Nicotine chewing gum16486640
Self-care (self-help)15358524
Physician advice7719017

Law and Tang (1995) looked at 10 randomized trials, carried out between 1975 and 1988, of hypnosis in smoking cessation. They found that the effect of hypnosis was highly statistically significant1. The research they examined involved 646 subjects, and cessation rates at 6 months post-treatment ranged from 10% to 38% (the average figure was 24%).

Table 2. Effectiveness of different types of intervention to achieve smoking cessation (adapted from data in Law and Tang 1995)
Type of intervention% who quit smokingno. of subjectsno. of trials
Supportive group session (heart attack survivors)362231
Hypnosis2464610
Supportive group session (healthy men in high risk for heart attack group)21132054
Nicotine patch (self-referral)13202010
Nicotine gum (self-referral11346013
Supportive group session (in pregnancy)8473810
Advice from GP (additional sessions)5646610
Gradual reduction in smoking56308
Nicotine gum (GP-initiated treatment)425974
Nicotine gum (GP initiated treatment)3714615
Acupuncture327598
Advice from GP (one-off)21443817
Supportive group session220598
Advice from nurses in health promotion clinics133692

Table 2 (above) shows that the meta-analysis of Law and Tang confirms, to a large extent, the meta-analysis of Chockalingam and Schmidt (1992); in both cases, hypnosis appears as the most effective form of intervention to achieve smoking cessation with the exception of groups who are highly motivated to quit for medical reasons, such as those with existing heart or pulmonary problems.

A more recent study, by Ahijevych et al (2000), produces a similar overall figure for the success of hypnosis. This study looked at a randomly selected sample of 2,810 smokers who 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. 22 percent of participants reported not smoking during the month prior to the interview.

Tailored Hypnosis—Taking It to the Next Level

The results discussed so far indicate that when the bulk of random trials are considered, hypnosis is shown to be the most effective intervention for achieving smoking cessation. Yet this is only half the story—many of the trials discussed so far have used very brief sessions, using standardized hypnosis techniques; many have, in fact, taken place in group sessions (making it difficult to tailor to each individual’s needs) and have not necessarily been carried out by expert practitioners of hypnosis. If, under these circumstances, hypnosis can achieve such positive outcomes in terms of enabling smokers to quit, then what might be achieved using programs of hypnosis which are carried out by expert hypnotists and are tailored to the needs of the individual who wants to stop smoking?

Nuland and Field (1970) found an improvement rate of 60% in treating smokers with hypnosis. The increased effectiveness was achieved by a more personalized approach, including feedback (under hypnosis) of the client’s own personal reasons for quitting. These researchers also employed a technique of having the client maintain contact by telephone between treatments and utilized self-hypnosis in addition.

Von Dedenroth (1968) devised an innovative unique approach which appears to have been extremely successful several weeks since cigarettes have become more and more unpleasant.

The study by Von Dedenroth has the highest quoted success rate for hypnosis in achieving smoking cessation which has been reported in the literature to date; Von Dedenroth found that his use of hypnosis enabled 94% of 1000 subjects to stop smoking (when checked at 18 months).

Practice Builders Study (2000) (Smoke Free International’s proprietary method)

This research was carried out on 300 subjects (beginning in January 2000 and continuing until March 2002) who responded to an advertisement. A ‘blind trial’ technique was used—subjects were not aware that they were taking part in a research project although they all ticked a box on their intake forms saying that they understood that the hypnotist’s methods were always being measured, tested, and improved, and that results would be collated and studied. Client confidentiality was assured so that their data could be used, but not their names, and these subjects were randomly allocated to receive either ‘standard’ hypnotherapy or a special formulation of hypnotherapy which Practice Builders has termed ‘advanced therapy’. 51% of respondents were male and 49% female; the median age of all subjects was 44 years.

No respondents had previous experience of hypnosis—51% of subjects had tried nicotine patches, 14% had tried nicotine gum, 7% had tried acupuncture, 6% had tried using a nicotine inhaler, and 30% had previously tried to quit using will-power alone. 11% of subjects had not previously tried to quit smoking.

For all subjects:

The client was interviewed to make sure that they wanted to stop smoking for their own reasons, and were not being pressured into it by someone else (doctor, loved one etc.).

The price was kept high (£250) to establish commitment, and to avoid people who were casually or speculatively trying hypnosis (as opposed to those who have some commitment, confidence or belief that hypnosis would help them to stop smoking).

All subjects waited a minimum of three weeks for an appointment in order to build expectancy—subjects were already thinking about, and planning being, a non-smoker for weeks before the treatment began.

Before the actual hypnosis, the client (or subject) is asked a series of questions about their smoking habit and their beliefs. This allows the hypnotherapist and the client to build rapport and also lets the hypnotherapist become aware of any thought patterns based on myths or misconceptions that need to be cleared up before the hypnosis. They are asked, for example:

  • ‘Do you believe you are addicted to nicotine?’ 
  • ‘What fears do you have about stopping?’ 
  • ‘What do you know about hypnosis?’ 

Hypnosis was then fully explained to the client, as well as how the conscious and the unconscious mind works, and any myths debunked (such as, you cannot make someone do something they don’t want to do, hypnosis is not sleep or unconsciousness, you will be aware of everything that is going on and will remember everything that happened in hypnosis after the session, you can stop the session at any time, etc.). This is called the “pre-talk”.

A hypnotic contract is then entered into, in which the client agrees to go along with all techniques and to accept all the suggestions that are for their benefit.

For subjects treated with the standard technique:

The client then reclines in the chair, and a basic stop smoking script is read. This type of standard technique doesn’t allow for much in the way of personalizing a session, as it is the same for every client. The wording of some of the best basic techniques uses hypnotic language patterns (Neuro Linguistic Programming). The client is then emerged.

For subjects treated with the advanced technique:

Hypnosis is induced using a progressive test induction tailored to the client. Ideo-motor techniques are used to gain unconscious communication. The client’s own motivations, Meta programs, and values are utilized in the session using a combination of metaphor and suggestion. NLP sub-modality and anchoring techniques are used according to the client’s processing style. At the end of the session, the client is emerged from hypnosis, and the change is tested, then future-paced and ratified.

Findings

Quit rates were established through telephone interviews 1 month and 6 months after the first session of treatment.

After 1 session, 95% of those who received ‘advanced therapy’ had quit smoking. The remaining 5% received a second session of treatment, leading to a further 1.3% of the group quitting smoking. In total, therefore, at 6 months, 97% of those who received ‘advanced therapy’ had quit smoking. 

Of those who received ‘standard therapy,’ 51% quit smoking after one session, and a further 6% quit after a second session—a total of 57% had quit smoking at 6 months.

Those who were still smoking at 6 months did not differ from those who had successfully quit in terms of gender, age, or therapies previously tried. These results mean that for both standard treatments and the ‘advanced treatment,’ quit rates are extraordinarily high and well above what has hitherto been reported in the literature. Results for both treatments were significant at the 0.001 level (chi-square).

Outcomes for the ‘advanced therapy’ are considerably higher than any findings previously reported in the literature. In addition, the success rate achieved using the standard technique was considerably higher than expected, and this may be due to the fact that the elements that the standard treatment and ‘advanced treatment’ have in common (price, waiting period for the session, advertising exposure, and pre-talk, etc.) have powerful effects on outcomes.

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