On Hypnosis and Smoking Cessation

Tobacco smoking is the leading preventable cause of adverse health outcomes, early mortality, as well as worsening progression of COVID-19 in the United States [1,2]. Nearly 1 in 5 deaths in the U.S. alone are associated with tobacco smoking, 10-fold the number of deaths attributed to all wars in U.S. history [3]. Moreover, tobacco smoking increases the risk of lung cancer by approximately 25 times, the risk of stroke and coronary heart disease by 2-4 times, and the risk of type II diabetes by 30-40% [3]. Government projections estimate more than 5.6 million children and adolescents in the United States will die prematurely due to smoking [3].

Yet, according to the Center for Disease Control and Prevention (CDC) [1], more than 40 million adults in the U.S. are tobacco smokers. Furthermore, according to the annual report of the Federal Trade Commission, in 2020, cigarette sales went up for the first time in 20 years, with 800 million more cigarettes bought than in 2019 [4]. Thus, reducing smoking is a top public health priority. Despite the high rates of smoking, about 70% of smokers in the U.S. report a motivation to stop smoking, and at least 50% have attempted quitting [3]. This is encouraging, as evidence suggests that quitting tobacco smoking can produce substantial improvements in physical health: within a few years after quitting smoking, the risk of heart attack drops, the risk of stroke decreases to an almost never-smoked level, and the risk of lung cancer drops by 50% after more than 10 years of not smoking [3,5].

Can hypnosis help with smoking cessation?

Several studies found hypnosis to be a beneficial drug-free approach for smoking cessation and other related habit control. For example, hypnosis for smoking cessation led to 40% cessation after treatment, 60% at 12-week follow-up, and 40% at 26-week follow-up [6]. Some found that even a single session of hypnosis can result in significant reductions in cigarette smoking compared to placebo or no-treatment control groups, as well as greater abstinence at 4, 12, 24, and 48 weeks after the session [7]. Although most studies of hypnosis for smoking cessation were relatively small, a large (N = 226) uncontrolled clinical trial found that a single session of hypnosis for smoking cessation yielded a 52% post-treatment cessation and 23% maintenance of continuous 2-year abstinence [8]. Hypnosis might also enhance the effects of behavioral interventions on smoking cessation. For example, one study demonstrated that after 3-months of hypnosis combined with counseling, 56% of participants stopped smoking, compared to 12% using counseling alone and 0% of those who received other task assignments (controls) [9]. Furthermore, at a 10-month follow-up, 50% of those who received hypnosis and counseling remained abstinent compared to 0% of those who received counseling alone [9]. Self-hypnosis is a readily available and effective means of reinforcing an number of quitting strategies. You can take a break, inhale fresh air rather than smoke, and feel better without the tar and nicotine.

Why is hypnosis a better alternative to smoking cessation?

First of all, the effects of hypnosis seem to be greater than those of medication and behavioral treatments. For example, meta-analytic studies (statistical summaries of findings across different studies) of drug therapy combined with behavioral interventions estimated that about 25% of individuals remained smoking-free one year after treatment ended [10], and physician advice alone produced only 2.5% smoking abstinence [11].

Nicotine replacement therapy (NRT), the most common drug-based approach for smoking cessation, does not require a prescription but comes with a substantial financial cost [12,13]. Moreover, a recent randomized trial found that hypnosis-based treatment for smoking cessation, whether combined with nicotine replacement therapy (NRT; such as nicotine patches) or by itself, is up to three times more effective in preventing smoking behavior than NRT (at a 26-week follow up) [14]. When combined with NRT, a randomized trial found that one year after treatment 29% of participants who received hypnosis remained abstinent, compared to 16% of those who received counseling for smoking cessation [15].

Aside from the discussion about effectiveness, some medications for smoking cessation come with substantial financial costs and potential side effects (e.g., nausea, headache, and insomnia) [16], as well as interactions with other medications [17]. Additionally, some of the first-line drug treatments for smoking are not recommended for individuals with risk for mental health problems due to potential increases in anxiety and mood symptoms [17].

Bottom Line

Hypnosis can be an effective approach to reducing tobacco use and maintaining abstinence. Hypnosis is likely more effective than common drugs and counseling for smoking cessation and can enhance their effects when combined with those approaches. Given the effectiveness, safety, and ease of use of hypnosis, and considering the devastating health effects of smoking, we strongly recommend hypnosis for smoking reduction and cessation. Let us know what you think!

 

References

  1. Cornelius, M. E., Wang, T. W., Jamal, A., Loretan, C. G. & Neff, L. J. Tobacco Product Use Among Adults — United States, 2019. Morb. Mortal. Wkly. Rep. 69, 1736–1742 (2020).

  2. Patanavanich, R. & Glantz, S. A. Smoking Is Associated With COVID-19 Progression: A Meta-analysis. Nicotine Tob. Res. 22, 1653–1656 (2020).

  3. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. (U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014).

  4. Federal Trade Commission. Cigarette Report for 2020. (2021).

  5. Shopland, D. R. & Burns, D. M. Medical and public health implications of tobacco addiction. in Nicotine Addiction: Principles and Management (eds. Orleans, C. T. & Slade, J.) 105–128 (Oxford University Press, 1993).

  6. Elkins, G., Marcus, J., Bates, J., Hasan Rajab, M. & Cook, T. Intensive Hypnotherapy for Smoking Cessation: A Prospective Study. Int. J. Clin. Exp. Hypn. 54, 303–315 (2006).

  7. Williams, J. M. & Hall, D. W. Use of single session hypnosis for smoking cessation. Addict. Behav. 13, 205–208 (1988).

  8. Spiegel, D. et al. Predictors of smoking abstinence following a single-session restructuring intervention with self-hypnosis. Am. J. Psychiatry 1090–1097 (1993).

  9. Pederson, L. L., Scrimgeour, W. G. & Lefcoe, N. M. Comparison of hypnosis plus counseling, counseling alone, and hypnosis alone in a community service smoking withdrawal program. J. Consult. Clin. Psychol. 43, 920 (1976).

  10. Tønnesen, P. Smoking cessation: How compelling is the evidence? A review. Health Policy 91, S15–S25 (2009).

  11. Stead, L. F. et al. Physician advice for smoking cessation. Cochrane Database Syst. Rev. 2013, CD000165 (2013).

  12. Howard, P., Knight, C., Boler, A. & Baker, C. Cost-Utility Analysis of Varenicline versus Existing Smoking Cessation Strategies using the BENESCO Simulation Model. PharmacoEconomics 26, 497–511 (2008).

  13. Rodu, B. & Plurphanswat, N. Quit Methods Used by American Smokers, 2013-2014. Int. J. Environ. Res. Public. Health 14, 1403 (2017).

  14. Hasan, F. M. et al. Hypnotherapy is more effective than nicotine replacement therapy for smoking cessation: Results of a randomized controlled trial. Complement. Ther. Med. 22, 1–8 (2014).

  15. Carmody, T. et al. Hypnosis for smoking cessation: A randomized trial. Nicotine Tob. Res. 10, 811–818 (2008).

  16. Hays, J. T., Ebbert, J. O. & Sood, A. Efficacy and Safety of Varenicline for Smoking Cessation. Am. J. Med. 121, S32–S42 (2008).

  17. Molero, Y., Lichtenstein, P., Zetterqvist, J., Gumpert, C. H. & Fazel, S. Varenicline and risk of psychiatric conditions, suicidal behaviour, criminal offending, and transport accidents and offences: population based cohort study. BMJ 350, h2388 (2015).

About the author:

Afik Faerman, Ph.D. is a postdoctoral scholar at Stanford University. He completed his doctoral training in clinical psychology with an emphasis in neuropsychology, and his clinical training at the University of California, San Francisco (UCSF) and Baylor College of Medicine in Houston, TX. Afik’s research centers on identifying key neurocognitive mechanisms in clinical change, focusing on hypnosis, pain, and sleep. His research was supported and acknowledged by the American Psychological Association, the Society for Clinical and Experimental Hypnosis, and the American Society for Clinical Hypnosis.