Hypnotherapy For Smoking Cessation

Health care professionals know that quitting smoking may be the single greatest factor toward improving a patient’s overall health and quality of life. But when alerting patients to existing tobacco related health problems, or the long-term consequences of smoking, far too often the provider’s warnings go unheeded. When coupled with extremely high relapse rates among patients who do attempt, the endless cycle of frustration can condition health care professionals to simply stop trying to motivate cessation. The fact is, adequately armed, as a medical professional you are perfectly positioned to make a major difference.

While health care professionals know the benefits of smoking cessation they are not always informed or trained on successful interventions. Many providers have been sold on believing that alternate nicotine delivery vehicles such as the over-the-counter nicotine gum, patch, lozenge are state-of-the-art treatment strategies.

While demonstrating almost two-fold efficacy in clinical trials, trials we now know were not blind as claimed, to date, in real-world settings, pharmacology has proven ineffective as a treatment strategy. As WhyQuit’s founder wrote in November 2008 CMAJ article , “pharmacologic treatment of chemical dependency may be the only known research area in which blinding is impossible.”

A 2002 JAMA study boldly concluded that “NRT appears no longer effective in increasing long-term successful cessation in California smokers.” The most recent such finding was in June 2009 when GlaxoSmithKline, the maker of Nicorette gum, was forced to report that its own quitting survey found that cold turkey quitters trounced pharmacology quitters.

Similar real-world findings are echoed in results from the UK’s national stop smoking program ( Statistics on NHS Stop Smoking Services in England, April to December 2007 – see Table 6); a 2006 unpublished U.S. National Cancer Institute survey of 8,200 quitters, as reported in the Wall Street Journal , Page A1, February 8, 2007; a study of “ Smoking status of Australian general practice patients and their attempts to quit “; English smoking treatment services: one-year outcomes published in Addiction (See Table 6); a 2005 study by Alberg AJ entitled Nicotine replacement therapy use among a cohort of smokers ; Tobacco In London, Facts and Issues (see Figure 14); and a 2002 study by Boyle RG entitled Does insurance coverage for drug therapy affect smoking cessation? .

A March 2003 meta-analysis by GSK consultants found that 93% of patients using over-the-counter NRT products relapsed to smoking within six-months. And the same GSK consultants reported in November of 2003 that 36.6% of Nicorette gum quitters became persistent long-term users of at least 6 months.

Pfizer’s five new varenicline studies (Chantix and Champix) were engineered for success. The studies were clearly not blind as claimed, excluded nearly 30% of applicants reflecting the most challenging quitting populations, were inflated by sixteen one-on-one counseling sessions and eight provider telephone calls, raised 165 potential side-effect concerns , including suicide, and, amazingly, were so sloppy that researchers allowed NRT use between the end of the 12-week treatment period and one-year follow-up without documenting NRT’s impact upon outcome.

Then, as you know, on July 1, 2009 the FDA announced black box warnings for both Chantix and Zyban due to “risk of serious mental health events including changes in behavior, depressed mood, hostility, and suicidal thoughts”. What the FDA failed to mention to physicians is that in the only head-to-head competition between Chantix and NRT, a 2008 Pfizer study in Thorax , that when examining 7-day point prevalence abstinence there, “were no significant differences” between Chantix and nicotine patch users at “either 6 months (varenicline 38.6% vs. patch 34.1%) or one year (varenicline 34.8% vs. patch 31.4%).”

No matter how much or how long a patient has smoked nicotine they need to understand that the possibility of quitting exists for them. The self-help resources and materials reviewed below can aid health care providers in helping patients quit smoking or end dependence upon other forms of nicotine delivery.

Whether WhyQuit’s free motivation, education and support resources are printed and shared as patient office handouts, sampled in the patient waiting area or their existence and availability is simply brought to the patient’s attention, given an opportunity these materials have the potential to make a significant difference over what you’ve previously experienced.

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