Published: October 26, 2007 12:24 am            

‘You will not smoke ... You will not smoke’

NORTH ANDOVER, Mass. — It wasn’t hypnosis alone that helped George McCabe quit smoking six years ago, but hypnosis certainly helped.

His hypnotherapy session happened to fall one day after he decided to have his last smoke.

“I wasn’t sure if I could relax enough to do what you’re supposed to do,” McCabe said.

But hypnotherapist Karen Pischke talked to him calmly and soothingly, and he was surprised by how easily he fell into a deep relaxation. She sent him home with a recording, which he played a couple times a day for the next few weeks to get him through the cravings.

Success stories like McCabe’s eventually led Pischke, a registered nurse who practices hypnotherapy at Salem (Mass.) Hospital, and the doctors there to take a closer look at hypnosis as a smoking cessation tool.

They designed a study involving smokers who were hospitalized for smoking-related heart or lung problems, and offered them a choice of quitting aids, including hypnotherapy.

“Hypnotherapy, interestingly, worked very well,” said pulmonologist Faysal Hasan, who reported some preliminary results from that study on Monday at a medical meeting in Chicago.

Smokers who had just one hypnotherapy session with Pischke had a 50 percent chance of kicking the habit and remaining smoke-free for six months, compared with just 16 percent of smokers who opted for a nicotine replacement patch. Smokers who used hypnotherapy and the patch together had the same success rate as those who used hypnotherapy alone.

Though hypnotherapy has been recognized by the American Medical Association as a valid therapy since 1958, research on whether it works has been sparse. A systematic review of studies on hypnotherapy and smoking, published in the Cochrane Library in 1998, found the results to be so inconsistent that the reviewers couldn’t draw any general conclusions.

“The literature on hypnotherapy is all over the place,” Hasan said. “Most of the studies have no controls. A lot of them are anecdotal. You don’t know what you’re getting for hypnotherapy.”

That’s one of the reasons Hasan’s study drew so much interest when he presented it at CHEST 2007, the annual meeting of the American College of Chest Physicians. The study had a control group — patients who chose to quit cold turkey. And, Hasan said, it is possibly the first study that compares hypnotherapy head-to-head with a traditional smoking cessation method, such as the nicotine replacement patch.

“I’m surprised, actually,” Hasan said. “I’m surprised our data is that good.”

But the fact hypnotherapy works is no surprise to people who practice it.

Deanna D’Angelo, a hypnotherapist at Essential Healing in Newburyport, Mass., claims that she can break a smoking habit in a week through just two hypnotherapy sessions.

“Hypnosis is all about how somebody thinks,” D’Angelo said. “It’s about the thoughts they think and the beliefs they hold, the false belief that they need a cigarette or that it helps them in some way. It’s all about changing that.”

Hypnotherapists have different approaches, but the basic concept is the same.

Typically, a smoking cessation session begins with an intake form and interview to find out the smoker’s history of trying to quit, their motivation for quitting and what they like about smoking that keeps them doing it.

Then, the hypnotherapist helps the person relax their body and reach a comfortable state where their conscious mind is “zoned out” and the subconscious is more open to suggestion. The hypnotherapist then helps the person see images of being healthy, in control, breathing easily, moving more comfortably and feeling pleasure in a smoke-free future.

“This is not a logical problem, it’s a subconscious emotional problem,” said Jerry Valley of Valley Hypnosis in Methuen. “You have to touch the emotions down in the subconscious mind, down where the smoker has attached pleasure to smoking. The hypnotist has to destroy that fallacy because it’s really not true. It’s all within their belief system.”

In the study, Pischke did just one standard hypnotherapy session with each patient, and the audio recording they were given was the same for every patient. For her regular clients, Pischke customizes the hypnosis session to each person, spreads the therapy over two sessions ($110 each), and the recordings they go home with to continue self-hypnosis feature the customized sessions.

As much as they tried to standardize Pischke’s technique for the study, Hasan told his colleagues at the meeting that Pischke’s skills as both a hypnotherapist and a behavior modification counselor probably had something to do with the high success rate.

Also, he noted that patients in the study were allowed to choose their treatment method, so self-selection could have biased the results. In general, women tended to opt for hypnotherapy and men were more likely to choose none of the therapy options and instead tried to quit “cold turkey.”

And finally, all the study participants were motivated to quit. They had all just suffered a frightening medical event caused by their smoking habit. And, if they told the doctors they weren’t interested in quitting, they weren’t invited to join the study. In addition to motivation, everybody except those in the control group had extensive counseling in addition to hypnotherapy and/or nicotine replacement.

“The important message is nothing works by itself,” Hasan said. “There is no magic patch or pill. You need motivation.”

That’s certainly true in McCabe’s situation. The Salem, Mass., resident said what made his final attempt different from every other time he tried to quit was that his mother had just died of lung cancer. Hypnotherapy and his smoking cessation class at Salem Hospital both gave him support in quitting, but he said his motivation was what ultimately made the difference.

“The hypnotherapy made it a little bit easier,” he said, “because I wasn’t as irritable, I guess, or as agitated.”



Julie Kirkwood writes for The Eagle-Tribune of North Andover, Mass. E-mail her at jkirkwood@eagletribune.com



The STOPP Plus trial

(Smoking Cessation Treatment of Pneumonia Patients Plus Cardiopulmonary Patients)

Purpose: To find out if hypnosis helps people quit smoking.

Background: Smokers have been using hypnosis to quit for years, but there haven’t been many studies to find out whether it really works. The few studies that have been done have shown mixed results.

This study: Registered nurse Karen Pischke started using hypnosis with smokers at North Shore Medical Center in Salem in 2001. Her colleague who runs the hospital’s smoking cessation program noticed that Pischke’s patients generally were more successful at quitting than people who hadn’t tried hypnosis.

Dr. Faysal Hasan, a pulmonologist at the hospital, was already running a study trying to find the most effective ways to take advantage of the “teaching moment” when a smoker is hospitalized for a smoking-related condition. He asked Pischke to incorporate hypnotherapy into the study.

What they did: Starting about a year and a half ago, doctors approached smokers who were hospitalized at Salem (Mass.) Hospital for lung and heart problems and asked if they wanted to quit smoking.

If they said yes, the doctors offered them a choice of free therapies: a hypnotherapy session, a month’s supply of nicotine replacement patches with gum and other nicotine replacement products, or both. These groups all received counseling in person and in six follow-up telephone calls over the course of six months. The doctors also kept track of a control group of patients who chose to quit “cold turkey.”

Results so far: Half the smokers using hypnotherapy succeeded in staying smoke-free for at least six months. The success rate was the same for those who used hypnosis and nicotine replacement together. Only about 16 percent of smokers who used nicotine replacement alone stayed smoke-free for six months. The cold turkey quitters had a surprisingly high success rate of about 25 percent, or one in four.

These are just the early results, based on 67 people who enrolled near the beginning of the study. About 80 people have enrolled in the study to date and Hasan is still recruiting another 80 more through the hospital.

—Julie Kirkwood

        

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