health guides

In the year 2000, the United States Public Health Service published updated smoking-cessation guidelines for doctors.¹⁶ This report identified counselling and behavioural therapies as proven effective components of a smoking-cessation programme. Effective components include providing basic information about successful giving up, identifying factors that will increase the risk of relapse, and teaching problem-solving and coping skills. Also effective is social support provided either in a healthcare setting (for example, being able to talk about the giving up process with a doctor) or by strategies that teach the quitter to build a support network among friends, family, and the community. Guidelines issued in other countries have reached similar conclusions about the effectiveness of counselling and behavioural therapies.¹⁷ Government-sponsored, free counselling resources in North America include Quitline [800-QUIT-NOW] and SmokeFree (www.smokefree.gov). Group or individual counselling is often a component of successful smoking cessation programmes offered in schools and the workplace.^{18, 19}

People tend to smoke more often under conditions of stress. Those who achieve long-term success in giving up smoking have been shown to have more social support and less stress than people who eventually relapse.²⁰ Stress-reduction techniques that have been shown in controlled trials to be effective for assisting smoking cessation include self-massage, guided relaxation imagery, and exercise.^{21, 22, 23}

Some research indicates that the effectiveness of acupuncture on abstinence from smoking is similar to that reported for nicotine chewing gum and behavioural therapy, and that these methods can complement each other.²⁴ One controlled trial showed that daily cigarette consumption decreased more significantly during acupuncture treatment to points associated with smoking cessation than in fake acupuncture treatment (i.e., acupuncture applied to points not associated with smoking cessation). Altogether, 31% of subjects in the treatment group had quit smoking completely at the end of the treatment, compared with none in the control group.²⁵ Electroacupuncture treatment to points on the ear has also been shown to aid in smoking cessation compared with fake ear acupuncture in a controlled trial.²⁶ However, most clinical trials have not achieved comparable results. An analysis of 22 studies found that while acupuncture is often as effective as other smoking cessation techniques, its effectiveness does not last very long. Moreover, in most studies the overall effect of real acupuncture was no better on average than fake acupuncture for smoking cessation.²⁷

A controlled clinical trial showed that people undergoing single hypnosis sessions smoked significantly fewer cigarettes and had a higher frequency of abstinence than a placebo control group.²⁸ However, most clinical trials have not corroborated these results.²⁹ A review of 59 studies of hypnosis and smoking cessation concluded that hypnosis “cannot be considered a specific and efficacious treatment for smoking cessation.”³⁰