ArticlePDF Available

Clinical Hypnosis For Smoking Cessation: Preliminary Results of a Three-Session Intervention

Authors:

Abstract

This study presents preliminary data regarding hypnosis treatment for smoking cessation in a clinical setting. An individualized, 3-session hypnosis treatment is described. Thirty smokers enrolled in an HMO were referred by their primary physician for treatment. Twenty-one patients returned after an initial consultation and received hypnosis for smoking cessation. At the end of treatment, 81% of those patients reported that they had stopped smoking, and 48% reported abstinence at 12 months posttreatment. Most patients (95%) were satisfied with the treatment they received. Recommendations for future research to empirically evaluate this hypnosis treatment are discussed.
CLINICAL HYPNOSIS FOR
SMOKING CESSATION:
Preliminary Results
of a Three-Session Intervention
1
GARY R. ELKINS
2
AND M. HASAN RAJAB
Texas A&M University System Health Science Center College of Medicine
and Scott & White Clinic and Hospital, Temple, Texas, USA
Abstract: This study presents preliminary data regarding hypnosis
treatment for smoking cessation in a clinical setting. An individu-
alized, 3-session hypnosis treatment is described. Thirty smokers en-
rolled in an HMO were referred by their primary physician for
treatment. Twenty-one patients returned after an initial consultation
and received hypnosis for smoking cessation. At the end of treatment,
81% of those patients reported that they had stopped smoking, and
48% reported abstinence at 12 months posttreatment. Most patients
(95%) were satisfied with the treatment they received. Recommenda-
tions for future research to empirically evaluate this hypnosis treat-
ment are discussed.
Each year more than 430,000 deaths in the United States are attrib-
utable to tobacco use (U.S. Department of Health and Human Ser-
vices, 1990), and smoking is a leading risk factor in a host of serious
illnesses. Epidemiological data suggest that approximately 46% of
smokers try to quit each year. However, only 5% of smokers who
attempt to quit on their own are likely to be successful (Giovino,
Henningfield, Tomar, Escobedo, & Slade, 1995).
Clinical hypnosis is a brief intervention that appears to be well
accepted by most medical patients (Elkins & Wall, 1996) and may be
of benefit to some smokers. However, clinical and experimental stud-
ies to date have reflected a mixed picture regarding the efficacy of
clinical hypnosis for smoking cessation, with some studies reporting
The International Journal of Clinical 0020-7144/04/5201-073$16.00
and Experimental Hypnosis
#
The International Journal of Clinical
2004, Vol. 52, No. 1, pp. 73–81 and Experimental Hypnosis
Manuscript submitted January 5, 2001; final revision received February 5, 2002.
1
This research was supported by a grant (R1737) from the Scott & White Research
Foundation. Findings were presented at the 15th International Congress of Hypnosis
meeting, October 2000. The authors gratefully acknowledge the assistance of Glen Cryer
in the preparation of this manuscript.
2
Address correspondence to Gary Elkins, Ph.D., Mind-Body Health Research
Program, Department of Psychiatry and Behavioral Sciences, Scott & White Clinic
and Hospital, 2401 South 31st Street, Temple, TX 76501, USA. E-mail: gelkins@
swmail.sw.org
73
a high success rate of more than 80% (Crasilneck, 1990) and others
reporting less than 25% abstinence (Ahijevych, Yerardi, & Nedilsky,
2000).
Recently, in a critical review, Green and Lynn (2000) examined 59
studies of hypnosis and suggestion-based approaches for smoking
cessation. Their conclusions included that, at the present time, the
evidence for whether hypnosis yields results superior to placebos is
mixed and that hypnosis may be considered a ‘‘possibly efcacious’’
treatment for smoking cessation.
In an earlier review, Holroyd (1980) suggested that the likelihood of
success for hypnosis in treatment of tobacco dependency may be
increased when four criteria were met: (a) more than one session,
(b) individualized hypnotic suggestions, (c) adjunctive treatment
and follow-up, and (d) an intense interpersonal relationship. The
primary objective of the present study was to examine the effectiveness
of a specic clinical hypnosis treatment that is consistent with these
criteria.
We examined the effectiveness of a clinical-hypnosis intervention at
the end of treatment and at 3 months, 9 months, and 12 months
posttreatment. In addition, this study examined the degree of patient
satisfaction with this treatment.
METHOD
Subjects
Thirty smokers enrolled in a health maintenance organization
(HMO) were referred by their primary care physician for smoking
cessation. After an initial consultation, 21 of the patients returned for
hypnosis. The average age was 47 (SD ¼ 11) and ranged from 21 to 69
years. Fifty-seven percent were men and 81% were married. The
average number of years smoking was 26 years (SD ¼ 11), and the
average number of packs of cigarettes smoked per day was two
(SD ¼ 1). All patients reported having failed in previous unassisted
attempts to stop smoking.
Intervention Protocol
The clinical-treatment protocol included three sessions. The rst
session was the initial consultation and did not include a hypnotic
induction. Sessions 2 and 3 involved individually adapted hypnotic
suggestions and an individual therapeutic relationship with each
patient. Each patient was also provided with a cassette tape record-
ing of a hypnotic induction with direct suggestions for relaxation
and a feeling of comfort. The patients were seen biweekly for
treatment.
74 GARY R. ELKINS AND M. HASAN RAJAB
Session 1. During the rst session the initial consultation was com-
pleted and data were collected regarding the patients history of
smoking and any previous attempts to quit. In addition, an assessment
was completed of the patients mental status and any psychopathology.
This session also included a discussion of the addictive aspects of
nicotine and the relationship between stress and cigarette smoking.
Each patient was asked to select a date to stop smoking, to discard all
tobacco products, and to return for hypnosis treatment on that date.
Each patient was asked to discuss their reasons for wanting to stop
smoking and the possible positive effects of stopping smoking. They
were also asked to consider the social support available to them. Each
patient was provided with a brief discussion regarding myths and
misconceptions about hypnosis and the process used in hypnotic
induction. The session lasted for approximately 45 minutes and al-
lowed for the development of rapport and a positive therapeutic
relationship but did not involve a hypnotic induction.
Session 2. During the second session, patients participated in a 25-
minute hypnotic session with suggestions to experience relaxation and
comfort. In addition, suggestions were given for deepening relaxation,
absorption in relaxing imagery, a commitment to stop smoking, de-
creased craving for nicotine, posthypnotic suggestions, practice of self-
hypnosis, and to visualize the positive benets of smoking cessation.
The induction was standardized, but the specic imagery for relaxation
and the positive benets for smoking cessation were individualized
based upon the patients preference regarding such imagery. The
suggestions may be summarized as follows:
(a) Eye-focus induction. ‘‘Begin by focusing your attention on a spot
on the wall. As you concentrate, begin to feel more relaxed. Concentrate
intensely so that other things begin to fade into the background. As this
occurs, noticing a relaxed and heavy feeling and allowing your eye-lids
to close.’’
(b) Relaxation. ‘‘Noticing a wave of relaxationthat begins at the top
of your head and spreads across your forehead, face, neck, and
shoulders. Every muscle and every ber of your body is becoming
more and more completely relaxed. More and more noticing a feeling of
letting go and becoming so deeply relaxed.’’
(c) Comfort. ‘‘. . . and as you become and remain more relaxed,
nding a feeling of comfort. Feeling safe and secure. A peaceful feeling,
calm and secure. Feeling so calm that nothing bothers or interferes with
this feeling of comfort.’’
(d) Mental imagery for relaxation. ‘‘As you can hear my voice with a
part of your mind, with another part going to a place where you feel
safe and secure. A place where you become so deeply relaxed that you
CLINICAL HYPNOSIS FOR SMOKING CESSATION 75
are able to respond to each suggestion just as you would like to, feeling
everything you need to feel and to experience.’’ (Here individualized
imagery is suggested, for example, suggestions for walking down a
mountain path or along the beach, depending on the patients pre-
ference.)
(e) Commitment for smoking cessation. ‘‘. . . and today becoming a
nonsmoker, becoming free from nicotine and free from ciga-
rettes. ...You will not smoke cigarettes or use tobacco again. With
each day that passes, your commitment to remain free from cigarettes
will become stronger and each time you enter this relaxed state you will
remember the reasons you want to stop smoking.’’ (Here individu-
alized imagery is suggested consistent with the patients individual
reasons for wanting to stop smoking, i.e., health, family, nancial, etc.)
(f) Dissociation from cravings. ‘‘As you enter an even deeper level of
hypnosis, you may notice a oating sensation, less aware of your body,
just oating in space. Your body oating in a feeling of comfort and
your mind, just so aware of being in that pleasant place [individualized
imagery for a pleasant place]. As your body oats, you will not be
bothered by craving nicotine. Your mind blocks from conscious aware-
ness any cravings and you can feel more detached from your body as
you become more relaxed.’’
(g) Posthypnotic suggestions. ‘‘. . . and as you become and as you
remain free from nicotine and free from cigarettes, you will nd a sense
of satisfaction and accomplishment. You will nd that, more and more,
you are able to sleep very well, your sense of smell will improve, and
your sense of taste will improve. You will not eat excessively and you
will nd an appropriate amount of food to be satisfying to you.’’
(h) Self-hypnosis. ‘‘Each time you practice self-hypnosis or listen to
the tape recording that I will provide to you today, you will be able
to enter a very deep state of relaxation, just as deep as you are
today ...and within this relaxed state, you will nd a feeling of control.
You will be able to become so deeply relaxed that you will become very
comfortable, and you will be able to have a feeling of dissociation that
keeps from conscious awareness any excessive craving for nicotine.
Within this relaxed state, your commitment to remain free from ciga-
rettes will become even stronger and you will nd a kind of strength
from your practice of self-hypnosis.’’
(i) Positive imagery for benefits of smoking cessation. ‘‘... now, seeing
yourself in the future as a nonsmoker, free from nicotine and cigarettes.
Notice all of the good things going on around you, how healthy you
feel, and ...[here, individualized imagery was introduced, depending
on the patients perceived benets from smoking cessation]. Seeing
how well you are able to feel and you will not smoke, no matter if times
76 GARY R. ELKINS AND M. HASAN RAJAB
become stressful or difcult. You will be able to remain calm and
relaxed, both now and in the future.’’
(j) Alerting. ‘‘Returning to conscious alertness as a nonsmoker.
Returning to conscious alertness in your own time and your own pace,
in a way that just feels about right for you today. Feeling very good,
normal, with good and normal sensations in every way as you return to
full conscious alertness.’’
Upon alerting, the therapist asked whether the patient felt fully
conscious, alert, and aware of his or her surroundings. The use of a
cassette tape recording to reinforce the use of self-hypnosis was dis-
cussed. It was discussed that the tape recording included only sugges-
tions for relaxation and for a comfortable feeling. (The tape recording
included the same induction and suggestions as summarized above,
with the exception that only suggestions for relaxation and comfort
were given; no suggestions specically regarding smoking cessation
were included on the audio tape.) It was discussed that the practice of
this tape would help the patient feel more comfortable and control any
excessive craving for nicotine. The patient was asked to practice with
the tape recording four or more times per week.
Session 3. Patients returned for follow-up at the third session.
Patients reported on their progress and any difculties they may have
had. Each patient was asked about his or her use of the audio cassette
tape recording and to report on his or her experience. At the conclusion
of the session, a hypnotic induction was completed as summarized in
Session 2.
Data Collection and Analysis
Data collection was accomplished by retrospective chart review and
telephone follow-up. The data collection/chart review was completed
by the Scott & White Clinical Data Analysis Laboratory (CDAL) and
was independent from the author. Patients were contacted 1 year after
their last session and asked whether they had stopped smoking and
for how long after treatment. Specically, patients were asked: ‘‘Did
you stop smoking after treatment? If yes, for how long? Have you
smoked any cigarettes at any time since you received treatment? If yes,
when after treatment did you rst smoke?’’ Patients were asked if they
had remained abstinent for 3 months, 6 months, 9 months, or 12
months. Abstinence was dened as the patients self-report of having
stopped smoking without relapse. If the patient reported having
smoked any cigarettes posttreatment, they were considered to have
relapsed.
Also, medical charts were carefully reviewed for consistency be-
tween the patients self-reports and notes made by their physician. Any
inconsistency was recorded as the patient having resumed smoking.
CLINICAL HYPNOSIS FOR SMOKING CESSATION 77
One inconsistency was found for 1 patient who had dropped out after
the initial consultation. No other inconsistencies were noted. Addi-
tionally, patients that attended at least two sessions were asked about
their satisfaction with the treatment that they received.
Nine patients had dropped out after the initial consultation (Session
1) and were contacted by telephone approximately 12 months after
their last missed appointment. Those 9 patients were contacted and
asked if they were still smoking, but we did not collect data on those 9
patients as to exactly when or how long they had stopped. Because
none of those patients had stopped smoking at the time of dropping
out, we only determined whether or not those patients reported
smoking at the time contacted after 1 year.
The data were coded by an assistant in the Department of Biosta-
tistics at Scott & White Hospital. The primary outcome was the number
of patients who reported having stopped smoking, and for how long,
after treatment. An additional outcome was the patients reported level
of satisfaction.
RESULTS
Thirty consecutive patients were referred by their primary care
physician for smoking cessation. Out of the 30 patients, 9 completed
only the rst session (consultation), leaving a total of 21 patients
who received hypnosis for smoking cessation (i.e., completed Sessions
2 or 3).
We obtained follow-up data on all of the patients for a minimum of 1
year. Most patients (95%) were satised with the hypnotic treatment
they received. The ndings regarding tobacco abstinence during the
follow-up periods for the 21 patients who received hypnosis treatment
for smoking cessation are presented in Table 1. Results indicated that of
the patients who attended two sessions, 67% had stopped smoking at
the end of treatment; 44% at 3 months had maintained abstinence, and
at 9 and 12 months, 30% reported abstinence. Among the patients who
attended all three sessions, 92% reported having stopped smoking at
the end of treatment; 86% maintained abstinence at 3 months; at 9
months, 67% had maintained abstinence; and at 12 months, 58%
reported abstinence. Data were also analyzed for all patients combined
(N ¼ 21) who attended more than one session. At the end of treatment,
81% had stopped smoking; at 3 months, 57% had maintained absti-
nence; at 9 months, 52% reported abstinence; and at 12 months, 48%
reported abstinence.
Of those patients who attended only the consultation session (Ses-
sion 1), none (0%) had stopped smoking at the time of dropping out.
Those 9 patients were asked if they eventually had stopped smoking,
and 22% reported they were not smoking when contacted after 1 year.
78 GARY R. ELKINS AND M. HASAN RAJAB
This information indicates that 22% were not smoking when contacted
one year after dropping out.
DISCUSSION
This study provides preliminary clinical data regarding hypnosis for
smoking cessation. A specic hypnotic intervention is presented which
is marked by: the inclusion of three sessions, individualized hypnotic
suggestions, follow-up, and the development of a one-to-one inter-
personal relationship with each patient. A 48% abstinence rate at 12
months posttreatment was found. Also, there was a high degree of
patient satisfaction (95%) posttreatment.
These results may be of clinical interest, but they can be considered
as only preliminary. A number of caveats should be noted when
considering the ndings reported here. First, the abstinence rates are
based upon self-reports. This study did not use any biochemical
measures of abstinence.
Second, this study was clinical in nature and did not include a no-
treatment control group. The addition of a control group is necessary to
determine the effectiveness of hypnosis versus the effect of other
variables.
Third, the present study did not include measures of hypnotizabli-
lity. At least one previous study (Basker, 1985; but see Holroyd, 1991;
Marcovitch, Gelfand, & Perry, 1980; Perry & Mullen, 1975) found that
there was a higher abstinence rate for high hypnotizables in compar-
ison with low hypnotizables. If hypnosis (and not nonspecic treatment
factors) is an active agent in the intervention, then it follows that those
who are highly responsive to the active agent (i.e., hypnosis) will attain
superior benet. This state of affairs would be reected in a positive
correlation between hypnotizability and improvement.
Table 1
Tobacco Abstinence for 30 Consecutive Patients Referred for Smoking Cessation
No. of sessions Abstinence
end of tx
Abstinence
3 mos.
posttx
Abstinence
9 mos.
posttx
Abstinence
1 yr.
posttx
Consult only (n ¼ 9) 0 (0%) ––
2 Sessions (n ¼ 9) 6 (67%) 4 (44%) 3 (30%) 3 (30%)
3 Sessions (n ¼ 12) 11 (92%) 8 (67%) 8 (67%) 7 (58%)
All Patients w/more
than 1 Session (n ¼ 21) 17 (81%) 12 (57%) 11 (52%) 10 (48%)
2 patients (22%) that dropped out after the initial consultation reported they eventually
stopped smoking and were not smoking at the time contacted after 1 year. No data are
available on these 2 patients regarding how long they had been abstinent.
CLINICAL HYPNOSIS FOR SMOKING CESSATION 79
Additional research is needed to further evaluate this clinical hyp-
nosis intervention for smoking cessation. Many patients seek hypnosis
for smoking cessation and effective clinical interventions are needed.
REFERENCES
Ahijevych, K., Yerardi, R., & Nedilsky, N. (2000). Descriptive outcomes of the American
Lung Association of Ohio hypnotherapy smoking cessation program. International
Journal of Clinical and Experimental Hypnosis, 48, 374387.
Basker, A.M. (1985). Hypnosis in the alleviation of the smoking habit. In D. Wasman,
P.C. Misra, M. Gibson, & A.M. Basker (Eds.), Modern trends in hypnosis (pp. 269275).
New York: Plenum.
Crasilneck, H.B. (1990). Hypnotic techniques for smoking control and psychogenic
impotence. American Journal of Clinical Hypnosis, 32, 147153.
Elkins, G.R., & Wall, V.J. (1996). Medical referrals for hypnotherapy: Opinions of
physicians, residents, family practice outpatients, and psychiatry outpatients.
American Journal of Clinical Hypnosis, 38(4), 254262.
Giovino, G.A., Henningeld, J.E., Tomar, S.L., Escobedo, L.G., & Slade, J. (1995).
Epidemiology of tobacco use and dependence. Epidemiological Review, 17,4865.
Green, J.P., & Lynn, S.J. (2000). Hypnosis and suggestion-based approaches to smoking
cessation: An examination of the evidence. International Journal of Clinical and
Experimental Hypnosis, 48, 195224.
Holroyd, J. (1980). Hypnosis treatment for smoking: An evaluative review. International
Journal of Clinical and Experimental Hypnosis, 28, 341357.
Holroyd, J. (1991). The uncertain relationship between hypnotizability and smoking
treatment outcome. International Journal of Clinical and Experimental Hypnosis, 39,
93102.
Marcovitch, P., Gelfand, R., & Perry, C. (1980). Hypnotizability and client motivation as
variables inuencing therapeutic outcome in the treatment of cigarette smoking.
Australian Journal of Clinical and Experimental Hypnosis, 8(2), 7181.
Perry, C., & Mullen, G. (1975). The effects of hypnotic susceptibility on reducing
smoking behavior treated by a hypnotic technique. Journal of Clinical Psychology, 31,
498505.
U.S. Department of Health and Human Services. (1990). The health benefits of smoking
cessation: A report of the Surgeon General (DHHS Publication No. CDC 90-8416).
Washington, DC: US Government Printing Ofce.
Klinische Hypnose zur Raucherentwo
¨
hnung: Vorla
¨
ufige
Ergebnisse einer 3 Sitzungen dauernden Intervention
Gary R. Elkins und M. Hasan Rajab
Zusammenfassung: Diese Studie stellt vorla
¨
ufige Daten zum Einsatz von
Hypnose bei Raucherentwo
¨
hnung in einem klinischen Setting dar. Eine
individualisierte Hypnosebehandlung u
¨
ber 3 Sitzungen wird beschrieben.
30 Raucher, die Mitglied einer HMO (Health Maintenance Organization,
Anm. d. U
¨
.) waren, wurden von ihrem Hausarzt zur Behandlung u
¨
berwiesen.
21 Patienten erschienen nach einer einleitenden Sitzung wieder und erhiel-
ten eine Hypnosebehandlung zur Raucherentwo
¨
hnung. Am Ende der
Behandlung berichteten 81% der Patienten, mit dem Rauchen aufgeho
¨
rt
zu haben und 48% berichteten weiterhin Abstinenz 12 Monate nach
der Behandlung. Die meisten Patienten (95%) waren zufrieden mit der
80 GARY R. ELKINS AND M. HASAN RAJAB
Behandlung. Empfehlungen fu
¨
r zuku
¨
nftige Forschung zur Evaluation dieser
Hypnosebehandlung wird diskutiert.
R
ALF SCHMAELZLE
University of Konstanz, Konstanz, Germany
Lhypnose clinique pour arre
ˆ
ter de fumer : Re
´
sultats
pre
´
liminaires dune intervention en trois sessions
Gary R. Elkins et M. Hasan Rajab
Re
´
sume
´
: Cette e
´
tude pre
´
sente les donne
´
es pre
´
liminaires dans une e
´
tude
clinique dun traitement par hypnose pour arre
ˆ
ter de fumer. Il est de
´
crit un
traitement individualise
´
en 3 se
´
ances d hypnose. Trente fumeurs inscrits
dans un HMO ont e
´
te
´
adresse
´
s par leur me
´
decin pour traitement. Vingt et
un patients sont revenus apre
`
s une premie
`
re consultation et ont eu de
lhypnose pour le cessation de tabagisme. A
`
la n du traitement, 81% de
ces patients ont signale
´
quils avaient arre
ˆ
te
´
de fumer, 48% a rapporte
´
labstinence a
`
12 mois du traitement. La plupart des patients (95%) ont e
´
te
´
satisfaits du traitement quils ont rec¸u. Sont discute
´
es des recommandations
pour la recherche a
`
venir and e
´
valuer empiriquement ce traitement par
hypnose.
V
ICTOR SIMON
Psychosomatic Medicine & Clinical Hypnosis
Institute, Lille, France
La hipnosis clı
´
nica para dejar de fumar: Resultados
preliminares de una intervencio
´
n de tres sesiones
Gary R. Elkins y M. Hasan Rajab
Resumen: Este estudio presenta datos preliminares con respecto a trata-
miento de hipnosis para dejar de fumar en una institucio
´
nclı
´
nica. Descri-
bimos un tratamiento individualizado de tres sesiones. Treinta fumadores
matriculados en un HMO fueron referidos para tratamiento por su me
´
dico de
cabecera. Veintiu
´
n pacientes regresaron despue
´
s de la consulta inicial y
recibieron hipnosis para dejar de fumar. Al nal del tratamiento, 81% de los
pacientes informo
´
que habı
´
an dejado de fumar, y 48% mencionaron absti-
nencia a los 12 meses del tratamiento. La mayorı
´
a (95%) estuvo satisfecha con
el tratamiento recibido. Discutimos recomendaciones para la investigacio
´
n
futura para evaluar empı
´
ricamente este tratamiento hipno
´
tico.
E
TZEL CARDEN
˜
A
University of Texas, Pan American, Edinburg,
Texas, USA
CLINICAL HYPNOSIS FOR SMOKING CESSATION 81
... Hypnosis is used to address smoking cessation, in addition to many other treatments, including pharmacology, education, nicotine replacement, individual treatment, cognitive-behavioral treatments, and the transtheoretical model (DiClemente et al., 1991;Hunt & Bespalec, 1974;Prochaska et al., 1994). However, conflicting findings have resulted from numerous research studies that have investigated the effectiveness with which smoking behavior may be treated using clinical hypnosis (Elkins & Rajab, 2004). Indeed, the success rates of hypnosis for smoking cessation has resulted in a range as large as 4% to 90% (Kinnunen, 2001). ...
... Although the inclusion of only motivated participants may be considered a limitation to the methodology of Barber's intervention, this inclusion criterion is informative regarding the importance of motivation for abstinence to be achieved and to then be maintained when using hypnotic intervention. 60 SAMANTHA O. MUNSON ET AL. Elkins and Rajab (2004) conducted a study based on Holroyd's (1980) study that hypothesized criteria for smoking cessation using hypnosis. Elkins and Rajab used a clinical-treatment protocol that included three sessions of hypnosis to treat 21 participants for smoking. ...
... First, many of the reviewed or mentioned studies referred to the influence of an individual's motivation to cease smoking (Barber, 2001;Carmody et al., 2008;Kinnunen, 2001;Riegel, 2013). Second, the reviewed and mentioned studies emphasized the importance of lessening ambivalence or increasing the positive aspects of smoking cessation while decreasing the negative aspects of smoking cessation (Barber, 2001;Elkins et al., 2006;Elkins & Rajab, 2004). ...
Article
Full-text available
On the basis of the transtheoretical model of change, we hypothesized that hypnosis would facilitate significantly greater movement through the stages of change toward smoking cessation in contrast to psychoeducation. Thirty participants were pretested for hypnotizability using the Elkins Hypnotizability Scale (EHS). Participants’ readiness for change was assessed using the University of Rhode Island Change Assessment scale (URICA). The EHS relaxation induction was used to induce hypnosis. Hypnotic suggestions addressed motivation and ambivalence. The URICA was administered following the intervention and at a 10-day follow-up. Two-factor split-plot ANOVAs showed significant changes within groups on the contemplation subscale (p = .002), action subscale (p = .00007), and the number of cigarettes smoked per day (p = .003).
... Research showed that hypnotherapy is effective in reducing the desire to smoke with a result: 81 % of patients successfully quit smoking after the treatments [10]. Research conducted by Mohamed and ElMwafie also proved that hypnotherapy was effective in reducing the desire to smoke. ...
... Hypnotherapy is one of the therapies that can be used to change human behavior by focusing on a person's subconscious. Hypnotherapy can reduce a person's desire to smoke by giving suggestions about the negative influence of cigarettes into the subconscious [10]. This was revealed based on the information given by the twelve subjects who revealed that the desire to quit smoking appeared after given hypnotherapy. ...
Conference Paper
Full-text available
Hypnotherapy is an effective technique to reduce the behavior of smoking by giving impulses to the subject in reducing the smoking desire. The research purpose is to analyze the hypnotherapy effect on decreasing the smoking intensity in adolescents. The research participant was 12 new students in one of the faculties at Universitas Negeri Makassar with an age range of 18-20 years. Instruments in this research are using pre-test and post-test measuring instruments. The analysis of the hypothesis will be performing used the Wilcoxon Match test. The results of the study prove that hypnotherapy affects the decrease in the intensity of teenage smoking (p = 0.001). Based on the results obtained, hypnotherapy can be an alternative technique for teens in reducing their smoking intensity.
... Barber [2] calculated a success rate of 90.6% when using an integrated approach combining hypnotic methods and rapid smoking treatment protocol. The article of Elkins and Rajab [6] presents preliminary data of a three-session hypnosis intervention for smoking cessation, which comes close to the method of hypnotic intervention used in our article; they came to a success rate of 81%. However, the picture of effectiveness of hypnotic intervention for smoking cessation is still mixed: e.g., the article of Ahijevych, Yerardi and Nedilsky [1] ended up with a success rate of less than 25%. ...
Preprint
Full-text available
In this article we present the results of our field study which investigates the effectiveness of online hypnosis for smoking cessation. Following an international call in Germany, Austria and Switzerland for subjects willing to stop smoking $99$ participants contributed to this study, which took place during the lockdowns of the COVID-19 pandemic. All subjects received two online hypnosis sessions in small groups and additionally got two MP3 audio files for invididual intensification. The participants sent back several questionnaires, from which we present the evaluation results, and we discuss the problems observed during the study. It turned out that $86\%$ of the participants are smoke-free after $6$ months as long as they participated according to the intervention protocol.
... Hypnosis can help patients to lessen pain, and anxiety, and has even been used in the invasive clinical procedures accompanying interventional radiology and oncological surgery 7 . For smoking cessation, the data on the efficacy of clinical hypnosis are mixed 8 , with some studies reporting less than 25% 9 and others reporting a high success rate of more than 80% abstinence 10 . In their recent Cochrane database review, Barnes et al. 11 concluded that most studies had methodological flaws and any treatment success may be influenced by many factors. ...
Article
Full-text available
Cigarette craving is a key contributor of nicotine addiction. Hypnotic aversion suggestions have been used to help smoking cessation and reduce smoking relapse rates but its neural basis is poorly understood. This study investigated the underlying neural basis of hypnosis treatment for nicotine addiction with resting state Electroencephalograph (EEG) coherence as the measure. The sample consisted of 42 male smokers. Cigarette craving was measured by the Tobacco Craving Questionnaire. The 8-minute resting state EEG was recorded in baseline state and after hypnotic induction in the hypnotic state. Then a smoking disgust suggestion was performed. A significant increase in EEG coherence in delta and theta frequency, and significant decrease in alpha and beta frequency, between the baseline and the hypnotic state was found, which may reflect alterations in consciousness after hypnotic induction. More importantly, the delta coherence between the right frontal region and the left posterior region predicted cigarette craving reduction after hypnotic aversion suggestions. This suggests that the functional connectivity between these regions plays an important role in reducing cigarette cravings via hypnotic aversion suggestions. Thus, these brain regions may serve as an important target to treat nicotine addiction, such as stimulating these brain regions via repetitive transcranial magnetic stimulation.
... Still, case studies and clinical reports (e.g., Elkins & Rajab, 2004;Hely, Jamieson, & Dunstan, 2011), narrative reviews (e.g., Green & Lynn, 2000;Law & Tang, 1995), and meta-analyses (Green, Lynn, & Montgomery, 2006Viswesvaran & Schmidt, 1992) support the use of hypnosis in smoking cessation, with success rates typically ranging between 25-35% (Green & Lynn, 2000). For example, Elkins, Marcus, Bates, Rajab, and Cook (2006) reported that 40% of participants successfully stopped smoking one year after an intensive hypnotherapy intervention. ...
Article
Smoking cessation remains a major health priority. Despite public campaigns against smoking and widespread availability of smoking-cessation treatments, many people continue to smoke. The authors argue that the “problem of motivation,” that is, suboptimal or fluctuating motivation to resist smoking urges and to comply with the demands of treatment, commonly undermines treatment seeking and adherence, appreciably reducing the success rates of smoking-cessation programs. The authors describe the history of the Winning Edge smoking-cessation program and discuss ways to enhance motivation before, during, and after formal treatment. They illustrate how hypnotic suggestions, administered in the context of their program, can promote cognitive, behavioral, and emotional commitment to treatment and enhance motivation to live a smoke-free life.
... A clinical hypnosis study at the College of Medicine at Texas A&M University had an 81% success rate in the three-session hypnosis group, with a 48% success rate at 12 months post-treatment. [39] This supported by Szudy and Vardigan, [1] they found that, imagery and self-hypnosis have been as effective as other behavioral and psychological approaches. The techniques were even more effective in smokers who found them pleasant. ...
Article
Background: Hypnotherapy is widely promoted as a method for aiding smoking cessation. It is proposed to act on underlying impulses to weaken the desire to smoke or strengthen the will to stop. The aim of this study was to examine the effect of hypnotherapy on smoking cessation among secondary school students. Method: A random sample of 59 male smokers was selected from two governmental secondary schools. Design: A quasi- experimental design was used. Tools: Data were collected using; A- an Interview Questionnaire included; I- smoking assessment tool to determine the smoking rate among males students. II-Characteristics of studied students regarding smoking pattern. III- Smoking Cessation Questionnaire. B- Wisconsin smoking withdrawal scale. The hypnotherapy was implemented after assessing the rate of male smokers, the researchers trained the students in practicing self hypnosis, and asked them to practice it at home and to document the frequency of daily smoked packs for nine weeks. Results: The present study findings indicated that the rate of male smokers among secondary school students in Beni-Suef city was 52.4%, about two third of studied students (65.4%) stopped smoking after nine weeks of practicing hypnosis and the percentage of smoked packs of cigarettes/ day decreased after implementing the program. Conclusion: The present study findings showed that hypnotherapy has a therapeutic effectiveness in achieving a high rate of smoking cessation among secondary school students. There was a highly significant difference in total score of smoking withdrawal index before and after intervention. Recommendation: Community and school education programs should include sessions on quitting smoking, implementing school-based interventions in combination with antitobacco mass media campaigns.
Article
Introduction Medical hypnosis has received an increasing attention during the past decades. Various applications of hypnosis can be incorporated into the oncology field. This study aims to assess the knowledge of Lebanese medical oncologists on the use of hypnosis in the management of cancer patients. Material and methods An anonymous questionnaire was sent to all Lebanese medical oncologists to assess their knowledge, opinion and understanding of hypnosis and its use in oncology, as well as the obstacles facing its application in Lebanon. Results Hundred and three Lebanese medical oncologists responded to the survey, with a response rate of 65%. The findings revealed that most oncologists had little or no knowledge about hypnosis, but recommended it due to the benefits they believed it provided for the patients in improving chronic pain, invasive procedures, chemotherapy-induced nausea and anxiety. Around 40% of participants were interested in receiving a training in hypnosis. Lebanese oncologists also described many obstacles to the practice of hypnosis, mainly the lack of training for this technique and the lack of financial resources. Conclusion Despite all obstacles, the majority of Lebanese oncologists would recommend hypnosis to their patients in order to improve their quality of life.
Article
Full-text available
In the history of the development of medical and psychological procedures, hypnosis has played a prominent role, being a valuable clinical intervention in the treatment of a wide variety of problems. However, it has not been spared controversy and myths about its nature. In the present work we review the historical development of hypnosis and the most relevant explanatory models from those who consider it an altered state of consciousness to those who argue that hypnotic phenomena can be explained by the same variables as behavior and experience Not hypnotic. We also review some of the definitions that have emerged from the different paradigms, as well as the empirical evidence of their effectiveness, proving that when used as an adjunct to medical and psychological treatments increases their effectiveness, being of special relevance the relationship Of communication between clinician and patient. It ends with a review of its application in the field of sport and the presentation of a case study (3 athletes and 1 player) in which hypnosis is used adjuvant with other techniques. In all cases optimal results are achieved.
Article
Sleep insufficiency, defined as inadequate sleep duration, poor sleep quality, and daytime sleepiness, has been linked with students' learning and behavioral outcomes at school. However, there is limited research on interventions designed to improve the sleep of school-age children. In order to promote more interest on this critical topic, we examine yoga and hypnosis as two approaches that can improve multiple aspects of sleep. Some studies have shown the benefits of hypnotic relaxation on school performance, but no controlled studies have examined sleep as an outcome in school children. The studies on school-based yoga are currently inconclusive, with effects ranging from positive to negative. Some replicated studies of yoga show modest effects on mood, but none of the published yoga studies measured sleep outcomes. Given the importance of sleep on school functioning, there is an urgent need to study the effects of hypnosis and yoga, or other promising interventions, on sleep and student performance. Examples of promising practices for improving sleep and school-related issues are provided.
Article
Full-text available
Literature on the relationship between hypnotizability and smoking treatment outcome was reviewed. 91 private patients treated for smoking with hypnotherapy participated in an investigation designed to correct problems in some of the earlier research. 43% quit smoking by the end of treatment but only 16% abstained at least 6 months. Neither immediate quitting nor continued abstinence correlated with hypnotizability. Other variables hypothesized to predict smoking cessation also were not correlated with outcome: number of treatment sessions, need to smoke, motivation to quit, and gender. The low abstention rate may have impeded verification of a relationship between hypnotizability and treatment outcome.
Article
Two experiments were conducted in order to evaluate the roles played by hypnotic susceptibility and client motivation in determining successful therapeutic outcome with a number of stop-smoking techniques. In the initial investigation, 46 clients provided motivation data from questionnaires which were completed prior to their being taught either a hypnotic or rapid smoking procedure to control smoking. A multiple regression analysis isolated three motivation variables which were found to be significantly related to therapeutic outcome at a 3-month followup period. Results indicated further that these same three variables could discriminate those clients displaying complete abstinence at followup from those which failed to achieve this criterion of success with 67.40% accuracy. The data demonstrated no significant relationship between hypnotic susceptibility evaluated in a 3-month post-treatment session and percent reduction in smoking. A second study in which 29 clients received treatment through use of a combined hypnosis-rapid smoking technique, was found to replicate both findings of the first investigation.
Chapter
An approach to alleviating the smoking habit is outlined when emphasis is placed on motivation in the employment of hypnobehavioral methods. Creative Imagination and hypnotic susceptibility and their influence on results are discussed.
Article
This study sought to obtain empirical data on the issue of whether susceptibility to hypnosis influences the outcome of an hypnotic therapy. At the first of two sessions, Ss had their susceptibility evaluated unobtrusively. At the second session, they learned Spiegel's self-hypnotic method to stop smoking. At the end of 3 months' follow-up 7 of 54 volunteers were completely abstinent (13%), while 31% had reduced smoking by 50% or more. Of the 7 totally abstaining Ss, 1 was high, 1 was low and 5 were medium susceptible, which is not unlike the distribution of hypnotic susceptibility in the general population. However, it was found that significantly more Ss of higher susceptibility reduced by 50% or more than did less susceptible Ss.
Article
In the past 35 years I have used a variety of hypnotic techniques to help patients stop smoking. The most successful method has been to see the patient for 3 consecutive days with a follow-up session about 3 weeks later. With this technique, about 81% of patients stopped smoking. Psychogenic impotence has many possible causes and must be approached with an understanding of the dynamics involved. However, hypnotic suggestions can be helpful in restoring erectile function. I have used the technique described here with almost 3000 patients with a success rate of 88%.
Article
17 studies of hypnosis for treatment of smoking published since 1970 were reviewed. Abstinence after 6 months posttreatment ranged from 4% to 88%. Effectiveness of treatment outcome was examined in terms of: S population, individual versus group treatment, standardized versus individualized suggestions, use of self-hypnosis, number of treatment sessions and time span covered by the treatment, and use of ad-junctive treatment. At 6 months follow-up, more than 50% of smokers remained abstinent in programs in which there were several hours of treatment, intense interpersonal interaction (e.g., individual sessions, marathon hypnosis, mutual group hypnosis), suggestions capitalizing on specific motivations of individual patients, and adjunctive or follow-up contact. The 17 studies are presented in sufficient detail to permit clinicians to follow the published procedures, and recommendations are made for future research.
Article
Knowledge of the epidemiology of tobacco use and dependence can be used to guide research initiatives, intervention programs, and policy decisions. Both the reduction in the prevalence of smoking among US adults and black adolescents and the decline in per capita consumption are encouraging. These changes have probably been influenced by factors operating at the individual (e.g., school-based prevention programs and cessation programs) and environmental (e.g., mass media educational strategies, the presence of smoke-free laws and policies, and the price of tobacco products) levels (for a discussion of these factors, see, e.g., refs. 2, 48, 52, 183, and 184). The lack of progress among adolescents, especially whites and males, and the high risk for experimenters of developing tobacco dependence present cause for great concern (48, 183-186). In addition to those discussed above, several areas of research can be recommended. 1. Better understanding of the clustering of tobacco use with the use of other drugs, other risk behaviors, and other psychiatric disorders could better illuminate the causal processes involved, as well as the special features of the interventions needed to prevent and treat tobacco dependence. 2. To better understand population needs, trend analyses of prevalence, initiation, and cessation should, whenever possible, incorporate standardized measures of these other risk factors. Future research should compare the effect of socioeconomic status variables on measures of smoking behavior among racial/ethnic groups in the United States. 3. For reasons that may be genetic, environmental, or both, some persons do not progress beyond initial experimentation with tobacco use (2, 48, 183, 187-192), but about one-third to one-half of those who experiment with cigarettes become regular users (48, 193, 194). Factors, both individual and environmental, that can influence the susceptibility of individuals to tobacco dependence need further attention. 4. To estimate their sensitivity and specificity, comparisons of the National Household Survey on Drug Abuse indicators of dependence with DSM-based criteria are needed. Public health action continues to be warranted to reduce the substantial morbidity and mortality caused by tobacco use (195). A paradigm for such action has been recommended and involves preventing the onset of use, treating tobacco dependence, protecting non-smokers from exposure to secondhand smoke, promoting nonsmoking messages while limiting the effect of tobacco advertising and promotion on young people, increasing the real (inflation-adjusted) price of tobacco products, and regulating tobacco products (186).
Article
Previous studies surveying attitudes and education regarding the clinical use of hypnosis have been conducted with patient populations only. The current study was undertaken to assess the attitudes, experiences, training levels, and interest in future education regarding the use of hypnosis by staff physicians, medical resident physicians, family practice outpatients, and psychiatry outpatients. All subjects were drawn from a 400-physician group practice in Central Texas affiliated with a large university health science center. Results indicate that the majority of physicians (79%) and residents (67%) had received no prior training and even fewer had experienced hypnosis. The percentages for personal experience with hypnosis were similar for psychiatric outpatients, physicians, and residents. The need for patient and practitioner education was elucidated by the high rate of endorsement of misconceptions regarding hypnosis by patients (over half) and by some medical practitioners as well. Limited awareness of the appropriate applications of hypnosis was reported. However, 85% of practitioners expressed an interest in hypnosis education. Further research in medical setting demographics is recommended to validate generalizability of results and facilitate construction of medical education programs in hypnosis.
Article
This article reviews 59 studies of hypnosis and smoking cessation as to whether the research empirically supports hypnosis as a treatment. Whereas hypnotic procedures generally yield higher rates of abstinence relative to wait-list and no-treatment conditions, hypnotic interventions are generally comparable to a variety of nonhypnotic treatments. The evidence for whether hypnosis yields outcomes superior to placebos is mixed. In short, hypnosis cannot be considered a specific and efficacious treatment for smoking cessation. Furthermore, in many cases, it is impossible to rule out cognitive/behavioral and educational interventions as the source of positive treatment gains associated with hypnotic treatments. Hypnosis cannot, as yet, be regarded as a well-established treatment for smoking cessation. Nevertheless, it seems justified to classify hypnosis as a "possibly efficacious" treatment for smoking cessation.
Article
Hypnosis smoking cessation treatment is one type of program available to smokers. This paper describes a large randomly selected sample from such a program, which has not been previously reported. During 1997, 2,810 smokers 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. Twenty-two percent of participants (n = 101) reported not smoking during the month prior to the interview. Use of other smoking cessation strategies since the treatment session were assessed. Interestingly, only 20% of participants who used pharmaceutical products to assist with smoking cessation took them for the recommended treatment duration. Hypnotherapy smoking cessation treatment offers an alternative cessation method, which may meet the unique needs of certain individuals.