Stop Smoking With Hypnotherapy Study

A Proposal

Bupropion studies

• 615 smokers – randomised to drug 100mg, 150mg, 300mg or placebo for 7 weeks

• Try to stop at 1 week• For 300 mg - at 7 weeks[course end]

– 10.5% stop with placebo – 24.4% stop with drug

• At one year point prevalence [ no smoking for last week]– 12.4% placebo– 23.1% drug

Bupropion studies

• 893 smokers one of 4 treatments for 9 weeks – 12 month point prevalence

– Placebo oral + placebo patch 15.6%

– Bupropion 300mg + placebo patch 30.3%

– Nicotine patch + oral placebo 16.4%

– Bupropion 300mg + nicotine patch 35.5%

Bupropion studies

• Continuous absence rates =– Bupropion alone 18.4%– Bupropion +patch 22.5%

• Cost– £86 + counselling – 5 sessions

Bupropion studies

• Problems with Bupropion

– 11% dry mouth

– 42% insomnia

– 6% hypertension { if given with patch}

– 1:1000 - fitting

Bupropion studies

• Contraindications– Epilepsy– Pregnancy– History of fits– History of head injury– Diabetes on drugs or insulin– Patients on

• Theophylline Systemic steroids• Antipsychotics• Antidepressants

Hypnotherapy Studies

• Hypnotherapy

– Safe

– Specific

• Difficult to generalise

• Few published single session studies

Hypnotherapy Studies

• 226 Smokers [ Spiegel Frishholz Spiegel]

– Single session treatment

– 2 year follow up

• 53% stop at one week

• 23% stop at two years

Hypnotherapy Studies

• 40 patients [Berkowitz Townsend Kohberger]

– Single session

• 25% stop at 6/12

Hypnotherapy Studies

• LCCH method

• Single sessions

• Cost £ 150 approx

• Easily learned

• No side effects

• Does it work ??

Hypnotherapy Studies

• LCCH study

– Single hypnotherapist

– LCCH method

• One hour session only

– Follow up one month to one year

– Postal Questionnaire

Stop Smoking With Hypnosis Study Dear Sir or Madam:

You recently had hypnotherapy to help stop you smoking. We are conducting a study to assess the effectiveness of this treatment. We would be very grateful if you would be willing to spend a few minutes to complete this questionnaire and return it in the stamped addressed envelope enclosed. Date of Hypnotherapy Name of Hypnotherapist

Before Hypnotherapy How long had you been smoking ? Years

How many did you smoke a day?

After Hypnotherapy Stopped Cut

down Continued unchanged Did you Stop smoking

completely ,cut down or continue smoking the same number [ tick one only ]

Less than 1 month

1-3 months

4-6 months 1 year I have not restarted

If You stopped completely please indicate how long you stopped for by ticking the relevant box

So far I have stopped for

months

Number Smoked per day Less than 1 month after treatment

1-3 months

4-6 months 1 year If you cut down please write the number of cigarettes you have been smoking in each of the periods after hypnotherapy

Did you use any additional treatment such as nicotine patches, or chewing gum at the time of hypnotherapy

Yes No

If yes please describe

P E T E R S F I E L D S C R E E N I N G M F / j e t / 6 9 9 7

M r J o e L u c k i n g 4 A l l e n C l o s e M i t c h a m S u r r e y C R 4 1 T L 3 r d O c t o b e r 2 0 0 0 D e a r M r L u c k i n g P l e a s e f i n d j u s t o n e m i n u t e t o c o m p l e t e t h e e n c l o s e d q u e s t i o n n a i r e . I t i s e q u a l l y i m p o r t a n t t h a t y o u r e p l y w h e t h e r y o u r h y p n o t h e r a p y w a s s u c c e s s f u l o r n o t . T h e r e h a s b e e n v e r y l i t t l e s c i e n t i f i c r e s e a r c h o n h y p n o t h e r a p y a n d t h i s s t u d y m a y h a v e i m p o r t a n t i m p l i c a t i o n s f o r n a t i o n a l p u b l i c h e a l t h s p e n d i n g . T h a n k y o u v e r y m u c h f o r y o u r t i m e . Y o u r s s i n c e r e l y D r M a r k F e l d m a n M B B S M R C G P ( D i s t ) D F F P D o c c M e d M D C H

P E T E R S F I E L D S C R E E N I N G M F / j e t / 6 9 9 7

M r J o e L u c k i n g 4 A l l e n C l o s e M i t c h a m S u r r e y C R 4 1 T L 1 s t N o v e m b e r 2 0 0 0 D e a r M r L u c k i n g P l e a s e f i n d j u s t o n e m i n u t e t o c o m p l e t e t h e e n c l o s e d q u e s t i o n n a i r e . I t i s e q u a l l y i m p o r t a n t t h a t y o u r e p l y w h e t h e r y o u r h y p n o t h e r a p y w a s s u c c e s s f u l o r n o t . T h e r e h a s b e e n v e r y l i t t l e s c i e n t i f i c r e s e a r c h o n h y p n o t h e r a p y a n d t h i s s t u d y m a y h a v e i m p o r t a n t i m p l i c a t i o n s f o r n a t i o n a l p u b l i c h e a l t h s p e n d i n g . T h a n k y o u v e r y m u c h f o r y o u r t i m e . Y o u r s s i n c e r e l y D r M a r k F e l d m a n M B B S M R C G P ( D i s t ) D F F P D o c c M e d M D C H

LCCH Study Results

• 59 questionnaires sent { follow up 1/12 to 1 yr }

– 35 Returned 59.3%

• Of those returned

– 30 stopped 85%

– 1 cut down 2.8%

– 4 continued unchanged 11..4%

• At one month

– 23 stay stopped 65.7%

LCCH Study Results

• Results beyond this unsatisfactory due to lack of follow up

• BUT no known restarters after 6 months– Restarters

• 3 at less than one month• 4 at 1-3/12• 2 at 4-6/12

– We have a definite 12 stopped at one year { 34% } but as data is incomplete

• Could presume 21 stopped at one year which would be 60% stop at one year

LCCH Study ResultsHypnosis Retrosepective Study ResutlsS=Stop C=cut down R=restarted I= incomplete data U = Unchanged NRT=Nicotine Replacement Therapy

Numbers Sent = 59

Number Returned Study Number Sex Yrs smoked Cigs/day Initial Result <1/12 1-3/12 4-6/12 1 yr data in months Additional aidsNotes

1 36 F 16 20 S S S S S 20 N2 41 M 23 45 S S S S S 18 N3 44 F 20 20 S S S S S 15 N4 27 F 7 20 S S S S S 16 N5 31 F 11 20 S S S S S 14 N6 30 F 5 15 S S S S S 14 N7 17 F 30 35 S S S S S 17 N8 2 F 13 30 S S S S S 20 N Restarted at 20 months9 49 F 10 30 S S S S S 21 N

10 32 F 20 25 S S S S S 20 N11 42 M 31 40 S S S S S 14 N12 16 F 20 30 S S S S S 15 N Restarted at 15 months after drinking with smoking friend. Had furthur hypnotherapy - unsuccessful13 11 F 30 10 S S S S I 9 N14 34 M 10 12 S S S S I 8 N15 33 F 7 15 S S S S I 7 N16 3 F 15 25 S S S S I 7 N17 28 F 12 20 S S S I I 7 N18 52 F 40 45 S S S I I 4 N19 14 F 1 7 S S S I I 3 N20 40 F 30 25 S S S I I 3 N21 50 F 33 30 S S S I I 2 N22 6 M 13 20 S S R R R NRT gum, Restarted at < 1/1223 13 F 14 22 S S R R R NRT gum, Restarted at < 1/1224 5 M 20 20 S S R R R Now stopped with zyban25 57 M 20 20 S S R R R 3 N26 58 F 15 20 S S S R S 7 N Restarted at 4-6/12 then had furthur session and is now stopped27 19 F 16 10 S S S R R NRT gum, Restarted at < 1-3/1228 35 M 16 15 S RC RC I I 6 N Stopped for one month then restarted at lower rate of 5 per day29 46 F 20 12 S RC RC I I 6 N Stopped for one month then restarted at lower rate o f4per day30 55 F 24 15 C C U I I 2 N Cut down for < 1/12 then back to normal amount31 10 M 26 30 U U U U U N32 24 F 30 20 U U U U I 6 N 3 sessions33 53 F 16 20 U U U I I 3 I34 45 M 27 7 S RC R I I 4 N Stopped for 2 days35 29 F 38 20 U U U I I 4

Summary of results59 sent35 back = 59.32 percent

29 stop = 82.86 percent

Hypnotherapy Proposal

• Randomised study - Possible Studies• In conjunction with Community Stop Smoking

Clinics

• Single session LCCH method hypnotherapy Vs Bupropion +

counselling

• Possible arms

– Single session hypnotherapy

– Single session hypnotherapy + NRT

– Single session hypnotherapy + Bupropion

– Bupropion + counselling