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SMOKING CESSATION METHODS NOT BASED ON SCIENTIFIC EVIDENCE. Cengiz ÖZGE , Associate Professor . Mersin University Faculty of Medicine Department of Chest Disease. Contents. Introduction Electronic Cigarette Acupuncture and associated methods Hypnosis. Among Cigarette Smokers.

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smoking cessation methods not based on scientific evidence

SMOKING CESSATION METHODS NOT BASED ON SCIENTIFIC EVIDENCE

Cengiz ÖZGE,Associate Professor.

Mersin University Faculty of Medicine Department of Chest Disease

contents
Contents
  • Introduction
  • Electronic Cigarette
  • Acupuncture and associated methods
  • Hypnosis
among cigarette smokers
Among Cigarette Smokers
  • 70% wants to quit smoking.
  • 35% seriosly attempted to quit in the last year.
  • 80% previosly attempted to quit.
  • 3% manages to quit in a year.
slide6
Quit in a single setting

Success more than 90%

Refund of money is guarantee

slide9

WHY

ME ?

slide10

Evidence

Pyramide

Meta

analysis

Randomised

controlled trials

Cohort studies

Case-control studies

Case-report

“Editorial”, clinical opinion...etc.

animal studies, in vitro studies...etc.

electronic cigarette1
A Commercial product of tobacco.

Certified by the Ministry of Agriculture.

Not designed for smoking cessation therapy.

No presented scientific study.

Electronic cigarette
acupuncture
Acupuncture
  • Have a history of 3000 years.
  • Have been in Europe since 1600ths.
  • Chen-Chin : Needle-Heat
  • Acus: Needle
  • Punctura: Prick
ac u puncture
Acupuncture
  • There are almost 1000 stimulation points in the human body.
  • 650-700 of these points are being used.
  • It is beleived that there is an acapunture point for every organ in the ear.
mechanisms of the effects of acapuncture
Mechanisms of the effects of Acapuncture
  • The body has two opposite energy called Yin and Yang working in synergy.
  • This energy travels in the canals called meridians.
  • If the balance fall off, an abnormaly ensues.
  • Acapuncture helps to maintain this balance.
theory of five elements
Theory of five elements
  • Wood,fire, earth, metal and water.
  • All the phenomenon in the universe structurally meets these five elements.
  • They are in a continuous movement and alteration.
  • If this balance is falls off diseases ensue.
  • Acapuncture maintains this balance
mechanisms of the effects of acapuncture1
Mechanisms of the effects of Acapuncture
  • Endorphine
  • Met-encephalin
  • Serotonine
  • Dopamine
fields of administration of ac u puncture
Fields of administration of acupuncture
  • Cure of pain
  • Apettite control and slimming
  • Reduction of Stress
  • Acceleration of metabolism.
  • Treatment of allergy.
  • Migrene and headache.
  • Treatment of Insomnia.
  • Cessation of smoking.
acupuncture1
Acupuncture
  • Auricular acupuncture
  • Moxibustion
  • Acupressure
  • Electro Acupuncture
  • LASER Akapunktur
  • Luxopuncture
  • Bioresonance
  • Moratherapy
slide24
Moxibustion

Application of heat to the acupuncture points instead of needles.

Electro Acupuncture

LASER Acupuncture

Electric current

LASER irradiation

  • Acupressure
  • Pressure application onto the acupuncture points.
luxopuncture
Luxopuncture
  • Developed in France
  • Condensed infra red light application to the acupuncture points.
bioresonance moratherapy
Bioresonance Moratherapy
  • Plain electrode contact on the human skin at certain sites
  • Electromagnetic vibration.
  • Depends on the claim that faint low frequency vibrations carry knowledge.
r i s e
R.I.S.E
  • Reflection Instrument Scanning Electro-pulse
  • I quit smoking (IQS)
  • Beta-endorphine
slide29
Between 1963-1989

Total of 27 studies

15 of them for smoking cessation.

A meta-analysis of studies into the effect of acupuncture on addiction G TER RIET, J KLEIJNEN, P KNIPSCHILDBritish Journal of General Practice, 1990, 40, 379-382.

slide30

A meta-analysis of studies into the effect of acupuncture on addictionG TER RIET, J KLEIJNEN, P KNIPSCHILDBritish Journal of General Practice, 1990, 40, 379-382.

slide31

A meta-analysis of studies into the effect of acupuncture on addictionG TER RIET, J KLEIJNEN, P KNIPSCHILDBritish Journal of General Practice, 1990, 40, 379-382.

slide32

A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40

  • Have at least two therapy groups,
  • Randomized
  • No old (previous) control group is used.
  • 9 studies are taken into consideration
  • A total of 2707 patients.
slide33

A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40

Total (95% CI) OR: 1.48 (CI:1.13-1.48)

slide34

A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40

  • Acupuncture seems to be better according to the control group;
  • *HOWEVER!!
  • NOT better than the Sham acupuncture.

( OR:1.16 % 95 CI: 0.90-1.49)

slide35

A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40

slide36

A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40

  • All are self-reports, no CO measurements
  • Only 4 studies have 12 months of follow up.
  • 4 studies single-blind, 5 studies open.
  • Studies are small.
  • Methodological scores are low.
slide37

White AR, Rampes H, Campbell J. Acupuncture and related interventions for smoking cessation.Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD000009

  • Randomized controlled studies
  • Acupuncture
  • Acupressure
  • LASER acupuncture
  • Electrostimulation
  • Sham acupuncture
  • 24 studies were evaluated
slide38

White AR, Rampes H, Campbell J. Acupuncture and related interventions for smoking cessation.Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD000009

slide39

White AR, Rampes H, Campbell J. Acupuncture and related interventions for smoking cessation.Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD000009

  • No high quality studies about acupunture and associated applications are present
  • No prominent dominancy in a year’s follow up.
  • The effectivness that was seen in the early period was abated by the removal of a study which was conflicting with the homogenicity of the study.
alternative therapies for tobacco dependence l m villano a r white med clin n am 88 2004 1607 1621
Alternative therapies for tobacco dependenceL.M. Villano, A.R. White / Med Clin N Am 88 (2004) 1607–1621
slide41

A Randomized Controlled Clinical Trial of Auricular Acupuncture in Smoking CessationTa-Peng Wu, Fang-Pey Chen, Jui-Yao Liu, Ming-Hsien Lin, Shinn-Jang HwangJ Chin Med Assoc • August 2007 • Vol 70 • No 8

acupuncture result
ACUPUNCTURERESULT
  • There are no scientific evidence for the effectivess of
  • Acupuncture,
  • Acupressure,
  • LASER acupuncture and
  • Electrostimulation

to be used for the cessation of smoking.

hypnosis
HYPNOSE: The name of the God of Sleeping in Greek Mythology.

This is a state of bringing someone into a deeply sleeping like situation where his/her behaviour can be kept under control by another person.

HYPNOSIS
h pnoz
HİPNOZ
  • A state of sleeping achieved by words, looks and suggestions. A person in this state (subject) is open to the suggestions and influences of the applying person but closed to the other stimulations from the surrounding.
hypnosis history
HypnosisHistory
  • Before the holy books, sorcery and medicine were used together in religious ceremonied.
  • In 1778 Dr.Franz Mesmer
  • In 1847 for quitting tobacco
  • In 1958 American Medical Association approved Medical hypnosis.
hypnosis fields of application 1
HYPNOSISFields of Application-1
  • Depression
  • Social phobia (zoophobia, acrophobia, hydrophobia)
  • Tic disorders 
  • Stammer 
  • Enuresis nocturna,
  • Psycological pain disorders. 
  • Obesity
  • Anorexia, Blumia 
  • Alcohol and tobacco addiction 
  • Panic attack.
hypnosis fields of application 2
HYPNOSISFields of Application-2
  • Conversion Disorders 
  • Posttraumatic Stress Disorders
  • Psycologic Memory losses
  • Sleep Disorders
  • Bruxism
  • Sexual Functional Disorders

(Impotence, premature,

ejaculation, vaginusmus)

  • Onichophagia
  • Obsession
  • Personality Disorders
hypnosis fields of application 3
HYPNOSISFields of Application-3
  • Psycological tremors
  • Dyslexia
  • Cure of chronic physical pain.
  • Painless child delivery
  • Trigeminal Neuralgia.
  • Nervous Hypertension
  • Asthma
  • Allergic Skin Disorders.
  • Psoriasis
  • Treatment of the wharts.
  • Migraine, 
  • Attenuation of pain due to cancer 
  • Treatment for the teeth without application of anesthesia.
hypnosis and cessation of smoking
Hypnosis and Cessation of Smoking
  • Its means of effect is not clear.
  • Relaxation,
  • Extreme suggestibility
  • Hightened imagination proposed to

act on the underlying impulses.

  • Inhibition of the left cerebral hemisphere
hypnosis and smoking cessation
Hypnosis and Smoking Cessation
  • 1st Session:Interview, understanding hypnosis, being hypnotized.
  • 2nd and 3rd Session:Administering regression hypnotherapy to eliminite obstacles to quitting smoking; uncovering unconscious reason cousing smoking.4th. Session:Direct suggestion session(Changing unconscious patterns causing smoking. Replasing with new habits.)
  • 5th Session:Ego strengthening hypnosis session (Strengthening positive emotions such as focusing on future, self-confidence self-esteem in the person who quitted smoking.)
  • 6th Session:Learnig self-hypnosis and EFT techniques

(Teaching daily techniques that will be used to preserve wellness consistently)

slide52

Cochrane Database of Systematic Reviews Hypnotherapy for smoking cessation (Review) Abbot NC, Stead LF, White AR, Barnes J 1998, Issue 2 Last assessed as up-to-date: 15 February 2005.

  • Between 1966-2005.
  • 28 studies are found.
  • appraisable 9 studies.
  • 19 studies were excluded.
  • Randomized.
  • Follow up at least for 6 months.
slide53

Cochrane Database of Systematic Reviews Hypnotherapy for smoking cessation (Review) Abbot NC, Stead LF, White AR, Barnes J 1998, Issue 2 Last assessed as up-to-date: 15 February 2005.

exclusion criteria

.

.

Exclusion Criteria

Cochrane Database of Systematic Reviews Hypnotherapy for smoking cessation (Review) Abbot NC, Stead LF, White AR, Barnes J 1998, Issue 2 Last assessed as up-to-date: 15 February 2005.

slide55

Cochrane Database of Systematic Reviews Hypnotherapy for smoking cessation (Review) Abbot NC, Stead LF, White AR, Barnes J 1998, Issue 2 Last assessed as up-to-date: 15 February 2005.

slide56

Cochrane Database of Systematic Reviews Hypnotherapy for smoking cessation (Review) Abbot NC, Stead LF, White AR, Barnes J 1998, Issue 2 Last assessed as up-to-date: 15 February 2005.

slide57

Cochrane Database of Systematic Reviews Hypnotherapy for smoking cessation (Review) Abbot NC, Stead LF, White AR, Barnes J 1998, Issue 2 Last assessed as up-to-date: 15 February 2005.

slide58

Hypnosis for smoking cessation: A randomized trialTimothy P. Carmody, Carol Duncan, Joel A. Simon, Sharon Solkowitz,Joy Huggins, Sharon Lee, Kevin Delucchi Nicotine & Tobacco Research Volume 10, Number 5 (May 2008) 811–818

  • Total of 286 patients
  • 2 grups: Hypnosis and behevioral counseling.
  • HYPNOSIS:Face to face for 60 minutes, two seance.
  • Behavioral counseling: Face to face for 60 minutes, two times and follow up by telephone on the 3rd, 4th, 6th, weeks.
slide59

Hypnosis for smoking cessation: A randomized trialTimothy P. Carmody, Carol Duncan, Joel A. Simon, Sharon Solkowitz,Joy Huggins, Sharon Lee, Kevin Delucchi Nicotine & Tobacco Research Volume 10, Number 5 (May 2008) 811–818

slide60

Hypnosis for smoking cessation: A randomized trialTimothy P. Carmody, Carol Duncan, Joel A. Simon, Sharon Solkowitz,Joy Huggins, Sharon Lee, Kevin Delucchi Nicotine & Tobacco Research Volume 10, Number 5 (May 2008) 811–818

CONCLUSION

  • May be more effective if hypnosis and nicotine bands are concomittantly used.
  • Future studies are necessary for the investigation of effectivness of such therapies.
h pnoz1
HİPNOZ

CONCLUSION

  • There are NO scientific evidence describing the effect of hypnosisi for the cessation of smoking!!!
allen carr s method
Allen Carr’s method
  • Allen Carr’s Easyway removes the need and desire to smoke.
  • No NRT
  • No needles
  • No LASER
  • No drugs! No herbs
  • No shock treatment
  • NO Scientific Evidence!!
slide63
There are no treatment methods with over 90% success rates in today’s practice.
  • The only scientifically evident method of treatment is the Supportive Therapy with pharmacological therapy
  • The pharmacological therapeutic agents whose effectivness are approved are: Nicotine replacement therapies, Bupropion and Varenicline.