Is There One Best Approach or Method to Quit Smoking?

by Ken Derow

In today’s world of tobacco addiction treatment there is no one recognized or accepted method or intervention that has wide acceptance as being the “best” or most effective to use or even to try first. Just in the USA, there are still over 45 million smokers today, and, of them, about 70% have an avowed desire to quit smoking. If a smoker who intends, or is considering quitting, goes looking for advice and counsel on how to quit, or what methods they can use to try and quit, they will not find any consensus on how to do this. If they first seek out a physician he/she may counsel them to try any number of approaches including going “cold-turkey,” entering a smoking cessation program, joining an Internet or group forum for support, or, quite likely trying Nicotine Replacement Therapy (NRT). However, even the medical community has no tried and true agreed upon first-line therapy.

If the smoker who is interested in quitting, instead goes to a private smoking counselor, who, may or may not, be associated with some type of for-profit clinic, they will likely get different advice and a different recommended approach. Most likely the private counselor will advocate using NRT, which may, or may not, be combined with personal counseling. It is also quite possible the private counselor or clinic will advocate some proprietary approach that is associated uniquely with their for-profit clinic, that they may claim has some totally unsubstantiated level of success in helping a smoker to quit.

If the smoker turns to the popular press for advice, he/she will find that there are almost as many books about how to stop smoking as there are fad diets on how to lose weight. These books advocate all sort of idiosyncratic quit smoking approaches, some of which may actually have some good advice or tips on how to quit, but, many of which are designed and written to capture the attention of the smoking public in order to fulfill one real objective, namely, to sell books.

The smoker may also try the first method that so many smokers try, with so little success. That is, they may simply tell themselves that starting on day X, they will never smoke again, that is they will go “cold-turkey.” Unfortunately, this may be thought of as the triumph of hope over experience, as very few are able to quit in this way, at least not without many prior attempts. In fact, in a given year only 4%-5% of smokers quit smoking successfully for the long-run.

Why is the rate of success so low? Why do so many smokers profess a real desire and intent to quit, yet so many do not succeed? The answer lies in the peculiar and very powerful combination of stimuli and reinforcement that smoking offers to entrap those it captures in a highly habituated behavior.  There are two critical, and, mutually reinforcing forces that keep smokers in the clutches of their habit, both are vital to recognize and to address in order to design the “best” and most effective approach to quitting smoking. These dual hooks are, the physical dependency on the nicotine delivered by cigarette smoking, and, the equally (and maybe even more potent and intractable) power of the psychosocial cues that trigger the “light-up” process. Both of these dependencies must be addressed, and, must be disrupted and broken in order to quit smoking for life and give the smoker the ability and likelihood of being able to deter a relapse (that is so common among those who quit, especially if they quit after only dealing with their physical dependency on nicotine).

In order to deal with the nicotine addiction issue associated with smoking the most frequent approach advocated today by many smoking and addiction counselors is to rely on a NRT method (e.g. the patch, gum, or nasal spray). However, these interventions, even by the admission of those tobacco treatment specialists who use it as a stand-alone therapy, increases the quitting success rate for only around 4% to 5% up to 8% to 10%, a doubling of the effective rate, but, still a very unacceptable success rate. This is stunning evidence which supports that addressing the physical dependency issue alone is not sufficient to providing a highly effective approach to quitting.

While one can say with some confidence that the “best” overall approach to quitting smoking will include features and characteristics that address both the issues of nicotine addiction and psychological dependency, there is much less agreement as to what specific method or intervention will best deliver this combination of benefits. If anyone offers you (a smoker) a particular method to use to quit smoking that does not include specific features countering and combating both critical dependency issues, I would walk away, and seek advice and counsel elsewhere.

The author of this posting quit smoking with a single intervention that took place over a three-hour period one afternoon over 30 years ago and never has had even the slightest urge to smoke again, and has never even come close to relapsing over these many years. In fact, this method seemed to work like magic, I started the day as a smoker and I ended the day, psychologically as a non-smoker. How did I do it, I used hypnosis. Hypnosis is not a panacea that works for everyone; in fact, there is statistical evidence that it is effective for only about 25% of those trying it. You might be thinking that this method violates the basic premise that I have been describing in this posting, namely that, the best quit smoking method will address both the physical dependency issues and the issues associated with psychological dependency. In actuality, hypnosis does both of these things. Hypnosis works directly on the mind, that is, on the brain itself, by inducing a highly relaxed state which enhances your ability to accept suggestions. The brain, with its pleasure and reward centers, is the focus and cause of both the physical addiction issue and the psychological issues associated with smoking, that is, the psychosocial cues that trigger us to smoke. Hypnosis, for the smoker who totally believes in its power, has the ability to relax, and is able to allow themselves to be fully induced into a deep hypnotic state, can be highly effective, as it was for me. Unfortunately, less that one third of people are highly susceptible to being deeply hypnotized, so hypnosis, while works like ‘magic’ for some, it is not the answer for all.

There is substantial evidence and support for the previously offered premises. Some of this evidence follows:

The website, “thestopsmokingguide.com” explains about types of smoking addiction and what a smoking cessation methods needs to offer to be highly effective. This website states “that in order for you to stop smoking successfully, it is first necessary for you to understand exactly why you smoke. I don't mean why you started smoking, or the overwhelming stresses and pressures in your life that cause you to light up every day. I am talking about the things that happen to your mind and body each time you smoke a cigarette.”

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