Smoking, the Brain and the Placebo Effect – How They are Connected
The human brain houses our pleasure and reward receptors that activate feelings of euphoria and pleasure when provided suitable stimuli. When such a stimuli is received repeatedly over a period of time, the desire and craving for continuing to receive the reward it provides may create an addictive response in those prone to addiction. This process works much as BF Skinner described in his famous and popular theory of operant conditioning(1). The keys to becoming addicted are that the stimuli is perceived as rewarding and pleasurable, and that it is repeated many times (or in the case of some drugs like heroin just once or twice).
The brain, however, is also the creator of the motivators we call willpower and resolve. These are manifested as our intention and commitment to do something, take an action, or change a behavior. Through such intentions, created by the brain, our willpower and resolve can counter and overcome an addiction just as the brain is responsible for originally creating that same addiction. By making a deliberate and conscious rational choice to eliminate an undesirable habit, such as smoking, especially when that intent is infused by the power of our emotional subconscious, an addiction and psychological dependency can be eliminated. Intent to change a behavior, or reduce and/or eliminate a habit, is a vital ingredient in successfully quitting smoking(2,3). Research statistics indicate approximately 90% of all those who quit smoking did so by going “cold-turkey(4).” They stopped on their own with no medical or psychological intervention. Using nothing more than their own intent to quit, infused by the power of their will and resolve to do so, they do so by a power created solely by the brain. This is a prime argument and support of the notion that the brain, which can create an addictive behavior, is also capable of eradicating that same addiction when appropriately motivated.
It is also true that the “cold-turkey” method for quitting smoking is only successful for 4% to 5% of smokers in any given year(4), and for those who do quit with this technique, they usually require multiple attempts, over an extended period of time. Is there any way the smoker can significantly increase their quit smoking success rate?
By mobilizing and enhancing our willpower and resolve to quit we can utilize the “hidden” power of the subconscious to greatly materially improve the odds of successfully quitting smoking for the long-run, for life. How can a person accomplish this? There are different, but related strategies to increase and magnify a smoker’s willpower and resolve (or for any individual who wishes to modify their behavior or eliminate a habit). These strategies are:
* Using professional assistance, the smoker can use the power and utility of hypnosis to implant a suggestion in their mind while the brain is in an altered state of consciousness. I can personally attest to the power and usefulness of hypnosis to quit smoking. In 1982, at age 35, I quit smoking after a one-time three hour commercial hypnosis program. The first two hours dealt with talking about smoking and our (there were 15 of us), desire and intent to quit for all of the reasons so well known to all of us. The last forty-five minutes involved a hypnotic induction and a suggestion, implanted by the person conducting the hypnosis session that we would be able to quit smoking easily, without any difficulty and immediately. The very next day, I awoke without the slightest desire to smoke, and from that day forward I felt psychologically like a non-smoker and have never had the slightest urge to take another puff on a cigarette. That was 30 years ago.
*Hypnosis is not for everyone. The statistics suggest it may work for about 25%+ of those who try it(5), and can work like “magic” for those smokers who can be most readily hypnotized.
*Hypnosis works via our emotional subconscious and greatly magnifies and empowers our conscious intent to quit smoking.(5)
* The effects of our willpower and resolve to quit smoking can also be increased by exploiting, in a positive sense, the power of the placebo effect. In fact, when a smoker tries any medical intervention (such as a drug or Nicotine Replacement Therapy) or psychological counseling, these interventions are largely effective because of the placebo effects’(6,7) power to energize and utilize the subconscious brain to materially influence our behavior, in this case, the choice to quit smoking.
It is well known that when a person has a real expectation and belief in a behavioral or psychological intervention, whether using drugs, surgery or any other therapy, the power of the placebo is activated via our brain to greatly enhance the likelihood of a successful outcome, whether that outcome is to successfully stop smoking or any other desirable medical outcome. The placebo, even when a drug contains no active ingredients, will increase the effectiveness of that drug or any intervention.(6,7)
In fact, most of the actual effectiveness and success of many medical/psychological procedures or drugs is due to the placebo effect alone. Although, the placebo effect is widely known and discussed, it is also very significantly under-used in a deliberate and pre-planned capacity. Medical practitioners, physicians/nurses and tobacco treatment specialists, can all do a much better job to employ the power of the placebo as an aid when they recommend and discuss an intervention for a patient or a client. For tobacco treatment specialists this means when they recommend the use of drug therapy or NRT, or any other smoking cessation intervention, they can choose to do so in a manner which is more likely to create in their client an expectation of success and thereby enlist the power of the placebo in the actual treatment process.
Such deliberate and conscious actions to exploit the placebo effect do not need to be deceptive, are not unethical and in fact, do not even need to be activated via the spoken word. The practitioner can employ the power of the placebo in their demeanor, via the office environment, and by their non-verbal communications. Further, even if their clients are made aware of the tobacco specialist’s deliberate engagement of the placebo effect, it will still work to their client’s advantage and enhance the effectiveness of the chosen treatment(8).
The power of the placebo is so well-known and well documented that it is usually chosen as the control cell in Random Clinical Trials (RCTs). If the RCT outcome shows that the “active” drug/procedures results in a “successful” (however defined) outcome, 8% to 10% of the time (as in many trials of NRT post one year smoking abstinence), and the placebo control cell experiences a successful outcome 5% to 6% of the time(9, (as in many clinical trials), then the placebo alone can be said to account for fully 50% to 60% of the effect of the “active” test cell intervention.
The placebo may account for more of the effect or efficacy of the intervention than the actual physical treatment (e.g. NRT). If the placebo’s power is this strong when activated incidentally by the care and attention given all clinical trial participants(10), how much more strongly might the placebo effect be realized if it was deliberately planned to mobilize it by the medical practitioner or the tobacco treatment specialist? The medical profession and all tobacco treatment specialists can increase the efficacy of their interventions by fully using and exploiting the power of the placebo effect.
The addictive nature of the smoking habit is created by the brain, and the brain, by employing the full resources of our conscious rational intent, and our emotional subconscious, and empowered by the placebo effect, can disrupt and break the smoking habit for life (or effect many other desired behavioral changes).
1 www.simplypsychology.org, Saul McLeod, 2007
2 www.haplecrone.com, Dr.Harold Crone, Developing the Desire to Change Behavior,” 1992
3 www.positivechangeinstitute.com, Gayle North, “Engage Your Inner Power to Change…on Addiction”
4 www.Wikipedia.org/wiki/smoking_cessation, studies reviewed by the Chochrane Tobacco Addiction Group
5 www.ezinearticles.com, “Quit Smoking Through Hypnosis,” Scott Lewis
6 www.skepdic.com/placebo, from the “Skeptics Dictionary”
7 www.psychcentral.com, “Placebo Outperforms Drug in Oxford Study,” Tarci Pedersen
8 "The Week” magazine, controlled random clinical trial reported in 2011 conducted by a Harvard University researcher
9 www.Wikipedia.org/wiki/smoking_cessation, studies reviewed by the Chochrane Tobacco Addiction Group