7.18 Unproven methods
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There are several methods that have been in widespread use that have little evidence to recommend them. It has not been established using well designed studies that any of these treatments have effect over and above the placebo effect or the 'incidental' counselling and support provided at the same time.
Hypnotherapy is widely promoted as an effective way to stop smoking by weakening the desire to smoke or strengthening the will to stop. Despite being in use for some decades, the number of well designed studies to evaluate its impact is small. The Cochrane review group concluded in 1998 that there was not enough evidence to determine whether hypnotherapy has any effect on six-month quit rates.313
Acupuncture is promoted as a treatment to help with quitting by reducing withdrawal symptoms. Related methods include acupressure, laser therapy and electrical stimulation. The Cochrane review group concluded that there was no benefit of acupuncture when compared to sham acupuncture, and that there was no consistent evidence that acupuncture or any of the related methods was superior to no treatment.314 Methodological problems with much of the research meant that no firm conclusions could be reached.314
Aversion methods have also been used to aid cessation, especially rapid smoking. Rapid smoking involves taking a puff of a cigarette every few seconds while concentrating on the unpleasant sensations it causes.315 Other methods have been tried including covert sensitisation (smoking while imagining unpleasant associations), smoke-holding, electric shocks, silver acetate or other noxious stimuli paired with smoking or urges to smoke.315, 316 While there is some evidence to warrant further research into rapid smoking, it can result in tachycardia (rapid heart beat) and sometimes nausea,44 and the current evidence is not of sufficient quality to recommend it. There is little evidence for any of the other methods.315, 316
Exercise has also been investigated as a means to reduce nicotine withdrawal and cravings and help with quitting. Many of the studies to date have been too small to be persuasive and only one of 11 studies showed higher abstinence at 12 months.317
There is some evidence that exercise may help reduce withdrawal symptoms and cravings, with one study recommending relatively small doses of exercise as an aid to managing cigarette cravings and withdrawal symptoms.318 More research is needed.317, 318
From time to time other unproven and sometimes implausible methods for smoking are marketed. These include homeopathic and herbal cures, glucose tablets, magnets, lasers, lobeline, herbal cigarettes, solutions for blocking the end of cigarettes, special filters and motivational secrets. Some have been studied, but many have not, and scepticism of unsupported claims is warranted. A reliable source of quality evaluations of the evidence for many methods and products for smoking cessation is the Cochrane Library.
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