Hypnosis and smoking cessation: the state of the science.

In his letter to the editor in this Journal, Dr. Yager (2009) is spot on target when he suggests that clinicians may mistakenly come to view the immediate results of hypnotic smoking cessation treatments (and by implication, other hypnotic treatments) as representative of long-term treatment success. Dr. Yager wisely calls for formal research in place of anecdotal case reports that lack the benefit of follow-up data. To his credit, Dr. Yager analyzed a colleague's outcome data and determined that after a period of 60 days, 22% of patients surveyed did not resume smoking. Evaluating clinical findings is of paramount importance insofar as hypnosis is a widely used smoking cessation method. In one survey (Sood, Ebbert, Sood, & Stevens, 2006) of 1,177 patients at an outpatient tobacco treatment specialty clinic, 27% reported they used complementary and alternative medicine techniques such as hypnosis, relaxation, acupuncture, and meditation. Respondents indicated that the treatment of greatest interest for use in the future was hypnosis. Yet the fact that a treatment is widely used provides no warrant that it has an empirical base that supports its ubiquity. We (Lynn & Green) entered the arena of smoking cessation treatment more than 25 years ago in response to the overblown claims of itinerant hypnotists who set up shop in hotels in our community and touted hypnosis as a highly effective technique that virtually locked-in success in achieving nicotine abstinence. Even at that time, a cursory review of the literature revealed that neither hypnosis, nor any other intervention, could reliably alleviate nicotine addiction. In this article, we examine smoking cessation studies from anecdotal case studies that date back to 1847, when hypnotic techniques were first used to control the use of tobacco, to increasingly sophisticated contemporary research. Early studies well illustrate Yager's point about the dangers of relying on anecdotal reports. In fact, in one of the first reviews on hypnosis and smoking cessation, Johnston and Donoghue (1971) reported success rates as high as 94% (Von Dedenroth, 1964) based largely on anecdotal or clinical case reports. Nearly a decade later, Holroyd (1980) examined 17 reports and concluded that more sessions are better than fewer sessions, that individualized treatments are superior to standardized suggestions, and that adjunctive treatment such as telephone contact