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Effectiveness of a cognitive behaviour therapy self-help programme for smokers in London, UK.

15 Aug

Catherine Sykes and David Marks of Middlesex University in London, in an attempt to see what might reduce smoking among economically disadvantaged, heavy smokers, studied 260 smokers in this randomized, controlled clinical study. 131 subjects were randomly assigned to a cognitive behavioral program (called QFL, or Quit for Life), where they were taught in one hour how to be vigilant around their internal rationalizing to smoke, and to how use guided imagery, relaxation and meditation. After 7-10 days of smoking reduction, they quit and move into a 3-month relapse prevention program over 3 months time. Nicotine replacement therapy is optional (but not free), and was used by an insignificant minority of participants. Subjects are advised that quitting is not a matter of will power but of self-efficacy. 129 subjects were placed in the control condition, a program called SSME (Stopping Smoking Made Easier), which consists of a leaflet or audiotape telling people how to quit, offering facts and figures, and advice around picking a date to stop cold turkey, using will power, getting support from family and friends, arranging for a self-administered reward system after a successful first day, week and month; and to call the "Quitline" if further help is needed. Here too nicotine replacement therapy was optional, and again used only by a small minority of subjects. At the 6-month follow-up, 21 (17.2%) of the 122 participants receiving CBT and relaxation therapy were abstinent and 14 (11.5%) had reduced cigarette consumption by at least 25% of their pre-treatment level. On the other hand, only six (5.6%) of 107 participants in the control group were abstinent and none had reduced consumption. This was in spite of the fact that amount of contact with the program was the same, and use of nicotine replacement therapy was the same. The study concludes that cognitive behavioral and relaxation therapy is more effective than health education advice in helping smokers quit. Smokers need more than information; they need the skills and techniques to enable them to control the psychological processes that underly smoking.

Citation: Sykes, Catherine and Marks, David. Effectiveness of a cognitive behaviour therapy self-help programme for smokers in London, UK. Health Promotion International 2001 Sep;16(3):255-60.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award