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SMOKING CESSATION METHODS NOT BASED ON SCIENTIFIC EVIDENCE

SMOKING CESSATION METHODS NOT BASED ON SCIENTIFIC EVIDENCE. Cengiz ÖZGE , Associate Professor . Mersin University Faculty of Medicine Department of Chest Disease. Contents. Introduction Electronic Cigarette Acupuncture and associated methods Hypnosis. Among Cigarette Smokers.

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SMOKING CESSATION METHODS NOT BASED ON SCIENTIFIC EVIDENCE

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  1. SMOKING CESSATION METHODS NOT BASED ON SCIENTIFIC EVIDENCE Cengiz ÖZGE,Associate Professor. Mersin University Faculty of Medicine Department of Chest Disease

  2. Contents • Introduction • Electronic Cigarette • Acupuncture and associated methods • Hypnosis

  3. Among Cigarette Smokers • 70% wants to quit smoking. • 35% seriosly attempted to quit in the last year. • 80% previosly attempted to quit. • 3% manages to quit in a year.

  4. Quit in a single setting Success more than 90% Refund of money is guarantee

  5. What is the scientific evidence ?

  6. WHY ME ?

  7. Evidence Pyramide Meta analysis Randomised controlled trials Cohort studies Case-control studies Case-report “Editorial”, clinical opinion...etc. animal studies, in vitro studies...etc.

  8. SCIENTIFIC EVIDENCE

  9. Electronic cigarette

  10. A Commercial product of tobacco. Certified by the Ministry of Agriculture. Not designed for smoking cessation therapy. No presented scientific study. Electronic cigarette

  11. Acupuncture • Have a history of 3000 years. • Have been in Europe since 1600ths. • Chen-Chin : Needle-Heat • Acus: Needle • Punctura: Prick

  12. Acupuncture • There are almost 1000 stimulation points in the human body. • 650-700 of these points are being used. • It is beleived that there is an acapunture point for every organ in the ear.

  13. Mechanisms of the effects of Acapuncture • The body has two opposite energy called Yin and Yang working in synergy. • This energy travels in the canals called meridians. • If the balance fall off, an abnormaly ensues. • Acapuncture helps to maintain this balance.

  14. Theory of five elements • Wood,fire, earth, metal and water. • All the phenomenon in the universe structurally meets these five elements. • They are in a continuous movement and alteration. • If this balance is falls off diseases ensue. • Acapuncture maintains this balance

  15. Mechanisms of the effects of Acapuncture • Endorphine • Met-encephalin • Serotonine • Dopamine

  16. Fields of administration of acupuncture • Cure of pain • Apettite control and slimming • Reduction of Stress • Acceleration of metabolism. • Treatment of allergy. • Migrene and headache. • Treatment of Insomnia. • Cessation of smoking.

  17. Acupuncture • Auricular acupuncture • Moxibustion • Acupressure • Electro Acupuncture • LASER Akapunktur • Luxopuncture • Bioresonance • Moratherapy

  18. Moxibustion Application of heat to the acupuncture points instead of needles. Electro Acupuncture LASER Acupuncture Electric current LASER irradiation • Acupressure • Pressure application onto the acupuncture points.

  19. Luxopuncture • Developed in France • Condensed infra red light application to the acupuncture points.

  20. Bioresonance Moratherapy • Plain electrode contact on the human skin at certain sites • Electromagnetic vibration. • Depends on the claim that faint low frequency vibrations carry knowledge.

  21. R.I.S.E • Reflection Instrument Scanning Electro-pulse • I quit smoking (IQS) • Beta-endorphine

  22. Between 1963-1989 Total of 27 studies 15 of them for smoking cessation. A meta-analysis of studies into the effect of acupuncture on addiction G TER RIET, J KLEIJNEN, P KNIPSCHILDBritish Journal of General Practice, 1990, 40, 379-382.

  23. A meta-analysis of studies into the effect of acupuncture on addictionG TER RIET, J KLEIJNEN, P KNIPSCHILDBritish Journal of General Practice, 1990, 40, 379-382.

  24. A meta-analysis of studies into the effect of acupuncture on addictionG TER RIET, J KLEIJNEN, P KNIPSCHILDBritish Journal of General Practice, 1990, 40, 379-382.

  25. A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40 • Have at least two therapy groups, • Randomized • No old (previous) control group is used. • 9 studies are taken into consideration • A total of 2707 patients.

  26. A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40 Total (95% CI) OR: 1.48 (CI:1.13-1.48)

  27. A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40 • Acupuncture seems to be better according to the control group; • *HOWEVER!! • NOT better than the Sham acupuncture. ( OR:1.16 % 95 CI: 0.90-1.49)

  28. A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40

  29. A meta-analysis of the effectiveness of acupuncture in smoking cessationASHENDEN R, SILAGY CA, LODGE M, FOWLER G. Drug and Alcohol Review (1997) 16, 33-40 • All are self-reports, no CO measurements • Only 4 studies have 12 months of follow up. • 4 studies single-blind, 5 studies open. • Studies are small. • Methodological scores are low.

  30. White AR, Rampes H, Campbell J. Acupuncture and related interventions for smoking cessation.Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD000009 • Randomized controlled studies • Acupuncture • Acupressure • LASER acupuncture • Electrostimulation • Sham acupuncture • 24 studies were evaluated

  31. White AR, Rampes H, Campbell J. Acupuncture and related interventions for smoking cessation.Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD000009

  32. White AR, Rampes H, Campbell J. Acupuncture and related interventions for smoking cessation.Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD000009 • No high quality studies about acupunture and associated applications are present • No prominent dominancy in a year’s follow up. • The effectivness that was seen in the early period was abated by the removal of a study which was conflicting with the homogenicity of the study.

  33. Alternative therapies for tobacco dependenceL.M. Villano, A.R. White / Med Clin N Am 88 (2004) 1607–1621

  34. A Randomized Controlled Clinical Trial of Auricular Acupuncture in Smoking CessationTa-Peng Wu, Fang-Pey Chen, Jui-Yao Liu, Ming-Hsien Lin, Shinn-Jang HwangJ Chin Med Assoc • August 2007 • Vol 70 • No 8

  35. ACUPUNCTURERESULT • There are no scientific evidence for the effectivess of • Acupuncture, • Acupressure, • LASER acupuncture and • Electrostimulation to be used for the cessation of smoking.

  36. HYPNOSE: The name of the God of Sleeping in Greek Mythology. This is a state of bringing someone into a deeply sleeping like situation where his/her behaviour can be kept under control by another person. HYPNOSIS

  37. HİPNOZ • A state of sleeping achieved by words, looks and suggestions. A person in this state (subject) is open to the suggestions and influences of the applying person but closed to the other stimulations from the surrounding.

  38. HypnosisHistory • Before the holy books, sorcery and medicine were used together in religious ceremonied. • In 1778 Dr.Franz Mesmer • In 1847 for quitting tobacco • In 1958 American Medical Association approved Medical hypnosis.

  39. HYPNOSISFields of Application-1 • Depression • Social phobia (zoophobia, acrophobia, hydrophobia) • Tic disorders  • Stammer  • Enuresis nocturna, • Psycological pain disorders.  • Obesity • Anorexia, Blumia  • Alcohol and tobacco addiction  • Panic attack.

  40. HYPNOSISFields of Application-2 • Conversion Disorders  • Posttraumatic Stress Disorders • Psycologic Memory losses • Sleep Disorders • Bruxism • Sexual Functional Disorders (Impotence, premature, ejaculation, vaginusmus) • Onichophagia • Obsession • Personality Disorders

  41. HYPNOSISFields of Application-3 • Psycological tremors • Dyslexia • Cure of chronic physical pain. • Painless child delivery • Trigeminal Neuralgia. • Nervous Hypertension • Asthma • Allergic Skin Disorders. • Psoriasis • Treatment of the wharts. • Migraine,  • Attenuation of pain due to cancer  • Treatment for the teeth without application of anesthesia.

  42. Hypnosis and Cessation of Smoking • Its means of effect is not clear. • Relaxation, • Extreme suggestibility • Hightened imagination proposed to act on the underlying impulses. • Inhibition of the left cerebral hemisphere

  43. Hypnosis and Smoking Cessation • 1st Session:Interview, understanding hypnosis, being hypnotized. • 2nd and 3rd Session:Administering regression hypnotherapy to eliminite obstacles to quitting smoking; uncovering unconscious reason cousing smoking.4th. Session:Direct suggestion session(Changing unconscious patterns causing smoking. Replasing with new habits.) • 5th Session:Ego strengthening hypnosis session (Strengthening positive emotions such as focusing on future, self-confidence self-esteem in the person who quitted smoking.) • 6th Session:Learnig self-hypnosis and EFT techniques (Teaching daily techniques that will be used to preserve wellness consistently)

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