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Best of Quit Smoking for Good

January 6, 2011 Written by JP       [Font too small?]

According to recent figures released by the US Centers for Disease Control and Prevention approximately $200 million dollars are wasted each year in health care costs and loss of productivity due to smoking. The World Health Organization estimates that by 2030, smoking related deaths will reach the 8 million mark annually. These figures may be shocking to some. But by now, almost everyone is aware of the health hazards associated with cigarettes. Still, the fact remains that many people continue to engage in this self destructive habit. The harsh truth is that once you get hooked on nicotine, it’s not so easy to break free. But, there are some holistic practices that may assist those who are ready to quit to find some much needed support.

There are obviously many reasons why an individual begins and continues to smoke. It’s pretty well established in the medical literature that cigarettes are frequently used to manage chronic anxiety, clinical depression and ordinary stress. Therefore, scientists frequently look to mind-body techniques, natural anti-depressants and prescriptive medications that tend to target these feelings and the biological chemicals that control them. (1,2,3)

One of the most widely used naturopathic substances for psychological conditions is Saint John’s Wort (SJW) extract. In recent years there have been several scientific inquiries into the potential application of SJW in helping smokers break the habit. First, the more promising findings:

  • In July, an animal study determined that SJW can inhibit dopamine, norepinephrine and serotonin uptake in the brain. This allows for greater concentrations of these antidepressant neurotransmitters to be present and “may additionally provide a rationale for the treatment of nicotine or drug addiction with SJW”. These findings are supported by two other trials that found behavioral and biochemical changes in mice who were treated with SJW extracts. The mice in question exhibited fewer signs of nicotine withdrawal and greater concentrations of the “feel good” neurotransmitter serotonin. (4,5,6)
  • A 2006 trial published in the journal Complimentary Therapies in Medicine found similar success in 24 human smokers. Each volunteer was given a 450 mg capsule of SJW twice daily over the course of 12 weeks. By the end of the study, the “quit rate” was 37.5%, significantly higher than the average smoking cessation rates found with conventional treatments. No change in weight or adverse effects were noted. (7)

Unfortunately, other research has demonstrated less impressive results. Because the following experiments were conducted on human subjects, in a more controlled manner, they hold more weight from a scientific standpoint.

A study released in June 2009 examined the impact of 900 mg of SJW extract and 400 mcg of chromium (a trace mineral often used to manage blood sugar and weight) or a placebo in 143 patients. All of the participants received treatment two weeks prior to their proposed “quit day” and continued taking said treatments for 14 additional weeks. Those on SJW did not fair any better than those using the placebo. However, there was a trend toward less weight gain in the chromium users. Another human trial from 2006 failed to find a benefit in 28 smokers receiving a lower dosage of SJW (300 mg – 600 mg). (8,9)

There will likely be more research on the potential of Hypericum perforatum (SJW) in the years to come. Some scientists still believe that under the right circumstances, it may yield benefits to those looking to overcome nicotine addiction. But since the current state of evidence is inconsistent at best, here’s a brief review of several other natural options that appear to offer real hope. (10)

  • Hypnosis - A recent study at the San Francisco Veteran Affairs Medical Center found that hypnosis outperformed “standard behavioral counseling” (20%-24% success rates vs. 14%-18%). Smokers with a history of depression responded even better to hypnosis. Other researchers have reported smoking cessation success rates of between 40% – 81%. The variations found may have to do with differences in patient selection and the forms of hypnotherapy involved. More research is currently underway to help determine how to best utilize this mind body practice. (11,12,13,14)
  • Massage - An interesting, but preliminary study from 1999 found that self-administered ear and hand massage helped to reduce cigarette cravings, improved mood, lowered anxiety scores and ultimately diminished withdrawal symptoms in a group of 20 smokers. The portion of the group that practiced self-massage also smoked less by the end of the 1 month experiment. (15)
  • Mindfulness Meditation - A pilot study conducted at the University of Wisconsin School of Medicine’s Center for Tobacco Research and Intervention found significant benefits for 18 smokers who underwent 8 weeks of instruction in mindfulness meditation. At the beginning of the trial, the smokers averaged about 20 cigarettes per day. 6 weeks after their “quit date” and the mindfulness training, 56% (10 out of the 18 volunteers) achieved a “7-day point-prevalent smoking abstinence”. Those who practiced mindfulness meditation most frequently demonstrated the greatest results in terms of smoking cessation and an improvement in mood and stress levels. At present there are two other nicotine-addiction/mindfulness trials underway at the MD Anderson Cancer Center and the University of Pittsburgh. (16,17,18)

Source: British Medical Journal – July 2007 (link)

The most important point that I want to get across is that there really is support out there for anyone who wants to stop smoking. If the modalities that I’ve described above are not appealing to you, other options are available. For instance, certain forms of acupuncture and guided imagery appear to hold great promise in this arena. (19,20,21,22)

Ultimately, it’s vital that you quit by any means necessary. But the added bonus of incorporating these holistic practices into your daily routine is that they can also help improve overall quality of life. Reducing stress levels and improving mood impacts every aspect of perception. If you or someone you care about is struggling with nicotine addiction, I hope you’ll consider the alternative therapies I’ve presented here today.

Update: January 2011: It’s long been known that smoking accelerates the aging process. There are few organs that make this more obvious than the skin. And while some researchers are investigating the exact mechanisms behind this observation, others are examining this cause-and-effect relationship in more practical terms. A recent paper in the journal Skinmed reports that quitting smoking can lead to dramatic changes in skin aging and appearance in as little as 6 months. In fact, after just 9 months of being smoke-free, a group of 64 women reduced the biological age of their skin by an estimated 13 years. If good health alone isn’t reason enough to quit, perhaps vanity will provide an added incentive. (23,24,25)

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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14 Comments & Updates to “Best of Quit Smoking for Good”

  1. Iggy Dalrymple Says:

    I’ve read that NAC (n-acetyl cysteine) helps break the smoking (and other chemical) habits.

  2. JP Says:

    Iggy,

    It may be worth a shot. There’s some compelling research that suggests NAC can help with different types of addictive and compulsive behavior:

    http://www.healthyfellow.com/401/nac-for-mental-health/

    http://www.healthyfellow.com/597/addiction-alternatives/

    Be well!

    JP

  3. Alex Audette Says:

    Hi JP,
    One thing that you might mention about acupuncture as it relates to smoking cessation is the NADA protocol. It is a series of 5 acupoints in the ears that is used in most methadone clinics on most addicts. I have had lots of success treating patients when I included this protocol. Although most often, I tend to take a combined approach with nutrition, herbs and supplements as every case is different.
    Be Well.
    Alex Audette TCMD

  4. Pradip Gharpure Says:

    Very good post. Quit Smoking for your health and your family. Adopt any method but give it once for all. Try Sahajayoga. It is best,free and experienced many in the world. Give up all addictions with sahajayoga.

  5. JP Says:

    Thank you for sharing your experience with us, Alex. It’s muc appreciated!

    Be well!

    JP

  6. JP Says:

    Pradip,

    I agree that yoga can be a useful aid in combating addiction and beyond:

    http://www.ncbi.nlm.nih.gov/pubmed/19842301

    http://onlinelibrary.wiley.com/doi/10.1196/annals.1352.039/abstract

    Be well!

    JP

  7. JP Says:

    Update:

    http://jop.sagepub.com/content/early/2014/05/28/0269881114536477.abstract

    J Psychopharmacol. 2014 Jun 4. pii: 0269881114536477.

    Effects of omega-3 fatty acids on tobacco craving in cigarette smokers: A double-blind, randomized, placebo-controlled pilot study.
    Rabinovitz S.

    Cigarette smoke induces oxidative stress with subsequent polyunsaturated fatty acids (PUFAs) peroxidation. Low concentrations of omega-3 PUFAs can affect neurotransmission, resulting in hypofunctioning of the mesocortical systems associated with reward and dependence mechanisms and thus may increase cigarette craving, hampering smoking cessation efforts. PUFA deficiency, in particular eicosapentaenoic acid (EPA; 20:5 n-3) and docosahexaenoic acid (DHA; 22:6 n-3), has also been linked to reduced psychological health and ability to cope with stress. Although stress is well linked to smoking urges and behavior, no research to date has examined the effects of PUFA supplementation on tobacco craving. In this double-blind, randomized, placebo-controlled pilot study, performed in regular cigarette smokers (n=48), administration of 2710 mg EPA/day and 2040 mg DHA/day for one month was accompanied by a significant decrease in reported daily smoking and in tobacco craving following cigarette cue exposure. Craving did not return to baseline values in the month that followed treatment discontinuation. This is the first study demonstrating that omega-3 PUFA supplementation reduces tobacco craving in regular smokers, compared to placebo treatment. Thus, omega-3 PUFAs may be of benefit in managing tobacco consumption. Further studies are needed on larger samples to explore the possible therapeutic implications for heavy cigarette smokers.

    Be well!

    JP

  8. JP Says:

    Update: Black currants may support oral health in smokers …

    http://online.liebertpub.com/doi/10.1089/jmf.2013.0149

    J Med Food. 2015 Mar 3.

    Acute Effects of Black Currant Consumption on Salivary Flow Rate and Secretion Rate of Salivary Immunoglobulin A in Healthy Smokers.

    The role of saliva in maintaining oral health and homeostasis is based on its physicochemical properties and biological activities of its components, including salivary immunoglobulin A (IgA). Both salivary rates and immunological status of saliva are found to be compromised in smokers. The aim of this study was to investigate the acute time-dependent effect of smoking and black currant consumption on the salivary flow rate (SFR) and salivary IgA secretion rate (sIgA SR) in healthy smokers. SFR, sIgA levels in saliva, and sIgA SRs were determined in healthy smokers (n=8) at eight times of assessment within three consecutive interventions: at the baseline; 5, 30, and 60 min after smoking; 5, 30, and 60 min after black currant consumption (100 g), followed by smoking; and 5 min after black currant consumption. Smoking induced a significant delayed effect on SFR measured 60 min after smoking (P=.03), while black currant consumption preceding smoking prevented that effect. Salivary IgA concentrations and sIgA flow rates were not acutely influenced by smoking. Black currant consumption preceding smoking induced a significant decrease in sIgA concentrations 5 min after the intervention compared with the baseline (P=.046), with a further increasing trend, statistically significant, 60 min after the intervention (P=.025). Although smoking cessation is the most important strategy in the prevention of chronic diseases, the obtained results suggest that the influence of black currant consumption on negative effects of tobacco smoke on salivary flow and immunological status of saliva could partly reduce the smoking-associated risk on oral health.

    Be well!

    JP

  9. JP Says:

    Update: Another reason to avoid smoking …

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4141451/

    Niger J Surg. 2014 Jul;20(2):83-6.

    Association between use of tobacco and age on graying of hair.

    AIMS AND OBJECTIVES: To determine the association between smoking, chewing tobacco (gutka), and age of individual on graying of hair.

    MATERIALS AND METHODS: The present study was conducted on 120 patients attending the Outpatient Department of the DJ College of Dental Sciences and Research, Modinagar, UP. The individuals were classified into four groups (group I, II, III, IV) on the basis of the form of tobacco use (smoking or chewing). The Pearson correlation coefficient was utilized to find the correlation between the mean percentage of individuals with gray hair, risk multiplication factor (RMF), and age of the individual.

    RESULTS: Mean percentage of individual with gray hair and RMF (r = 0.6487) are found to be positively associated. A significant and positive correlation was observed between the age of the individual and the frequency of individuals with gray hair.

    CONCLUSION: This study suggests that there is a significant association between tobacco use and aging on graying of hair.

    Be well!

    JP

  10. JP Says:

    Update: 4/13/15:

    http://ntr.oxfordjournals.org/content/early/2015/04/11/ntr.ntv074.abstract

    Nicotine Tob Res. 2015 Apr 11.

    Effect of Brief Mindfulness Practice on Self-Reported Affect, Craving, and Smoking: A Pilot Randomized Controlled Trial Using Ecological Momentary Assessment.

    INTRODUCTION: Despite efficacious pharmacological and behavioral treatments, most smokers attempt to quit without assistance and fail to quit. Mindfulness practice may be useful in smoking cessation.

    METHODS: This ecological momentary assessment (EMA) study was a pilot parallel group randomized controlled trial of a brief mindfulness practice (Brief-MP) intervention on self-reported smoking behavior delivered to smokers on a Personal Digital Assistant (PDA) in the field. Adult community smokers (N = 44) were randomly assigned to a Brief-MP (n = 24) or Control (sham meditation; n = 20) group. Participants were instructed to smoke as much or as little as they liked. Participants carried a PDA for two weeks and were instructed to initiate 20 minutes of meditation (or control) training on the PDA daily, completing an assessment of cognitive and affective processes immediately afterwards. Additionally, they completed assessments at random times up to four times per day. Primary outcome variables were negative affect, craving, and cigarettes smoked per day, all self-reported.

    RESULTS: Thirty-seven participants provided EMA data totaling 1874 assessments. Linear Mixed Model analyses on EMA data revealed that Brief-MP (vs. Control) reduced overall negative affect, F [1, 1798] = 13.8, p = .0002; reduced craving immediately post-meditation, (Group x Assessment Type interaction, F [2, 1796] = 12.3, p = .0001); and reduced cigarettes smoked per day over time (Group x Day interaction, F [1, 436] = 5.50, p = .01).

    CONCLUSIONS: Brief-MP administered in the field reduced negative affect, craving, and cigarette use, suggesting it may be a useful treatment.

    Be well!

    JP

  11. JP Says:

    Updated 06/04/16:

    http://hpq.sagepub.com/content/early/2016/04/01/1359105316637667.abstract

    J Health Psychol. 2016 Apr 4.

    Mindfulness training for smoking cessation: A meta-analysis of randomized-controlled trials.

    Recent studies have shown that mindfulness training has a promising potential for smoking treatment. In order to examine the efficacy of mindfulness training in smoking cessation, we performed a systematic review of the literature and meta-analysis of randomized controlled trials. Four randomized controlled trials with 474 patients were included in our analysis. The results showed that 25.2 percent of participants remained abstinent for more than 4 months in the mindfulness group compared to 13.6 percent of those who received usual care therapy (relative risk, 1.88; 95 percent confidence interval, 1.04-3.40). Our results suggest that mindfulness training may have an important role to play in efforts to lower cigarette smoking rates.

    Be well!

    JP

  12. JP Says:

    Updated 08/02/16:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932035/

    J Phys Ther Sci. 2016 Jun;28(6):1681-5.

    Effects of breathing exercises on lung capacity and muscle activities of elderly smokers.

    [Purpose] Elderly smokers have a reduced chest diameter due to weakening of the respiratory muscles, and this results in decreased ventilation, leading to a vicious circle. Therefore, the present study investigated the effects of an intervention program to enhance the pulmonary function and muscle activity of elderly smokers.

    [Subjects and Methods] Participants were randomly assigned to one of two experimental groups or a control (CG) group. The experimental groups performed exercises three times per week for six weeks, whereas the CG performed no exercises. One of the experimental groups performed a Feedback Breathing Exercise (FBE) for 15 minutes, and the other repeated three sets of Balloon-Blowing Exercises (BBE) with sufficient rest of more than one minute between sets.

    [Results] In the experimental groups, FVC, FEV1/FVC, PEF and muscle activity of the rectus abdominis significantly improved after four weeks, but no significant differences were observed in FEV1 or VC after six weeks.

    [Conclusion] The results show that FBE and BBE improved the pulmonary functions of elderly smokers, demonstrating the potential benefits of the development of various training methods using balloons, and group programs, including recreational factors, for increasing respiratory muscles strength.

    Be well!

    JP

  13. JP Says:

    Updated 11/15/16:

    http://online.liebertpub.com/doi/10.1089/acm.2016.0246

    J Altern Complement Med. 2016 Nov 9.

    Effects of T’ai Chi on Serotonin, Nicotine Dependency, Depression, and Anger in Hospitalized Alcohol-Dependent Patients.

    OBJECTIVES: The aim of this study was to investigate the effects of t’ai chi on blood serotonin levels, nicotine dependence, depression, and anger in hospitalized alcohol-dependent patients.

    METHOD: This study followed an experimental and nonequivalent control group in a non-synchronized design. It was performed in a hospital located in Young Ju city, Korea, from April to August 2013. Thirty-eight patients who were hospitalized with alcohol dependence were included. They were randomly divided into an experimental and a control group, with 19 patients in each group. Patients in the experimental group practiced the 24-posture yang style t’ai chi for 50 min three times per week for 8 weeks as part of the routine hospital rehabilitation program, and those in the control group followed only the routine hospital rehabilitation program. The effect of treatment was measured using blood serotonin levels and a questionnaire on nicotine dependence, depression, and anger. Both measurements were performed before and after 8 weeks of intervention. Data were analyzed using the t-test, chi-square test, and paired t-tests.

    RESULTS: The experimental group showed a significantly increased blood serotonin level (p = 0.001) and significantly reduced nicotine dependence, depression, and anger (p = 0.001) than the control group did after 8 weeks of treatment.

    CONCLUSIONS: T’ai chi was shown to be an effective nursing intervention in hospitalized alcohol-dependent patients.

    Be well!

    JP

  14. JP Says:

    Updated 01/23/17:

    http://onlinelibrary.wiley.com/wol1/doi/10.1111/ajad.12502/abstract

    Am J Addict. 2017 Jan 20.

    A pilot investigation of the impact of smoking cessation on biological age.

    BACKGROUND AND OBJECTIVES: Smoking is known to increase biological age. However, whether this process is reversible through smoking cessation is not known. In this pilot study, we attempt to determine whether smoking cessation reduces biological age.

    METHODS: We conducted regression analyses of methylation data from 22 subjects, as they entered and exited inpatient substance use treatment, to determine change in biological age, as indicated by the deviation of their methylomic age from chronological age across two time points.

    RESULTS: We found that, as compared to those subjects who did not stop smoking, subjects who significantly decreased their smoking consumption over a 1 month time period exhibited a marked reduction in methylomic age.

    CONCLUSION: The rapid and substantial reversal of accelerated aging associated with successful smoking cessation suggests that it can reverse well-known smoking effects on methylomic aging. This preliminary finding can be readily examined in other, larger data sets, and if replicated, this observation may provide smokers with yet another good reason to quit smoking.

    SCIENTIFIC SIGNIFICANCE: Successful smoking cessation makes patients appear biologically younger than they were at baseline, and to do so quite rapidly. In today’s youth driven society, our observations may serve as a powerful impetus for some to quit smoking.

    Be well!

    JP

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