A recent enquiry has urged me to raise a thorny issue that exists within the world of hypnotherapy. In truth it is the elephant in the room that hypnotherapists are encouraged NOT to talk about. Mention the term “success rates” to most hypnotherapists and all of a sudden it’s like entering a mythological world where hypnotherapy has been castigated and designated as an inconvenient problem child.

So what’s the problem with success rates? Well curiously enough the problem is NOT hypnotherapy or even its effectiveness, the problem is elsewhere and two-fold: there is no financial incentive for governments or independent bodies to test hypnotherapy properly and even if there were, the nature and criteria of scientific proof required has become an obstacle in itself.

Governments have to test the products that they (and the medical profession) are going to recommend and tax. The testing is ostensibly to protect the public but it also becomes a means of shutting out competing approaches. In the area of smoking cessation the whole field is deeply political and suffice to say that Nicotine Replacement Therapy (NRT) is now a very big business, it is after all the latest profit line for the world’s huge tobacco/nicotine industry.

Governments appear happy to pass on the claims for success rates for smokers who stopped after using NRT for periods as short as 3 months. They tend not to be so forthcoming about the same product’s success rate after 12 months. After a year the figures are relatively low and unimpressive and this is usually hidden behind a spurious description such as “twice as effective as willpower alone”.

The reason it is spurious is that the vast majority of people who stopped using willpower alone have never been included in any form of scientific research. The gold standard of proof within scientific research is a procedure called “Double-Blind”. This process is ideal for testing pills and medications, it depends on neither the patient nor the practitioner knowing whether a placebo has been given. It has to be said that double-blind really has been a vitally important tool in the development of new effective medicines but it has limitations. After all, how would you use double-blind to test the effectiveness of stopping smoking by willpower alone? What placebo is there for willpower? More to the point, how could the person quitting not know whether or not they are stopping using willpower?

The Nicotine (replacement?) industry will frequently quote willpower to be as low as 3 to 6%. A growing number of people in the scientific community are now seriously questioning these low figures, some even view them as unethical as it makes stopping unaided, appear to be an act just short of folly. So why is it that so many people have stopped smoking by doing exactly that? People who never sought any help and did not enrol themselves into a scientific study, their experience lost from science and conveniently forgotten.

It is now believed that anything up to 40% of the people who have actually stopped smoking did so unaided. So why the huge difference in the figures? Well, It appears that for many years there has been a skew introduced by the very manner in which research candidates are recruited to take part in the trials. The process has been likened to the way that defence lawyers pick the type of jurors they believe would be best for their clients in a court of law. Clearly someone who has tried and failed to stop smoking numerous times using willpower alone is unlikely to be any more successful than they were before. Such people are ideal candidates for a trial that hopes to show how weak-willed and needy we all are! On the flip side, people who used to smoke but stopped using willpower alone are simply dismissed as not part of experiment. To be fair, the way in which they stopped was not observed by science and the evidence would be categorised as anecdotal, either way the truth is lost/ignored. Oh well, so much for good science! The burning question then arises about how this has come about? Put simply, research costs a lot of money and takes a lot of time. It is very rare that government bodies will commission pure research of this nature because the public are simply not asking for it. In the eyes of the establishment, it is a “non-issue” so the status quo is unperturbed. In practice, research is usually funded by multinational corporations with an eye to future profits. The research is extremely useful because it also provides an opportunity to build a body of promotional evidence to help market their product or “wonder-drug”.

It is now high time that the general public called for genuine research. Research that can finally be recognised as the truth. That will almost certainly mean including the experience of people who stopped smoking unaided.

In terms of scientific proof, hypnotherapy suffers from exactly the same problem as willpower. How can you have a placebo that could both be medically neutral and yet also passes as an ersatz for a full hour of genuine therapy? The principal challenge in attempting to find a double -blind test is that neither the practitioner nor the patient should be able to know whether people are receiving genuine therapy or a placebo treatment. Double-blind is not a feasible method of testing hypnotherapy and yet the ASA (Advertising Standards Authority) prevent any hypnotherapists from declaring their success rates unless their results have been proved with double-blind testing. There is a distinct whiff of Catch 22 here…

Experienced hypnotherapists are very aware that their skills are viewed by governments and certain large corporations as a mild irritant that they wish would go away and disappear completely. In fact the establishment takes great care not to mention hypnotherapy at all. Following this theme, ASH the main UK campaigning charity whose remit is to “eliminate the harm caused by tobacco”. A rather curious turn of phrase, they could have made their aim “to help the greatest number of people stop smoking” but no. The reason for bringing ASH into this topic is because if you look on their site, hypnotherapy is significantly noticeable by its absence. In fact if you search their site for “hypnotherapy” it simply informs you that “Your search has not returned any results.” Some would call this a conspiracy of silence. Indeed it is strange that ASH is happy to promote every option that involves a profit-making product and it even perpetuates the myth that willpower alone is an ineffective strategy. Shame.

It is now a matter of record that Valerie Austin pioneered a specific hypnotherapy technique for smoking cessation in 1989. Both Valerie and the national media were amazed by the success of her technique. As a result, she began a process of calling people up 12 months after receiving their hypnotherapy to stop smoking. All but a very small percentage (5%) were non-smokers. There was a potential skew in her results in that Valerie charged a lot of money for her hypnotherapy. The effect of the high price is intriguing as it appears to have ensured that those who were prepared to pay this sum were clearly genuinely committed to stop. That said, as with willpower, being genuinely committed to stop is the surest route to stopping smoking and staying stopped.

So, given this state of affairs is it really such bad science to have an independent person call up people to find out whether people are still not smoking? Their smoking status could easily be checked measuring their carbon monoxide levels. What more proof is required? After all, if I had to choose between the information in a glossy advert and the personal recommendation of a trusted friend, I’d ditch the advert. How about you?

Pierre Marcar BSc