October 23, 2007 (Chicago) — Of hospitalized smokers who receive hypnotherapy, 50 show sustained quit rates 6 months after discharge, investigators reported here at CHEST 2007, the American College of Chest Physicians 73rd Annual Scientific Assembly.

This is twice the success rate of smokers who quit "cold turkey," which is even higher than the sustained quit rate with nicotine replacement therapy (NRT), principal investigator Faysal M. Hasan, MD, of North Shore Medical Center in Salem, Massachusetts, reported yesterday during a news briefing.

Dr. Hasan and colleagues studied 67 patients admitted to their institution with a cardiopulmonary diagnosis and a willingness to stop smoking. Patients were divided into 4 groups. The control group quit smoking without any supportive treatment, a second group underwent hypnotherapy, a third group received NRT, and the fourth group received both hypnotherapy and NRT.

Patients selected their own treatment approach, which Dr. Hasan explained was strongly influenced by their previous experiences with smoking cessation, with most patients choosing a different method.

Women were more likely to choose hypnotherapy, whereas men were more likely to choose a patch or go cold turkey. The men were looking for the "quick fix," news panel moderator Frank T. Leone, MD, of the University of Pennsylvania Health System in Pittsburgh, commented.

At 26 weeks postdischarge from the hospital, 25% of the control group, 15.78% of the NRT group, and 50% of both the hypnotherapy and hypnotherapy-plus-NRT groups remained smoking free.

"Adding NRT did not help" improve efficacy of hypnotherapy, Dr. Hasan said.

Success rates were higher with a cardiac diagnosis than a pulmonary diagnosis, at 45.5% and 15.63%, respectively, he added.

Dr. Hasan told Medscape Pulmonary Medicine that motivation is the key to success in any treatment approach: "Patients made their own [treatment] choice — this is important," he said. "Smoking cessation is only going to work if the patient is motivated."

Virginia Reichert, NP, of North Shore-Long Island Jewish Health System in Great Neck, New York, agreed. "We do anything we can to support the patient's willpower.... We need to offer whatever works."

"This concept of motivation is a mystery," Dr. Hasan commented. "It may be fear based, but you also need hope and frequent feedback.... As we say, you need the will, you need a pill — we couldn't rhyme with patch! — and you need Dr. Phil."

Both investigators stressed that many patients move from one addiction to another. "In general, every intervention doubles the success rate," Dr. Hasan said.

Ms. Reichert, Dr. Hasan, and Dr. Leone have disclosed no relevant financial relationships.

American College of Chest Physicians 73rd Annual Scientific Assembly: Abstract 6066. Presented October 22, 2007.