July 7, 2021
Some people extol the virtues of alternative medicines, miracle cures to quit smoking. But what does the research say about this?
Quitting smoking is a difficult journey, and it may take several attempts to get rid of your nicotine dependence for good. That's why many people offer so-called alternative medicines that are supposed to help you in this process. However, only medication and behavioral therapies that target smoking behavior have been proven to work. None of the alternative medicines have been scientifically proven to be effective. In this article, we will review what the research says about the effectiveness of these methods.
Alternative medicines can have a beneficial effect on some people who want to quit smoking. But is it specifically these methods alone that have helped to quit smoking? Wouldn't we have seen the same effect with other methods, or even without doing anything in particular? Generally speaking, when these alternative medicines are followed by beneficial effects, it's mainly due to what is called the placebo effect. This is a positive effect observed by a person after taking a substance or undergoing a procedure presented as effective. The intensity of the placebo effect depends on the person's situation, his or her beliefs, the quality of the relationship with the person who prescribed the procedure or substance, etc. There is no magic formula or miracle cure for quitting smoking.
Many alternative medicines rely on this power of suggestion and may thus appear to be effective for quitting smoking. But, most of the time, they have not followed a rigorous protocol to evaluate their effects; and for those that have been studied, they are often of poor methodological quality, and the effects found are at best of low intensity. One study attempted to evaluate the contribution that these “alternative” and “traditional” medicines could have as a complement to recognized treatments (medical advice and nicotine replacement therapy). The authors concluded that these alternative medicines don’t increase the chances of successful smoking cessation. Let's go into a little more detail.
Hypnosis sessions are often considered as an effective method to quit smoking. Hypnosis, in itself, when practiced according to a set protocol, can have beneficial effects, for example, in reducing the dose of anesthetic during surgery. However, in the context of smoking cessation, hypnosis therapies are often performed without a strict protocol, preventing rigorous study of their effectiveness. Thus, studies attempting to evaluate the benefits of hypnosis on smoking cessation are difficult to interpret, and it's difficult to draw a definitive conclusion, as the methodology is so different from one study to another.
A meta-analysis* of the Cochrane Foundation, which is a reference in the evaluation of treatments, has examined the question by gathering all the scientific studies carried out on the subject on a total number of 1926 people. The analysis shows that most of the existing studies on the subject are of poor quality and concludes that there is currently no sufficiently strong evidence of a specific superior efficacy of hypnosis compared to other types of behavioural interventions, or to doing nothing. In the few studies that do report a beneficial effect, the effect is small at most. However, there are no side effects reported to date in the scientific literature, except for people with certain psychiatric disorders. If you wish to try hypnosis despite the current lack of proof of its effectiveness, ask your physician for advice. He or she will be able to direct you to a practitioner with a recognized diploma: some physicians and psychologists practice hypnosis therapies that can be effective in other situations.
Acupuncture is one of the alternative medicines promoted for quitting smoking, especially for reducing withdrawal symptoms at the beginning of this journey. Here again, research is useful to disentangle the true from the false. The Cochrane Foundation has analyzed the available studies on the effectiveness of acupuncture in smoking cessation.
Their meta-analysis is based on the results of approximately 2000 individuals and concludes that, in order to maintain cessation, it's as effective to do nothing as to use acupuncture. Also, acupuncture has shown no superior efficacy to nicotine replacement therapy and medical counselling. The same is true for related techniques such as acupressure and laser stimulation. When these techniques are performed in a supervised manner, they do not present any particular danger, however, in some cases they can lead to complications, such as pneumothorax.
To date, there is no evidence that acupuncture and related techniques are effective in increasing the chances of successful smoking cessation: 8% of people who have undergone acupuncture sessions succeed in their withdrawal, compared to 9% for people who have followed a placebo procedure.
Homeopathy is based on the principle that “fire must be fought with fire”. Thus, pharmaceutical laboratories marketing homeopathic treatments claim to use extreme dilutions of certain substances supposedly related to the person's condition. These diluted substances are fixed on sugar granules. In smoking cessation, some claim that homeopathy could decrease withdrawal symptoms and thus help to quit smoking. In most countries, homeopathy is sold as a dietary supplement and therefore doesn't need to demonstrate its effectiveness to be marketed, unlike drug treatments.
It's very difficult to find evidence for or against homeopathy as an effective aid for smoking cessation, as there are no rigorous scientific studies on the subject to our knowledge. Claims that homeopathic treatments are effective in smoking cessation are therefore not based on established evidence. Here again, it's better to rely on recognized and validated therapeutic solutions, which are recommended by the health authorities.
Essential oils are touted by some as a remedy for the cravings that can arise when one wants to quit smoking. First, it's important to keep in mind that essential oils don't follow a standardized manufacturing protocol, and that depending on the brand, their composition may change: thus, recommending an essential oil is particularly delicate. It would be like recommending olive oil. There are a multitude of them with different tastes, and yet, the basic substance is the same: it's olive oil! In addition, many essential oils from different plants contain the same substances. However, if one of these substances is active and effective on a problem, we may mistakenly think that it's specifically this essential oil that was effective, while others would have had the same effect. To take the example of edible oil, beneficial omega-3 can be found in rapeseed oil, but also in walnut, flax or hemp oil!
Also, many articles aimed at the general public relay isolated research results by generalizing them too much. This is, for example, the case of lavender essential oil which, according to some newspapers, would be as effective as an anxiolytic drug to fight against anxiety and stress. But to do this, these newspapers generalize to humans results obtained in very precise experimental conditions on a few individuals of a certain line of rats exposed to a certain dose of the product. However, there are several meta-analyses evaluating the effectiveness of lavender essential oil to fight anxiety, and in general, they report a low quality of the available studies, many methodological problems and protocols differences to allow clear conclusions. Thus, some components of certain essential oils may have an effect, but the absence of standardized and rigorous studies doesn't allow to recommend this or that essential oil, its dosage and its mode of administration.
Thus, while waiting for standardized protocols defining the essences, dosages and adapted modes of administration, it's not recommended to use aromatherapy to help in the success of one's cessation. Furthermore, essential oils contain substances that can cause allergic reactions and can be toxic if ingested or inhaled in large quantities, especially for pregnant women and young children.
On the other hand, a recent study shows that smelling a scent that you like would delay the response to a craving and therefore could be a good short-term strategy to distract yourself until the urge goes away on its own. To your noses!
Generally speaking, there is no evidence to date that alternative medicines are effective in quitting smoking. Some of them could be effective in your case, in addition to methods that have proven their effectiveness, such as Cognitive and Behavioral Therapies on which Kwit is based, or nicotine replacement therapy. In all cases, ask your doctor for advice, as some alternative medicines can have serious side effects or interact with other current treatments.
**A meta-analysis is a global analysis of all scientific studies dealing with the same subject. This method provides a global view of the state of research on a topic by combining the results of different studies. It's the most reliable type of analysis on the scale of levels of evidence.