NONPHARMACOLOGIC METHODS (cont'd)
{"Image DocumentName": "NONPHARMACOLOGIC METHODS (cont\u2019d)", "Image ImageDescription": "Formal cessation programs. Self-help programs. Individual counseling. Group programs. Telephone counseling QUITNOW Web-based counseling.    Acupuncture therapy. Hypnotherapy. Massage therapy. Formal cessation programs: An abundance of formal smoking cessation programs are available. These range from self-help manuals to individual and group counseling programs. The National Quitline, launched in 2004 ( QUITNOW), provides all Americans with toll-free telephone-based counseling. For individuals with Internet access, many Web-based programs offer private and convenient ( 24/7/365 availability) cessation support. The effectiveness of these types of behavioral programs is enhanced further when pharmacologic agents also are used for cessation. Alternative and complementary therapies: In recent years many patients have turned to various alternative and complementary therapies for cessation (Villano & White, 2004; Sood et al., 2006): Acupuncture therapy (and related techniques including acupressure, laser therapy and electrostimulation) are believed to modulate neurotransmitter release thereby attenuating symptoms of nicotine withdrawal (Villano & White, 2004; White et al., 2006). A recent meta-analysis (White et al., 2006) concluded that there is no consistent evidence that acupuncture, acupressure, laser therapy, or electrostimulation are effective and the Clinical Practice Guideline (Fiore et al., 2008) does not recommend these approaches for smoking cessation. Hypnotherapy also has been used for smoking cessation. Hypnotherapists implant subconscious suggestions to deter smoking. Evidence on its efficacy is conflicting, and currently the evidence is insufficient to support hypnosis as a treatment for smoking cessation (Abbott et al., 2000; Fiore et al., 2008). Massage therapy is thought to reduce anxiety, decrease stress hormones, and improve mood. In one study, patients used either hand or ear self-massage during tobacco cravings for a period of 1 month. Patients reported improved moods and decreased anxiety, withdrawal symptoms, and number of cigarettes smoked per day (Hernandez-Reif et al., 1999). Massage therapy might be useful as an adjunct therapy to alleviate cravings and anxiety. \u266a Note to instructor(s): Members of your audience might have heard of an approach known as aversion therapy. In brief, this technique requires patients to smoke so much that they are nearly nicotine intoxicated, which makes them feel sick and (supposedly) makes them not want cigarettes any more. According to the U.S. Public Health Service Clinical Practice Guideline for treating tobacco use and dependence, aversive smoking interventions are not effective and have high incidence of adverse effects and are therefore not recommended (Fiore et al., 2008). Abbot NC, Stead LF, White AR, et al. (2000). Hypnotherapy for smoking cessation. Cochrane Database Syst Rev 2:CD Fiore MC, Ja\u00e9n CR, Baker TB, et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. Hernandez-Reif M, Field T, Hart S. (1999). Smoking cravings are reduced by self-massage. Prev Med 28:28\u201331. Sood A, Ebbert JO, Sood R, Stevens SR. (2006). Complementary treatments for tobacco cessation: a survey. Nicotine Tob Res 8:767\u2013771. White AR, Rampes H, Campbell JL. (2006). Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev 1:CD Villano LM, White AR. (2004). Alternative therapies for tobacco dependence. Med Clin N Am 88:1607\u2013", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}