All acupuncture works. The question is: how does it work?
This question comes to mind every day I’m in my clinic, because I bring myself and my predilections to work with me. I discuss my approach to acupuncture with my patients in an effort to be as transparent as possible and to think out loud. And today it comes to mind because I’d like to discuss my approach to smoking cessation.
I love helping people who want to stop smoking. It is a privilege to be a part of the process of change, even more so when change is accompanied by such positive, tangible outcomes. For the patient, the outcomes include the satisfaction of achievement, the immediate experience of the body’s repair, the savings in the purse. For myself, it’s the chance to be part of the process, to be a witness. We all have the potential to change; I have watched my own changes (almost all of them for the better!) across the course of a long-ish life. It is possible to reach a different place, to experience the felt-sense of our better selves, to embark on the next stage of personal evolution. Putting down your pack is the one of the best kinds of personal evolution.
The process of change starts with the initial phone call. When someone calls me about smoking cessation, I make it clear that acupuncture is not magic, that I can only help someone who really wants to stop, and that I will do my utmost to support the process. I explain that I use needling strategies to elicit a state of deep relaxation to help the person get through the initial stages of physical jonesing and mental anxiety.
In the history forms the patient fills out, I ask the prospective stop-smoker to sign an agreement that reads, in part, “I will do my utmost to help you stop smoking. The real work is yours. The essence of my acupuncture strategy is to elicit a whole-body relaxation to re-frame what is, for many people, a difficult passage. The form this relaxation takes differs from person to person, as each person differs from each other. It is up to you to take this state of mind/state of being and use it to reach your goal.”
There’s a lot of good information on the net about the why’s and wherefore’s of smoking cessation. The City of New York has a great page about the how and why: http://www1.nyc.gov/site/doh/health/health-topics/smoking-nyc-quits.page.
According to www.quit.com:
Over 1 million Americans quit smoking every year.
Among adult American smokers, nearly 7 out of every 10 want to quit completely.
A smoker who smokes half a pack a day could save $2000 in one year.
Within 2 weeks to 3 months of quitting, your risk for heart attacks decreases as your lung function increases.
In a paper at the National Institutes of Health website, Nancy Rigotti, M.D., makes the point that “tobacco is the leading preventable cause of death worldwide” and that stopping smoking “is the one of the most cost-effective actions in health care.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562427/
Yet none of the mainstream stop-smoking websites suggest acupuncture as an intervention. Dr. Rigotti’s article makes the point that “Neither hypnosis nor acupuncture has strong evidence of efficacy for smoking cessation.” I have some ideas about why acupuncture isn’t taken seriously and I’ll write about it over the course of the coming year.
My clinical approach
In my treatment room, helping someone to stop smoking involves two to three steps. Initially, while the patient is face down, I needle alongside the entire vertebral column, from the base of the neck to the lumbar vertebrae. The greater number of needles, the greater the relaxation effect. While the person is face down, I also use electroacupuncture to provide a rhythmic massage to the upper traps and the shoulders. When I take the person’s history, I learn whether there is a better electroacupuncture target than the shoulders, for instance, the knees or low back. If we can reduce this pain we can relieve another source of the daily tension that can be part of an addiction’s vicious cycle: we smoke to relieve the pain and tension in our lives and the pain in our lives makes it impossible to make the changes we crave. Sometimes, as a third step, I also treat face up, both with needles and hands-on bodywork, to complete the intervention. I may also apply electrostimulation to the ear, a more typical smoking-cessation approach in the acupuncture world.
This sense of physical and mental relaxation, combined with the mental alertness that can accompany a relaxed state, is what I offer someone who wishes to embark on breaking nicotine addiction. The patient does the real work. I am strictly a helper. I urge the person to come in for one or two follow-ups during the initial week or two and I make regular phone calls during this period to check on progress. I’m a coach-cheerleader. I give the person a box of Chinese green tea as an alternative to reaching for instead of a cigarette. Does the process work? More often than not, it seems to. Most of my follow-ups, over a course of two to three weeks, seem to be appreciated and provide positive reports. Long-term progress is harder to track.
About nine years ago, I thought I would build in a longitudinal monitoring process. I tried contacting smoking-cessation patients after three months, six months and a year. But no one wanted to be pestered, so I have no exact idea about how many people I’ve treated have stopped permanently.
In two-and-a-half years ago, I treated someone for smoking cessation who went home and slept for 36 hours. He hasn’t smoked since. The prolonged sleep provided what may best be called a pivot-point for him. I know this for sure because I wrote to him a few days ago to ask permission to use his experience as an example. But I know of no one else who has gone home to sleep for 36 hours. But I have heard from others after several years who have continued to be smoke-free.
What constitutes success when you stop smoking? Most would agree that one week’s abstaining from tobacco does not equate to success. Stopping for the rest of a lifetime is surely success. Where’s the balance? To my way of thinking, three months of smoke-free living is a kind of success. And perhaps the nature of the trigger that returns the smoker to smoke can be thrown into the equation. The first person I ever treated for smoking cessation was doing fine for several weeks, until her closest friend, living in Paris, had a miscarriage. She immediately flew to be at her friend’s side and picked up again. Perhaps a Gauloise? I never knew. Years ago, I read that people who stop smoking and then return to smoking, but continue to seek for ways to stop again, will, at the end of the long road, eventually find the solution that works for them and stop for good.
At the top of this article, I referred to the agreement I ask smoking-cessation patients to sign. It also says: “Nicotine addiction is real. It is not easy to quit smoking. I will work energetically to assist and support you through the process of quitting. People sometimes stop for a period of time and, due to a life event or other trigger, they are induced to start smoking again. Feelings of shame or inevitability sometimes color people’s decision either to return to smoking or to keep from seeking help again. Please consider using my office as a long-term support at any time, whether a month or a year from now.”
No one has ever taken me up on this. After the initial encounter or encounters, no one has ever called me for that booster shot. I don’t know why. I’ve followed up for as long as a month, and I know that many have stayed away from what the Virginia colonists referred to as the sot-weed for at least that long. In a handful of instances, I know that it’s been as long as several years. But no one has come back after having relapsed. Surely there have been some relapsers in the group.
Now, as for the question posed in the title of this article. Whose eyes does your smoke get into? Your own eyes, and those of everyone around you. If you smoke, it’s time to stop, for your sake and for everyone else’s.
My next post will focus on the major acupuncture strategy for helping people stop smoking, or to desist from other chemical addictions, auriculotherapy.
© 2016 William Weinstein