Stop Smoking Support Program
By Leah Martino, OMD, L.Ac.
After setting the appointment for my first smoking treatment as a new practitioner 12 years ago. I looked up the protocol. Only one paragraph outlined the treatment points and frequency of treatment. End of subject. Sound familiar?
I administered the auricular treatment, sent the patient home and hoped for the best. There were times when this treatment worked. However, my results over time didn’t equal my expectations. It wasn’t until I learned that acupuncture only reduces nicotine cravings that I realized I didn’t really understand the role of acupuncture and hadn’t been coaching my patients properly.
Later I received an announcement from James S. Olms, M.D., regarding the discovery of a new point, Tim Mee and the resulting successes for patients trying to stop smoking.
Adding that point to my protocol showed promise. Over the years I continued to gather information about smoking. Through trial and error I gained further insight and developed a comprehensive stop-smoking program that gives effective and lasting results. There are numerous smoking-cessation point formulas, all of which can be quite effective. But there is no “magic bullet” treatment that can make the detox experience disappear. A successful acupuncture program requires proper case management which includes patient preparation, patient commitment, and education about what acupuncture will and will not do.
There are five steps to the stop-smoking program I developed:
herbal treatment; and
The telephone consultation is important, so your office staff needs to be properly trained. Along with the fear of quitting smoking and the fear of acupuncture in general, it takes lots of courage for a person to make the call. This is a time you can offer hope and encouragement. You can also weed out those who are not yet ready to quit.
Speak personally to the person who wants to quit smoking. Explain that acupuncture is an effective tool to enable one to quit smoking by minimizing cravings, calming the nervous system and strengthening will power. Acupuncture can only work if the person is ready to quit and willing to commit to the process. I always mention that I’ve helped many people successfully quit smoking.
Explain what people can expect acupuncture to do for them. Acupuncture intercepts messages sent by the brain to the body that demand more nicotine, thereby disrupting the addictive process. It can eliminate most cravings, but not the habit. Generally the treatment reduces cravings from 20 plus to only 3-5 a day. The person’s responsibility is to make it through those few cravings, which you will discuss in greater detail at the initial appointment
Outline your treatment program – how many visits, how often, cost, etc. Ask if the person is ready to quit now and would like to set an appointment.
Set a morning appointment when possible. Acupuncture works best if the person is in detox. Instruct the client to refrain from smoking upon awakening, or for at least five hours before the treatment.
PATIENT INFORMATION HANDOUT
At the initial office visit I give a handout to the patient with the following instructions:
Support Person – The decision to stop smoking can elicit uncomfortable emotions. Ask someone who is available to you in the next few weeks to act as a sounding board and provide encouragement when needed.
Affirmation – An affirmation is a positive statement repeated often to create desired changes in your life. Repeating the affirmation helps not only to remind you why you are no longer smoking but imprints a new image of health so that the body can then produce health. Examples: “I am a non-smoker. I make healthy choices in my life.”
Setting Boundaries – Set up contracts with other smokers to refrain from smoking in your presence. This includes spouses. When possible stay away from smokers until you feel more confident with your nonsmoking health status.
Drink water – Research shows that dryness causes cravings. Sip water frequently throughout the day.
Refrain from drinking coffee – Research shows that coffee causes cravings and dehydrates the body.
Food choices – Eat a lot of carrots. celery and other vegetables throughout the next few days. Candies upset blood sugar level, which can aggravate smoking-withdrawal symptoms. Sugar substitutes such as NutraSweet are sweeter than sugar and cause further sugar cravings.
Managing cravings – Cravings feel like they will last forever but actually fade in two minutes. Plan what you will do during a craving. Examples: Take your herbs; repeat your affirmation; breathe deeply; walk to another place; sing a song; dance; call your support person.
During the initial treatment instruct patients to refrain from smoking or having any cigarettes in their possession. If they make it through the next 24 hours smoke-free, they have a 90% chance of being successful. I give four treatments total, two the first week, two days apart, and two follow-up appointments a week apart. I’ve tried many ear points and find the following points work best:
Kidney- increases will power
Master Point Zero (Nogier system) returns the body to homeostatic balance
Lung 1 or 2 – relieves withdrawal symptoms
Hunger – Diminishes appetite and cravings.
Tim Mee-located at the level of Lung 7, proximal to L.I. 5 in a depression between the tendons that make up the anatomical snuffbox. Perpendicular needle insertion.
LI 4 (Hegu) – pacifies spirit, regulates chi and blood.
Treat ear and body points on one side only, alternating sides with each visit. Using electrical stimulation, connect a positive (red) clip to ear Shen Men and negative (black) clip to hand Tim Mee, and positive (red) clip to hand LI-4 and negative (black) to ear Lung 1 or 2 using 10 Hz for 40-45 minutes. After removing the needles, apply either ear press needles or silver magrain pellets to the ear points.
There are three areas to address for herbal support:
Lung yin tonic. Remember that dryness causes cravings.
Liver Qi stagnation.
Any quality herbal products can be used. I use Seven Forest Lily 14 by ITM, similar to Ophiopogon Combination, for lung yin support. Although clients don’t feel a direct effect from Lily 14, when I added it to my treatment, they reported a feeling of sustenance and “not running on empty. ” I recommend a second bottle and many people continue taking it for months. Other formulas may be indicated if there is lung disease.
Ardisia 16 (Seven Forest by ITM), similar to Bupleurum Dragon Bone, helps relieve irritability and Anxiety associated with detox. I instruct the client to take it three times a day for two days, then on an as-needed basis. Many people use this formula to help them through stressful situations. I believe it helps minimize relapse.
Allertox Tobacco by Apex Energetics, is a homeopathic remedy which relieves tobacco cravings. Any homeopathic formulas for smoking cessation could be helpful. I haven’t used Chinese smelling herbs, but they would probably serve the same purpose.
After the initial four treatments, the focus becomes wellness, so differential diagnosis and constitutional work is appropriate. I recommend monthly treatments for four to six months. I usually include auricular points in the treatment since patients generally look forward to the treatment that gave them results.
No one expects a person to quit drinking alcohol by attending a few AA meetings. Quitting smoking is only the tip of the iceberg.
There are a lot of triggers that can cause relapse. Cigarettes can act as a shield to insulate uncomfortable feelings and situations. A new nonsmoker can feel vulnerable and confused when trying to handle a stressful situation. Monthly treatments provide support and bring the person back into harmony. It is not our job to provide therapy. However, we can help the client clarify feelings. If a person “slips” and smokes, question what was really at issue, and how could the person handle it differently. Relapse is often part of the process.
It is important to change the negative, failure concept in assessing what happened and how the person can use the experience to prevent the situation from occurring again. Encourage people to call immediately if necessary to get back on track. People sometimes request to try quitting wit fewer sessions, or without herbs. I remember Iris Gold’s words of wisdom in her practice building seminar, “This is the way I work.” I tell people, “If you follow my program you will be successful.” Compromise is rarely effective.
I built some of my practice around my smoking program. I find this work to be very rewarding and beneficial for future referrals. Smoking treatments are an effective way to increase credibility of our profession and to help mainstream acupuncture into modern health care.