Advertising Smoking Cessation Hypnotherapy

Sole copyright © Donald Robertson, 2007

[The text of this article was checked and approved by Donna Mitchell of the ASA Communications Team (31/1/07) before publication by the NCH journal and GHR newsletter.]

What advertising claims can you make about hypnotherapy to quit smoking?  There are three main restrictions which bind UK hypnotherapists, 

1. The UK law insofar as it restricts certain forms of advertising.
2. Having made an agreement to abide by their (NCH) code of ethics, they are bound to abide by any restrictions imposed by their professional body, failure to do so might be construed as a breach of contract.
3. The Advertising Standards Authority (ASA) administer self-regulatory codes of practice for the advertising sector.  Written advertisements are regulated by the CAP Code (the British Code of Advertising, Sales Promotion and Direct Marketing – www.asa.org.uk or www.cap.org.uk)

The ASA have the power to investigate complaints about specific advertisements and to impose sanctions on advertisers who break their codes.  They publish a very useful database of adjudications online.

            I should mention in passing that, unfortunately, the ASA database shows that a number of therapists, including hypnotherapists, have made advertising claims in the past which they have been unable to substantiate when evidence was requested by the ASA Council.  The adjudications make very interesting reading. 

            All hypnotherapists should be aware that the Committee of Advertising Practice (CAP), which is responsible for writing the CAP Code that is administered by the ASA, publishes a number of very valuable articles in their AdviceOnline database available from their main website.  In particular, hypnotherapists should be familiar with, 

1. Ailments, Treatments and Therapies: General

2. Ailments, Treatments and Therapies: Hypnotherapy

3. Smoking, Stopping

CAP also provide a very useful service through the CAP Copy Advice team who will inspect your proposed advertising copy and make recommendations on wording to help ensure it complies with the codes.  Several of our students have found this service very helpful.  In fact, the Copy Advice team have not only helped us avoid transgressions but actually, on a more positive note, came up with some good ideas for new advertising headlines!

            One important requirement of the CAP Code is that specific claims should be supported by appropriate evidence.  We spotted that an adjudication relating to Nicotine Replacement Therapy (NRT) had made use of the important meta-analysis by Viswesvaran and Schmidt (1992) of the University of Iowa.  This study compares many different pieces of individual research to compare the efficacy of different methods of stopping smoking.  The evidence shows that NRT is more effective than willpower alone.  (A finding, incidentally, which many researchers now consider a research artefact due to the dubious research design used with NRT.)  However, we were aware from our own research that this study also authoritatively shows hypnotherapy to be more effective than NRT for smoking cessation.

            I believe that there are strong grounds for concluding that meta-analysis tends to substantially underestimate the efficacy of treatments like hypnotherapy which can evolve significantly in response to research findings, unlike chemical therapies including NRT and Zyban, which are pretty fixed in their nature and therefore do not improve much over time.  If you take the statistical average of old studies using clumsy hypnotherapy methods and new ones using sophisticated multi-component cognitive-behavioural hypnotherapy strategies you necessarily negate the benefits of progress that has been made over time.  Nevertheless, even in these unfavourable conditions, research consistently shows hypnotherapy to be more effective than NRT and other treatments.  It is therefore something of a scandal that anti-smoking charities and the NHS continue to recommend NRT as the treatment of choice for smoking and resist calls to endorse hypnotherapy.  Most therapists suspect that this has something to do with the David versus Goliath problem, the voice of the hypnotherapy profession is inherently feeble, indeed virtually non-existent, compared to the “Big Pharm” lobby who have the ears of the decision makers and media.

            It is my personal belief, based on the research, that NRT will be conclusively shown to be of negligible efficacy within the next ten years or so.  It’s not much better than placebos, i.e., dummy patches.  As my students know, I believe that the key to smoking cessation lies in evidence-based client selection procedures derived from other research studies.  We provide training in our own approach on our “Smoking Cessation Masterclass” available in central London.  Most private hypnotherapists will not undertake treatment with clients who they feel are unmotivated or only coming for treatment because someone else wants them to stop smoking.  That’s just common sense.  There are much more sophisticated and empirically-based ways of assessing clients’ suitability for treatment, though.

            We attempted to take a proactive stance on advertising smoking cessation by submitting our own advertising copy to the copy advice team for approval, and supporting specific claims by reference to independent research.  The copy advice team exchanged several emails with us during which we carefully revised our wording until we arrived at agreement upon the following wording,

Obviously, this is a template and individual advertisers would need to add their details and modify the wording to suit their requirements.  However, we would recommend that any changes to wording which might change the meaning or even connotation should be cleared with the CAP Copy Advice team on an individual basis.  In particular, the Copy Advice team were insistent that the wording make it clear that the evidence relates to hypnotherapy in general and not the outcome rates for the specific practice being advertised.  We eventually agreed that the wording above satisfied this requirement. 

* Clarification.  Since publication of this article, several professional organisations have emphasised that they think the guarantee should be time-limited.  This wording was only meant to demonstrate the kind of claims that could be acceptable, we never intended hypnotherapists to use it as it stands without further elaboration.  As you can see from our manual, we have ourselves always recommended that satisfaction guarantees are time-limited.