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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:
- telephone consultation;
- patient information;
- acupuncture treatment;
- herbal treatment; and
- maintenance.
TELEPHONE CONSULTATION
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.
ACUPUNCTURE TREATMENT
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:
Ear points:
- Shenmen-alleviates tension
- 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.
Body points:
- 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.
Treatment Method:
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.
HERBS
There are three areas to address for herbal support:
- Lung yin tonic. Remember that dryness causes cravings.
- Liver Qi stagnation.
- Craving Support.
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.
MAINTENANCE
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.
RECIDIVISM
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.
Resource listings do not signify an endorsement of the products mentioned in this article. For more information, please contact:
Institute for Traditional Medcine (Lily 14, Ardisia 16) at 800-544-7504, Longherb Health Products, Inc., 800-766-5372, (Chinese smelling herbs) and Apex Energetics, 800-736-4381 (Allertox Tobacco).
Institute for Traditional Medicine Aromatic herbs
as an adjunct to acupuncture stop-smoking treatment programs: Longherb Health Products, Inc. 3007 E. Washington Avenue
Fairfield, IA 52556 Tel: (800) 766-5372 Allertox Tobacco, by Futureplex
Reprinted with permission form the California Journal of Oriental Medicine.
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