SURVEY RESULTS OF THE ‘ROB KELLY METHOD’: AN APPLIED PSYCHOLOGICAL TECHNIQUE FOR SMOKING CESSATION
Kelly, R.C. & Allen, C.E.L.
ABSTRACT: This study presents the results of an online questionnaire for a novel smoking cessation treatment utilising applied psychological techniques. Participants were 107 paying clients attending Rob Kelly’s Cambridge Clinic. Post treatment 92.5% of participants reported that they had stopped smoking.
Cigarette smoking has a high risk for a wide range of negative consequences for an individual (Mattson, M., Pollack, E.S. and Cullen, J.W., 1987; Freund, Belanger, D’Agostino and Kannel, 1993). As a result, smoking cessation has been widely researched and a great many treatments are available to help a person to stop smoking (See for example, Viswesvaran and Schmidt, 1992).
Smoking cessation is widely believed to be very difficult to achieve, with many giving a pessimistic outlook on obtaining abstinence, particularly without treating what is commonly believed to be an underlying nicotine addiction. One meta-analysis suggested a control group quit rate of just 6.4% (Viswesvaran and Schmidt, 1992). On the other hand Schachter (1982, as cited in Katz and Singh, 1986) found that 64% of those in a non-clinical population who tried to quit smoking on their own ultimately managed to do so – many without much difficultly.
It has been suggested the notion that ‘stopping smoking is a very difficult thing to achieve’, establishes an unhelpful and negative belief system that actually fuels difficulty in quitting. For example, Atrens (2001) suggested that while smoking continues to be seen as an inescapable addictive process, smoking cessation programmes will be limited by a self-fulfilling prophecy.
Eiser and Sutton (1977) proposed that the decision a smoker faces is typically not one of continuing to smoke or stopping, but one of continuing to smoke or trying to stop. Many smokers believe that significant willpower is required to achieve smoking cessation (for example, Roddy, Antoniak, Britton, Molyneux and Lewis, 2006; Ingall and Cropley, 2010), and lack of willpower is often cited as a reason for failure to abstain from smoking (for example Katz and Singh, 1986; Copeland, 2003).
It is, however, proposed that willpower is not a fixed trait, but that the amount of willpower or persistence a person demonstrates in a particular situation is linked to their expectancy of success or self-efficacy. Mukhopadhyay and Johar (2005, p781) suggest that the greater the self-efficacy, “the more vigorous and persistent are people’s efforts”.
In relation to smoking cessation, Yates and Thain (1985), found that self-efficacy in relation to cessation success was the best predictor of whether or not a person would stop smoking without relapse at both 4 months and 8 months after quitting. Research by DiClemente (1981) found that, after a cessation attempt, relapsers and maintainers did not differ on any demographic or smoking history variables. However, maintainers did show significantly higher self-efficacy scores than relapsers. Eiser, Van der Pligt, Raw and Sutton (1985) found that whether or not participants believed that they could stop smoking significantly distinguished abstainers from relapsers 1 year later. Etter, Bergman, Humair, and Perneger, (2000) found that baseline smoking self-efficacy scores predicted smoking cessation sixteen months later.
It therefore seems plausible that treatment interventions that aim to alter limiting beliefs around smoking cessation and increase self-efficacy would improve quit rates. This has already been demonstrated in weight loss research, where Weinberg, Hughes, Critelli, England and Jackson (1984) found that both manipulated and pre-existing high self-efficacy groups lost more weight over the 8 weeks than those with low pre-existing and manipulated self-efficacy.
This study examined the effectiveness of a currently available smoking cessation treatment, ‘The Rob Kelly Method®’, which utilises applied psychological techniques, that aim to alter detrimental beliefs surrounding smoking cessation and increase self-efficacy and willpower. The ease of quitting was also investigated.
107 participants took part in the treatment and completed the survey. Participants were smokers, who were paying clients that had visited Rob Kelly’s Cambridge Clinic in order to undergo the smoking cessation treatment. There were 54 women and 53 men. The exact age of the participants was not determined, but two participants were within the range 18-25 years, ten were within the range 26-35 years, nineteen were within the range 36-45 years, twenty nine were within the range 46-55 years, thirty two were within the range 56-65 and fourteen were over 65 years old. One participant did not disclose his age range.
The majority (87.9%) of participants had tried other smoking cessation methods prior to this treatment, including: willpower, nicotine replacement therapy, Zyban, visiting an NHS stop smoking clinic, other hypnotherapy treatments, acupuncture and laser treatment. Thirteen participants had made no previous attempts to quit, twenty four had made one previous attempt, forty had made two previous attempts, twenty one had made three previous attempts, five had made four previous attempts, one had made five previous attempts and one had made more than five attempts previously.
(i) Treatment Protocol
The same practitioner administered the smoking cessation treatment to all participants, largely individually to each participant. In a minority of cases the treatment was administered jointly to two participants, who were a couple. Participants were smokers, who paid for the session. Treatment consisted of one sixty to ninety minute session, which was split into two parts:
(a) The face-to-face discussion.
This part of the session lasted approximately fifty to eighty minutes and firstly involved a discussion in which the participant’s beliefs around smoking were discussed, challenged and changed, based on a training programme entitled ‘Changing Limiting Beliefs’ (Kelly, 2010). This included presenting the participant with evidence that suggested stopping smoking could be much easier than most people expected and showing him/her how his/her psychological processes were involved in his/her smoking habit. This was designed to boost self-efficacy, and thus willpower, as the participant was shown that he/she has far more control over his/her smoking than previously realised. This component also included a discussion around what the participant currently gained from smoking and what they would gain if they were to quit, particularly highlighting the tangible rewards they would receive through quitting. Participants were encouraged to now see themselves as a non-smoker.
(b) A short hypnosis session.
The second part of the session involved the use of hypnosis and lasted approximately ten minutes. This short hypnosis component involved a progressive relaxation induction, in which the participant was asked to close his/her eyes and to focus on breathing slowly and deeply. The participant was asked to focus on relaxing different muscle groups of his/her body in turn. The relaxation induction was followed by carefully worded positive suggestions to the effect that the participant would find it easy to stay a non-smoker, suggestions for self-efficacy, and a reminder of the benefits of quitting.
For example: “This thing that you have always thought was going to be difficult, is going to prove to be remarkably easy”; “everyday you will feel more in control of your life”; “you are going to feel fitter, healthier and more full of life”.
(ii) Survey Questionnaire
Over a fourteen month period, all smoking clients who contacted Rob Kelly through his smoking cessation website (www.stopsmokingeasily.com) and later visited him for this treatment, were asked to take part in this survey. Post treatment, participants were asked if they would fill in a short online post treatment questionnaire in their own time. It was stressed that this questionnaire was optional.
The post-treatment questionnaire (appendix one) was self-administered online. The online method was used rather than a face-to-face interview or telephone survey, in order to reduce social desirability bias (see for example Tourangeau & Smith, 1996; Presser & Stinson, 1998; Tomlin et al, 1998; Vuillemin et al, 2000). Participants were given a password that enabled them to access the questionnaire, to prevent those who had not taken part in the treatment from filling it in. The online form explained the purpose of the research and detailed that participants’ identifying details would not be disclosed to a third party.
The survey obtained a number of demographic details from participants, including gender and age-range. It asked what previous methods for stopping smoking the participants had used and how many attempts at stopping they had already made. The participants were asked what their reasons for quitting were.
Participants were then asked whether or not they had stopped smoking post treatment, and asked to state their beliefs as to why they had or hadn’t stopped. They were also asked to comment upon how easy or hard they found the process and whether or not they suffered cravings, withdrawal or side effects.
92.5% (99) of participants reported that they had stopped smoking after the treatment.
Participants filled in the questionnaire between one day and 209 days (approximately seven months) after the session. The average time at which participants completed the questionnaire was 28.1 days post-session. The average time at which those who stated that they had stopped smoking completed the questionnaire was 29.7 days post-session (approximately one month), whereas the average time at which those who stated that they had not stopped smoking completed the questionnaire was 7.9 days post-session.
When given the opportunity to state why they felt that they had or hadn’t stopped smoking, as well as comment on the effects of the process, 84 participants out of 107 (78.5%) submitted answers.
61 participants’ responses indicated that they found the process of stopping smoking easy or very easy (72.6% of those that gave answers to this part of the questionnaire). Responses were categorised as indicative of this if they explicitly stated the words ‘simple’, ‘easy’, ‘very easy’, ‘not hard at all’, or stated that it was ‘painless’, involved ‘no effort’, they had not had any cravings, withdrawal symptoms or side effects, or that they did not miss smoking at all. Examples of such comments included:
“I stopped easily, and with no cravings at all”
“very simple and easy process”
“really easy – piece of cake”
“I can’t belive