Maryland's Tobacco Resource Center - Linking Professionals to Best Practices

Alternative Techniques

Many of the following techniques lack conclusive evidence for tobacco use cessation. Therefore, providers should closely consider the needs of clients before promoting any alternative techniques in treatment, and encourage them to consult a physician when medical risks may be involved.


This centuries-old Chinese method of strategically placing needles in the body to promote health has shown evidence of benefits for a variety of medical conditions. The evidence for its effectiveness in smoking cessation has not been confirmed.1

Aversive Therapy

This treatment aims at creating an aversion to the behavior of a client by pairing it with other negative stimuli. In smoking cessation, this may include rapid smoking, rapid puffing, and other concentrated and unpleasant ways of smoking. Medical risks, such as asthma attacks, should be considered before implementing aversive smoking therapy. Although this method may be associated with increased abstinence rates, it is not commonly used.1

Dieting and Exercise

Smoking abstinence rates may be increased by a regime of moderate to vigorous exercise and improved diet. While promoting health and helping to prevent the weight gain sometimes associated with quitting, this can also help clients fight smoking temptation and better cope with the psychological aspects of the addiction and quitting.2


Hypnotherapy can be used as a method for smoking cessation. In theory, it works by weakening the desire to smoke or by strengthening the will to stop smoking. A meta-analysis examined the efficacy of hypnotherapy as a smoking cessation treatment and concluded: "The review of trials did not find enough good evidence to show whether or not hypnotherapy can help people trying to quit smoking."3 Word of Caution: Hypnotherapists do not have formal licensing. Thus, it is important to find a health professional with extensive training and experience in hypnotherapy, such as psychologists, counselors, doctors, or dentists.

Smoke-Free Zones

Clients can be encouraged to locate places in their home, work environment, and community that are smoke-free. These should be convenient and comfortable places that the client enjoys, where the pressures of smoking are escaped.2

Smoking Substitutions

Smoking substitutions such as hobbies or activities (e.g., knitting, puzzles, reading) and oral fixations (e.g., toothpicks, peppermints, gum) are helpful ways for clients to avoid smoking and assert control of their therapy. There are any number of substitutions that can be used, and this technique can be most successful in conjunction with individual counseling.

Stress Reduction

For many smokers, use is associated with stress relief. Stress-reduction techniques such as exercise, self-massage, and guided relaxation imagery may aid in cessation, reduce temptation, and promote long-term abstinence from smoking, respectively.4, 5, 6

Vitamins and Herbs

There are many vitamins and herbs marketed for use in smoking cessation, although evidence of their effectiveness is minimal. These include tryptophan, vitamin form of the precursor to serotonin (a brain chemical thought to be increased during nicotine use), and the following herbs:

  • lemon balm (Melissa officinalis)
  • llobelia (Lobelia inflata) or Indian tobacco
  • loat straw (Avena sativa)
  • lscullap (Scutellaria lateriflora)
  • lvalerian (Valeriana officinalis)
  • lvervain (Verbena officinalis)

Helpful Links

National Center for Complementary and Alternative Medicine (NCCAM), NIH

Get the Facts: Are You Considering Using Complementary and Alternative medicine?

Please visit for an Introduction to CAM, Key Points, Questions and Answers, and Additional Information


1 U.S. Department of Health and Human Services (2000). Treating Tobacco Use and Dependence: Clinical Practice Guidelines. Retrieved October 4, 2006 from

2 Therapeutic Strategies in Smoking Cessation. Retrieved September 2006 from

3 Abbot NC, Stead LF, White AR, Barnes J. Hypnotherapy for smoking cessation. Cochrane Database of Systematic Reviews 1998, Issue 2. Art. No.: CD001008. DOI: 10.1002/14651858.CD001008

4 Hernandez-Reif, M. Field, T., & Hart, S. (1999). Smoking cravings are reduced by self-massage. Preventative Medicine, 28, 28-32.

5 Wynd, C.A. (2005). Guided health imagery for smoking cessation and long-term abstinence. Journal of Nursing Scholarship, 37, 245-250.

6 Marcus, B.H., Albrecht, A.E., King, T.K., et al. (1999). The efficacy of exercise as an aid for smoking cessation in women: a randomized controlled trial. Archives of Internal Medicine, 159, 1229-1234.