A therapy marketed as a guaranteed way to stop smoking appears to lack a sound theoretical basis and to have little experimental support.
As health researchers in the field of tobacco smoking cessation our aim is to find effective ways to help people quit smoking, and to improve access to effective smoking cessation treatments. The New Zealand government is currently investing heavily in policies that support such actions.
Proven therapies for helping people to quit smoking
When people decide to quit smoking without any assistance (ie by going ‘cold turkey’), they have to cope with the loss of all the dependency-forming aspects of smoking at once. Consequently, approximately 90 percent of people who try and quit without any assistance fail1.
Most smoking cessation support strategies involve the use of nicotine replacement therapy (NRT). With NRT, people stop smoking and replace the ‘dirty’ nicotine they would normally get from smoking a cigarette with ‘clean’ nicotine delivered in a lower concentration (such as via patches, gum, inhaler, and lozenges) and in a safer way (that is, without the harmful constituents present in tobacco smoke). In this manner smokers can deal with cravings and other unpleasant nicotine withdrawal symptoms, thus making it easier for them to quit.
Research evidence for the use of NRT has shown it to approximately double the chances of long-term quitting(2-3). When combined with behavioural support, pharmacological support is even more effective. Good quality evidence from placebo-controlled randomised trials indicates that behavioural support can improve the chances of successfully quitting by two to seven percent(1,4-6). Behavioural support (eg counselling people about dealing with cravings and urges, encouraging them to persist, helping them to consider the benefits and possibilities of being an ex-smoker) can be delivered face-to-face, by telephone or through the internet.
In New Zealand, the cost of NRT patches, gum and lozenge is subsidised ($5 for four weeks’ supply). Subsidised NRT is available to smokers coming into contact with cessation support services (such as the national telephone- based Quitline services and the Maori cessation service Aukati Kai Paipa), which also offer behavioural support. The Government has plans to further improve access by promotion of low cost NRT through primary care (ie through a general practitioner).
Despite good access to inexpensive, effective treatment to assist in quitting smoking, unproven and costly therapies are still actively promoted in the media in New Zealand. A recent review of the scientific evidence for the effectiveness of alternative smoking cessation interventions reported that acupuncture, St. John’s Wort and NicoBloc are probably not effective(7). There was insufficient evidence to determine the effectiveness of Allen Carr’s Easyway Programme and Nicobrevin, and hypnosis did not appear to be any more effective than simple advice to quit.
Another therapy being marketed in New Zealand as a “guaranteed way to stop smoking” is bioresonance therapy. This therapy appears to have originated from Europe and according to its proponents has been in use since the 1970s. Claims made on a website (www.stopsmokingclinic.co.nz) state that “Bioresonance therapy works through the body’s energetic system” or more specifically, “the technique uses biophysics – the physics of the body”. According to the above website it works by eliminating nicotine from the body and thus takes away the cravings for cigarettes.
“All living cells give off energy as weak electromagnetic waves similar to brain waves used in orthodox medicine (EEG scans). Bioresonance therapy, using the Bicom machine, uses these and those of substances (cigarettes) for therapy. The Bicom separates these waves into harmonious (healthy) and disharmonious (unhealthy) components. The healthy signals can be boosted and sent back to the patient to strengthen normal functions, while the unhealthy signals are ‘inverted’ or turned upside down by an electronic mirror circuit before returning them to the patient through electromagnetic mats. What actually happens is more complicated but the ‘inverted’ wave cancels the harmful wave that was stressing the body’s energetic system. You can see this effect at the beach where a wave reflected from a rock flattens the next incoming wave.”
Furthermore, it is claimed that:
“…nicotine has an electromagnetic charge over your body giving you the craving to smoke. Bioresonance therapy inverts the energy patterns of nicotine which are then passed to the body via electrodes. This process produces phase cancellation which means that the electromagnetic charge of nicotine is reduced. Therefore, it becomes easier for the body to eliminate nicotine over the next 24 hours and your cravings dramatically reduce as your body detoxifies. Additionally, the phase cancellation removes the energetic pattern of nicotine from the body, erasing the ‘memory’ of nicotine which also reduces the cravings.”
To simplify this process even more, according to the Auckland proprietor of a bioresonance clinic, the patient smokes their last cigarette and places it into the bioresonance machine, which then measures the “frequency” of the cigarette. This frequency is then “reversed” and fed back to the patient via two brass electrodes which the patient holds.
The appointment takes about an hour and it appears some behavioural support is offered, as the website correctly mentions the need to avoid second-hand smoke exposure and smoky environments, known triggers for relapse. Patients are advised not to use NRT during treatment nor use any other pharmacological treatments for smoking cessation. “Detoxification” apparently takes a couple of days (patients are advised to drink water to help with this process) and can include the following symptoms: “headaches, fatigue, upset stomach, metallic taste in the mouth, sweaty palms or a sluggish feeling”. Most of these are classic symptoms of nicotine withdrawal.
Perhaps most bizarrely, patients are also:
“…provided with a Bicom chip that contains the memory of the stop smoking treatment provided. This information lasts for up to 4 weeks and is placed on the body, two finger widths below the navel. This chip will support the detoxification process and help if any cravings are experienced. Drops are also available to support you in times of stress in the following weeks.”
Does bioresonance therapy work?
The New Zealand Stop Smoking Clinic website states that Bicom Bioresonance therapy is “the most successful stop smoking therapy in New Zealand.” Even the authoritative BBC and New Zealand’s very own Close Up TV programme have extolled the virtues of this intervention – see www.stopsmokingclinic.co.nz for video links. However we were unable to locate any randomised controlled clinical trial evidence to support this treatment, despite an extensive search for the term “bioresonance” in a number of medical databases, specifically Medline (1948 to May 22 2009), Embase (1980 – week 21, 2009), AMED (Allied and Complementary Medicine) database (1985 – May 2009), Cochrane Central Register of Controlled Trials (2nd Quarter 2009), ACP Journal Club (1991 to April 2009), Cochrane Database of Abstracts of Reviews of Effects (2nd Quarter 2009), the Cochrane Database of Systematic Reviews (1st Quarter 2009) and the Conference Papers Index (1985 – present).
In total, only 13 articles were located that even mentioned the term, of which eight were non-English publications. The articles with English abstracts were commentaries, non-randomised rat studies, case-series studies or physiology studies. The papers were predominantly published in journals that focused on alternative therapies and no reference to smoking was made in any of the publication titles or English abstracts provided by the database searches. One paper discussed treating 12 athletes with “strain syndrome” with Bicom therapy and 12 with more traditional methods (eg ultrasound, stimulating current, etc)(8). This study reported less therapy time and treatment time in the Bicom group, but we were unable to determine if the study was truly randomised nor the validity of the rest of the study design. However, given the small sample size (24 people only), any positive findings could well be due to chance alone. Interestingly, one paper discussed the use of pseudo-scientific language to cloud important issues (how to present nonsense as science), using bioresonance therapy as an example.
The evidence is not there
Overall, no studies that stand up to the standard level of scrutiny used for orthodox treatments could be identified. The weight of evidence to support the use of this therapy (for any condition and not just smoking cessation) seems to consist of material in non-peer-reviewed publications, such as case studies provided on websites and in books(10-12) and promotional literature provided by those marketing the therapy. A number of Bicom websites (e.g. www.bioresonance.net.au/bicom_therapy.htm) mention the existence of three studies on allergic conditions supposedly published in Chinese medical journals(13-15). These studies were not identified by our search above, but translations for the papers are provided on the above website (although there are no details provided about the source journals so it is not possible to verify their authenticity), along with two additional studies (one on chronic inflammatory bowel disease16 and one on central nervous disorders in children)(17) – once again with no details provided about their source. Four of the five studies are case studies or case-series(14-17). One of the Chinese studies claims to have randomised 300 children, but no details were provided on how the randomisation was undertaken(13). Furthermore, if the randomisation had been done it seems not to have worked given 213 children were in one group and 87 were in the other. Our suspicions are that the study was not randomised and therefore the findings are likely to be biased and meaningless.
It is possible that our search may have missed identifying some papers. It remains odd, however, that so little research appears to have been published given that:
- In May 2009 bioresonance therapists meet in Germany to celebrate the 49th (ie they have had 48 previous meetings) International Congress for Bicom Therapists. Most congresses and conferences (even those in the complementary and alternative medicine field) publish posters or presentations from their meetings and these are referenced on international databases – yet none of these conference proceedings were located.
- The therapy is claimed to be so effective.
- The therapy is claimed to be in widespread use. One website (www.bicom.co.nz) states that “the technique is almost mainstream in Germany, and the German-speaking countries, Austria and Switzerland”, and that the instrument is “widely used in Poland for helping smokers to quit and has over 70 percent success (over 100,000 people have been treated over six years).” And that in China, the therapy is “used exclusively in children’s hospitals mainly to treat eczema and asthma.”
If it truly worked surely you would be doing everything to show the world that it did … and there have been at least 35 years to show the world.
Accepted international criteria for what is regarded as an effective smoking cessation method use the benchmark of six months of continuously not smoking (not even a puff) after quitting. The New Zealand Stop Smoking Clinic website claims that Bicom Bioresonance therapy has “70-90 percent success after one hour” for stopping smoking. Anyone can stop smoking after an hour … it’s a bit like asking you to stop eating for an hour. The issue is when you start smoking again. The Auckland proprietor was unable to provide us with this information.
There is no evidence to support the therapeutic claims made by those promoting bioresonance therapy other than uncontrolled case studies. Any benefits are likely to be due to the placebo effect. A systematic review of 105 NRT trials (involving a total of 39,503 smokers) found that when the quit rates for all the trials were pooled using the longest duration of follow-up available from each trial (6-12 months), 17 percent of smokers allocated to NRT had quit compared to 10 percent in the placebo control/no NRT group2. Clearly the placebo effect plays a significant role in smoking cessation.
Is it therefore wrong to make a claim about a product when simply believing that the product will work makes it effective for some individuals? Does it matter how you try to give up smoking as long as you make an attempt to give up?
In 2002/3, 24.5 percent of New Zealand adults smoked (47.2 percent of Maori), with this figure dropping to 19.7 percent in 2006/7 (38 percent in Maori)18. Despite this recent evidence of change, based on the current rate of progress it is estimated that it will take 100 years before the New Zealand adult smoking rates reach five percent, the level of smoking in New Zealand doctors19. New approaches to assist smokers to quit are still urgently needed, ideally ones with proven efficacy and that are cheap, easily accessible, and acceptable to Maori and people from the lowest socio-economic group (who have a three times higher rate of smoking than people from the highest socio-economic group18). At $450 per treatment (second treatment free if taken within the first month), Bicom Bioresonance therapy is far from accessible to the people that need it most. One could argue that it is designed to generate revenue as quickly as possible, by using pseudoscience to bamboozle the innocent. Are we too cynical? One company (www.bicom2000.com) will gladly send you a detailed profitability calculation form.
For a rather interesting conversation of how another member of the skeptic community views this treatment, see www.sciencepunk.com/2007/03/monadith-bioresonance-smoking-cure/
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