A joke I’ve made about self-help quit-smoking books that claim high rates of success is that they in effect state, “This book is guaranteed to work if you follow the instructions to the letter,“ then add, “Instruction #1: Stop smoking now.”
The Easy Way for Women to Stop Smoking: A Revolutionary Approach Using Allen Carr’s Easyway Method was published almost simultaneously with Life After Cigarettes. Because Life After Cigarettes is not prescriptive but rather encourages women to find stop-smoking and weight-management strategies that fill their own needs and preferences, I was hopeful that this book could serve as a useful companion piece to Life After Cigarettes.
And possibly it can. Certainly the personal testimonials and celebrity endorsements the program has garnered suggest that many have happily succeeded using this method. That said, it must be added that the easyway approach does not play well with others. Indeed, an alternative phrase it adopts is “The Only Way.” Unsuccessful quitters are dismissed as having failed to understand or correctly apply easyway principles. (“Instruction #1: Stop smoking now.”) Medications like nicotine replacement products, Zyban, and Chantix, which have repeatedly been shown to double quit rates in highly dependent smokers, are off limits to easyway quitters.
A little background: This book is a reissue of a book originally published in 1985, updated by an easyway therapist (Francesca Cesati) and purporting to focus on issues of particular concern to women, especially weight. (I say “purporting” because it actually includes surprisingly little specific information on managing weight, instead simply rejecting the weight-suppressing effects of smoking as “myth.”) It is what might be called a guru-based (rather than research-based) program, representing the vision of Allen Carr, who was able to quit using a method he developed on his own after years as a 100-cigarettes/day smoker. Like most stop-smoking gurus, he became an enthusiastic proponent of his own method. Unlike most, he was also an astute businessman who devoted the remainder of his career to developing clinics and books for treating smoking (and subsequently other addictions, weight loss, and even worrying) widely marketed for use by individuals and in corporate settings around the world. Sadly, he died of lung cancer in 2006, but his clinics and books continue to propagate his message and his program.
I don’t for an instant doubt the sincerity of the easyway people. I also don’t doubt that the easyway approach has helped many smokers who might otherwise have been unable to quit, and that is all to the good. It is full of testimonials that will ring true for many, many smokers and includes bon mots that some will find comforting (e.g., “Remember: you’ve only stopped smoking, not living!”). I do, however, have two serious reservations:
1) The success claims do not meet established scientific standards for evaluating smoking intervention outcomes. As is typical of self-help books, The Easy Way has received five-star reviews on amazon.com from smokers who succeeded in quitting using its principles (and as noted above, there are many) and one or two stars from those who didn’t. Although these reviews, especially those that provide enough detail to allow determination of how relevant they are to the reader’s own situation, can be very helpful, they are no substitute for trials with well-defined outcome measures in which would-be quitters are randomly assigned to either the easyway method or a control condition, abstinence is biologically verified (by measures of a nicotine metabolite or expired carbon monoxide), and findings are peer-reviewed prior to publication. These studies have not been done, but less rigorous attempts by independent observers to evaluate easyway outcomes do not support the superiority of the method over alternative approaches.
2) A number of the premises on which it rests are factually just plain wrong. The title alone includes two – first, that it is easy for most smokers to quit, and second, that it is easy to avoid any weight gain. There is no evidence from data in the scientific literature on patients in clinical trials, self-quitting in population-based samples, or any other type of study that stopping smoking and avoiding subsequent weight gain are easy. So unless you are willing to accept the claim that there is only one easy way, Allen Carr’s, and that if it wasn’t easy for you, you just didn’t “get it,” then the title doesn’t live up to its promise. To add just one more example, the book states that nicotine is not addictive, despite overwhelming scientific evidence to the contrary.
Despite these concerns, let me emphasize that The Easy Way works for those for whom it works, and if you’re one of them, I’ll never knock it – any more than I would knock other approaches that have not (or not yet) been fully tested. If, after reading the reviews of the book on the major bookseller sites, you find you resonate with the experiences described by successful quitters, then by all means invest in the book. But please don’t buy into the implicit easyway dictum that if this doesn’t work for you then all is lost – and that you yourself are to blame. There are many paths to quitting and to controlling weight; as Life After Cigarettes makes clear, you need to find the one that works for you, whether it be the easyway or someotherway.
Cynthia S. Pomerleau, Ph.D., is currently research professor emerita in the University of Michigan Department of Psychiatry. From 1985 to 2009 she served as director of the Nicotine Research Laboratory, where much of her research focused on the impact of smoking on women. She is the author of more than a hundred articles and book chapters on smoking and a contributor to the 2001 Surgeon General’s Report on Women and Smoking.