The Persistence of Error

There is an embarrassing, unanswered question about theories and models in Psychology that is screaming to be answered. If the evidence in support of Psychology’s models and theories is so meagre and feeble, how have they survived for such a long time?

The scientific method is intended to be a fail-safe procedure for abandoning disconfirmed hypotheses and progressing with hypotheses that appear not to be disconfirmed. The psychologists who dream up these theories and test them claim to be scientists, so what the heck is going on?

One reason that theories and models become semi-permanent features of textbooks and degree programmes is that simple rules at the very heart of science are persistently broken. If a theory is tested and found wanting, then one of two things happens: either (1) the theory is revised and retested or (2) the theory is abandoned. The history of science suggests that (1) is far more frequent than (2). Investigators become attached to the theories and models that they are working with, not to mention their careers, and they invest significant amounts of time, energy and funds in them, and are loath to give them up, a bit like a worn-out but comfortable armchair.

We’ve all been there – seen it, done it, even have the T-shirt:

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Nothing dishonest is happening in most such cases, simply an unwitting bias to confirm one’s theoretical predilections. This is the well-known confirmation bias studied by, yes, you guessed it, psychologists (e.g. Nickerson, 1988).

The process of theory or model testing is illustrated in the diagram. The diagram shows how the research process insulates theories and models against negative results, leading to the persistence of error over many decades. Continuous cycles of revisions and extensions following meagre or negative results protect the model from its ultimate abandonment until every possible amendment and extension has been tested and tried and found to be wanting.

Screen Shot 2018-09-07 at 08.51.32What textbooks don’t tell you: the persistence of error – the manner in which a model or theory is ‘insulated’ against negative results

Several protective measures are available to insulate investigators from ‘negative’ results:
(1) Amend the model and test it again, a process that can be repeated indefinitely.
(2) Test and retest the model ignoring the ‘bad’ results until some positive results appear that can happen purely by chance (a type 2 error).
(3) Carry out some ‘statistical wizardry’ to concoct a more favourable-looking outcome.
(4) Do nothing, i.e. do not publish the findings, and/or:
(5) Look for another theory or model to test and start all over again!

Beside all of these issues, there is increasing evidence of lack of replication, selective publication of positive findings, and outright fraud in psychological research, all of which militate against authentic separation of fact from fantasy (Yong, 2012).

Little attention has been paid to the cultural, socio-political and economic conditions that create the context for individual health experience and behaviour (Marks, 1996). Thousands of studies have accumulated to the evidence base that is showing that socio-cognitive approach provides inadequate theories of behaviour change. Any theory that neglects the complex cognitive, emotional and behavioural conditions that influence human choices is unlikely to be fit for purpose. Furthermore, health psychology theories are disconnected from the known cultural, socio-political, and community contexts of health behaviour (Marks, 2002). Slowly but surely these issues are becoming more widely recognized across the discipline and, at some point in the future, could become mainstream.

As we have seen, critics of the socio-cognitive approach have suggested that SCMs are tautological and irrefutable (Geir Smedslund, 2000). If this is true, then no matter how many studies are carried out to investigate a social cognitive theory, there will be no genuine progress in understanding.

Weinstein (1993: 324) summarized the state of health behaviour research as follows: ‘despite a large empirical literature, there is still no consensus that certain models of health behaviour are more accurate than others, that certain variables are more influential than others, or that certain behaviours or situations are understood better than others.’ Unfortunately, there has been little improvement since then. The individual-level approach to health interventions focuses on theoretical models, piloting, testing and running randomized controlled trials to demonstrate efficacy.

It has been estimated that the time from conception to funding and completing the process of demonstrated effectiveness can take at least 17 years (Clark, 2008). Meta-analyses, reviewed here, suggest that the ‘proof of the pudding’ in the form of truly effective individual-level interventions is yet to materialize.  Alternative approaches for the creation of interventions for at-risk communities and population groups are needed. A fresh approach requires a general theory of behaviour that encompasses human intentionality, desire and purpose within an ontology of change.

Psychology Bankrupt?

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Is Psychology a bankrupt science? The majority of theories are wrong, the majority of methods do not work and the majority of studies cannot be replicated. In A General Theory of Behaviour I argue for a complete redesign of the discipline.

There are several reasons why the most popular techniques used by psychologists to help people change are ineffective. The evidence does not justify any confidence in the theories, in the methods used or in the explanations provided. Meta-analyses of theory testing studies paint a gloomy picture. The overall pattern of findings suggests that current psychological theories and models cannot provide a viable foundation for effective interventions.

One core limitation with many theories and therapies is their use of the ‘Social-Cognitive Model’ (SCM). The SCM holds that a person’s ability ‘get better’ or to change is a social-cognitive problem, i.e. the person is said to have the ‘wrong’ thoughts and beliefs. According to the theory, these ‘unhelpful’ cognitions must be changed to produce a change in behaviour. But what if the beliefs are correct, or are only a small part of the whole picture, and what if they have little relevance to the behaviour or symptoms that the person is wishing to change?

Other reasons for the failure of the SCM in real-world behaviour change are briefly described below.

Individualistic Bias
Choice and responsibility are internalized as processes within individuals similar to the operating system of a computer. The human ‘operating system’ is assumed to be universal and rational, following a fixed set of formulae that the models attempt to describe. Yet even within its own terms, the programme of model testing and confirmation is failing to meet the goals it has set.

Lack of Ecological Validity and Questionable Statistical Methods
Thousands of published studies have used null hypothesis testing with small samples of college students or patients. The power, ecological validity and generalizability of these studies is questionable. We do not really know their true merit because of uncertainties about representativeness, sampling, and statistical assumptions. Rarely are alternative approaches to theory testing utilized, for example, Bayesian statistics and power analyses, to assess the importance of the effects rather than their statistical significance (Cohen, 1994).

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Self-report measures
Most studies use self-reported measures of intention and behaviour rather than objective measures. Always a huge problem! It means that the academic studies have little contact with the universe of real-world, objective behaviour.

Neglect of Culture, Religion and Gender
Religion, culture and gender are neglected by most socio-cognitive models. The models aim at universal application that is unachievable.

Unfalsifiable
Some strident critics have suggested that the models are tautological and, therefore, unfalsifiable (Smedslund, 2000). A tautology is a statement that is necessarily true, e.g. ‘Jill will either stop or not stop smoking’ or “The earth is round (p<.05)” as one famous paper would have it (Cohen, 1995). Whatever data we obtain about Jill’s smoking, the statement will always be true – a very safe prediction. Smedslund (2000) deduced that, if tautological theories are disconfirmed or only partially supported by empirical studies, then the studies themselves must be flawed for not ‘discovering’ what must be the case!

Bad models can only be supported by bad research. Others have argued that behavioural beliefs (attitudes) and normative beliefs are basically the same thing. Ogden (2003) analysed empirical articles published between 1997 and 2001 from four health psychology journals that tested or applied one or more social cognition models (theory of reasoned action, theory of planned behaviour, health belief model, and protection motivation theory). Ogden concluded that the models do not enable the generation and testing of hypotheses because their constructs are unspecific. Echoing Smedslund (2000), she suggested that the models focus on analytic truths that must be true by definition.

Unsupported Assumptions
The transtheoretical model has received particular criticism. Sutton (2000b) argued that the stage definitions are logically flawed, and that the time periods assigned to each stage are arbitrary. Herzog (2008) suggested that, when applied to smoking cessation, the TTM does not satisfy the criteria required of a valid stage model and that the proposed stages of change ‘are not qualitatively distinct categories’.

Procedural Issues
Studies measuring social cognitions rely upon questionnaires which presuppose that cognitions are stable entities residing in people’s heads. They do not allow for contextual variables which may influence social cognitions. For example, an individual’s attitude towards condom use may well depend upon the sexual partner with whom they anticipate having sexual contact. It may depend upon the time, place, relationship and physiological state (e.g. intoxication) within which sex takes place.

French et al. (2007) investigated what people think about when they answer TPB questionnaires using the ‘think aloud’ technique. French et al. found problems relating to information retrieval and to participants answering different questions from those intended and they concluded that: ‘The standard procedure for developing TPB questionnaires may systematically produce problematic questions’ (p. 672).

Neglect of Motivation
Another problem with the SCMs is that they do not adequately address the motivational issues about risky behaviours. Surely it is their very riskiness that in part is responsible for their adoption. Willig (2008) questioned the assumption that lies behind behind much of health and sex education ‘that psychological health is commensurate with maintaining physical safety, and that risking one’s health and physical safety is necessarily a sign of psychopathology’ (p. 690).

Redesign of the Discipline
Many people love taking risks; they find taking risks enjoyable, exciting, and exhilarating. If you doubt this fact, take a stroll into any casino or race track, or wait at the bottom of Mount Everest for the body bags.

Until psychology addresses the causes of behaviour, it will never succeed in helping people to change. For this, we need a complete redesign of the discipline. For an in-depth analysis, see my book A General Theory of Behaviour.

Changing Behaviour

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The vast majority of people change their behaviour with no external help. They just do it. ‘Change experts’ include psychologists who advocate behaviour change techniques in their interventions. A behaviour change technique (BCT) is any systematic procedure (or a category of procedures) included as an active component of an intervention designed to change behaviour. The defining characteristics of a BCT are that it is:

• Observable
• Replicable
• Irreducible
• A component of an intervention designed to change behaviour
• A postulated active ingredient within the intervention (Michie et al., 2011).

The description, classification and investigation of BCTs has become a cottage industry. Places like UCL, Aberdeen and Cambridge Universities, together with IBM, have received several millions of pounds from the Medical Research Council and Wellcome Trust to construct an ‘ontology’ of behaviour change.

According to the project website, “Behavioural Scientists are developing an ‘ontology’: a defined set of entities and their relationships” which will be used to “organise information in a form that enables efficient accumulation of knowledge and enables links to other knowledge systems.”

bs-diagramdetailedThe top level of the ‘Behaviour Change Intervention Ontology’ (project website)

An ontology is a set of concepts and categories in a subject area that shows their properties and the relations between them. An ontology can only be helpful when nothing of importance to the system as a whole is left out.

A ‘BCT Taxonomy’ has been employed to code descriptions of intervention content into BCTs (Michie et al., 2011, 2013). The taxonomy aims to code protocols in order to transparently describe the techniques used to change behaviour so that protocols could be made clearer and studies could be replicated (Michie and Abraham, 2008; Michie et al, 2011). A taxonomy also can be used to identify which techniques are most effective so that intervention effectiveness could be raised and more people would change behaviour.

The production of a structured list of BCTs provides a ‘compendium’ of behaviour change methods which helps to map the domain of behaviour change and inform practitioner decision-making. However it also risks becoming a prescriptive ‘cook-book’ of what therapeutic techniques must be applied to patients presenting with a specific behavioural problem.

Another problem with the compendium approach is that BCTs are not all optimally effective when combined in ‘pick-and-mix’ fashion. There needs to be coherence to the package that is provided by a theory that offers power and meaning and connects the components into a working set.

I can illustrate this point by considering an intervention for smoking cessation, Stop Smoking Now (Marks, 2017). This therapy is an effective method for clearing the human body of nicotine. The desire to smoke and any satisfaction from smoking are abolished using different forms of CBT and mindfulness meditation. Stop Smoking Now includes 30 BCTs integrated within a coherent theory of change based on the concept of homeostasis. In Stop Smoking Now a structured sequence of BCTs is provided that takes into account the nesting of BCTs such that guided imagery works best in combination with relaxation and both of these work best following enhancement of self-efficacy, achieved using self-recording, positive affirmations and counter-conditioning.   In addition, our field evidence shows that the outcome is enhanced by having a personable delivery from a charismatic person who builds a positive therapeutic alliance.                  

bs-diagramdetailedWith so many missing elements, this an Incomplete Model of Behaviour Change

Where is the client person in the ‘Behaviour Change Intervention Ontology’, and what about their feelings and their own striving for new balance and equilibrium?  Where is the therapist and the therapeutic alliance?  The quality of the change agent, their clinical and interpersonal skills and the quality of the therapeutic alliance can be more important than the BCTs (Hilton & Johnston, 2017) .With so many missing elements, this is beginning to appear like a top-down model of behaviour change. One may be excused for wondering whether the people designing the ‘ontology’ have any real-world hands-on experience of delivering interventions.

Hagger and Hardcastle (2014) suggest that “Interpersonal style should be included in taxonomies of behavior change techniques”. The whole point is that the therapeutic alliance is something the therapist and the client need to strive for. The alliance creates a more equal power balance between therapist and the client. It is more important than another technique, another item on the list. It is more about the ‘chemistry’ of the client-therapist relationship than about a finely polished set of BCTs. The trouble is that the advocates of the BCT compendium/ontology appear unwilling to engage with the problem. Somewhat ironically, they are resistant to change. However, the problem will not just go away, but rears its head each and every time a therapist swings into action.

Behaviour change involves a collaboration between the client wanting to make the change, with their own desires and feelings, and the change agent/therapist. The therapeutic alliance between the two parties is crucial to the project’s ‘outcome’.  Therapist’s attributes such as being flexible, honest, respectful, trustworthy, confident, warm, interested, and open contribute to that alliance. From all of this it can readily be seen that the situation is far more complex than the proposed ‘Behaviour Change Intervention Ontology’. It is never as  simplistic as an ‘Intervention’,  ‘Mechanisms of Action’ and ‘Target Behaviour’.

To use an analogy, there is so much more to baking a cake than a set of ingredients. Of course one needs a set of ingredients (the BCTs) but one also needs a baker – the behaviour change agent (BCA). The BCA/therapist must be fully trained to prepare, mix and cook the ingredients, to be fully competent to deliver the BCTs in a stylish manner. The qualities of effective therapists have been studied for at least 50 years. The stock piling of a compendium of BCT ingredients without attending to the mixing and ‘baking’ of the ingredients by the BCA on the front line is a recipe for disaster.

smart chef character cooking behind kitchen table with various o

Including therapist attributes of flexibility, authenticity, respect, trustworthiness, confidence,  warmth, interest, and openness, along with the client’s goals, desires and striving provides a more accurate and comprehensive approach to behaviour change.

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Stop Smoking Now

If you’re a smoker and want to give up the habit, then Stop Smoking Now is designed for you. The approach involves restoration of homeostasis without nicotine in the body or nicotine replacement, e-cigarettes or any other kind of crutch in the form of medication.

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The truth is Stop Smoking Now could not only save your life, it offers you a healthier and longer life as well. It also could save you a shed-load of money. A new car every year, fabulous holidays, and a much higher quality of life are all yours if you really want them. But it isn’t really about the money. It’s about your health and well-being.

To gain these benefits, all you need to do for the next 7-10 days is to follow the process. Yes, that’s right, it really is that simple. Hard to believe, right?

Well consider this. I have spent the last forty years fine-tuning the best possible ways for smokers to overcome the habit. My role as a Health Psychologist has brought me into contact with people from all backgrounds and cultures who have been at all the different stages of stopping smoking. In many cases, the smokers started out as desperate and hopeless cases, feeling that nothing could work for them. They had tried almost everything to stop smoking, but nothing had succeeded. Instead of blaming the faulty and futile systems they had been using to stop smoking, including most of all, their own willpower, they typically blamed themselves. They blamed themselves for being “weak”. Sounds familiar?

All a person needs to stop smoking is a system that actually works. A week or two weeks of serious application and, bingo, you will hit the jackpot, stop smoking, and remain a smoker for the rest of your life. Like many ex-smokers, you will experience feelings of joy and empowerment, hugely increased self-control and life satisfaction by achieving what previously seemed impossible – to stop smoking. Nothing can offer you a greater boost to your self-esteem than to stop smoking, absolutely nothing. It’s better than winning the lottery. Because it’s not just about the money you’ll save, it’s about a Whole New You.

Stop Smoking Now gives you the most effective method of stopping smoking. The processes described here will enable you to bring about the change.

I know – I have been there!

In my twenties virtually everybody was smoking. Smoking was the natural and normal thing to do. You could smoke almost anywhere. In shops, cafes, pubs, clubs, cinemas, theatres, absolutely everywhere. It seems crazy now, but that’s how it was. I was a pack-a-day smoker and guess what, I actually thought I was enjoying it. Sound familiar?

Cigarette advertising was everywhere. In newspapers, magazines, on TV, at the movies and on huge billboards all over the place. People would literally drive along motorways and freeways smoking cigarettes and crash their cars gawping at the billboards. It seems a different reality now, but that’s exactly how it was. All kinds of subtle and clever messages designed to get everybody to smoke a particular brand. Brands for ladies, brands for teens, brands for minorities, brands for everyone.

My brand was XXXXX. I don’t really know why. I can’t explain it. As far as I was aware, it had nothing to do with the evocative brand imagery. But at a pre-conscious level, it almost certainly had a lot to do with it. Of course, I tried other brands too, but I usually drifted back to XXXXX. I had probably been smoking for about 10-11 years when something happened that stopped me in my tracks and got me thinking. I switched to the low tar version of XXXXX, called XXXXX Ultra Lites.

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I was living in the US when I switched to this ‘sleek’ low-tar brand, a supposedly ‘safer’ method of smoking – ‘safer’ according to the the big tobacco companies, that is. My grey-and-white pack of XXXXX looked smooth and on-trend, the perfect thing for a ‘Man-about-Town’. Like millions of others all over the world, I was one ‘cool dude’ making the switch to ‘low tar’. Until I discovered the truth, that is…

Little did I realize at first what a complete sham these ‘lights’ really were. The tobacco companies had discovered the sneaky idea of making tiny holes in the sides of the filters so when you inhaled you got extra air mixed in with the smoke. This fooled the machines used for measuring cigarette tar levels into assigning lower tar levels inside the cigarettes. Millions of ‘cool dudes’ all over the world were being taken for a ride because the cigarettes contained the exact same chemical concoction of tobacco as the regular, high tar brands. And you paid extra for the privilege! When the government scientists finally figured out what was going on, the terms “light,” “low,” and “mild” in product labeling and advertisements were banned in the USA.

A week or two after I had made the switch I woke up one morning with an unexplained headache and began to notice I was having to inhale ever more deeply to get any real ‘satisfaction’ from my Ultra Lites. This was in 1976 when I was working at the University of Oregon with Professor Ray Hyman. Ray Hyman remains one of the tiny number of people to have one of Psychology’s few real ‘laws’ named after him: the ‘Hick-Hyman Law’.

One evening over dinner Ray gave me a penetrating stare and said: Given all you know about the ill-effects of smoking, why the heck are you still smoking? He stopped me dead, so to speak. I really couldn’t give a rational answer. It was at that very moment that I decided to give up smoking. Within a few days of preparation, I did it. I destroyed my remaining cigarettes and never smoked again.

As I sit at my laptop, forty years later, I can honestly say that I gave up smoking thanks to the headaches from my XXXXX Ultra Lites and the pep talk from my friend. My thanks go out to them both. This was the best health-related decision that I took in the whole of my life. Thanks Ray! Thanks XXXXX Ultra Lites! It’s now forty short years since I quit smoking.

Once I took the decision to quit smoking, however, it was far from plain sailing. I discovered how very difficult it can be. I was crotchety with the whole world. I couldn’t sleep properly. I was sharing my woes with the inside of a beer bottle. There was an inexplicable gap in my life. A vacuum of nothingness that was difficult to fill.

This was how it all started, the main reason I decided to write books and run programmes and campaigns to help other people to stop smoking. After I returned from my visit to the US, a very smart PhD student called Paul Sulzberger came to me with the idea. He and I started running Stop Smoking courses. We put together a course of five sessions that groups of people attended over a period of eight days. The sessions started on a Tuesday and finished the following Wednesday. It was highly successful. Eighty-five percent of smokers had given up by the end of the eight days. The remaining 15 percent had all reduced their consumption significantly.

News of our Stop Smoking programme spread like wildfire and we took the programme all over New Zealand and into Australia. We must have helped 20,000-plus smokers give up the habit. Our research and an independent research organisation told us that we were producing some very exciting results, the highest cessation rates ever recorded. We did ads on TV and in the major papers and franchised the system internationally and it is still running under various umbrellas to this day.

In the mid-80s I returned to London as Head and the first Professor of Psychology at the School of Psychology at Middlesex Polytechnic. The busy London lifestyle felt a bit different to more laid-back New Zealand. In my efforts to continue the march against smoking, I needed a more efficient approach so I converted the method into a self-help pack I called the QUIT FOR LIFE Programme, which was published by the British Psychological Society.

The BPS QFL Book Cover

In 2005, the first edition of the version you are now reading was published. In its current edition, Stop Smoking Now has proved to be the most successful stop smoking method ever invented. Yes, that’s right, ever invented.

I have the results of scientific trials prove this. One of my most memorable moments was when I returned on a visit to the beautiful South Island of New Zealand on holiday with my son, Michael. While in Dunedin we visited a friend who lived in the suburb of St Clair. It was a warm and sunny afternoon. A person who, at first I did not remember, had taken my smoking cessation programme many years before came over, looked me straight in the eye, and said: “You saved my life. You helped me stop smoking 25 years ago. Now I’m 75 and fit as a fiddle, thanks to you, I wouldn’t still be here if you hadn’t helped me stop smoking.” This is not the only time I have received the heart-warming announcement: “You saved my life”. Many others have said exactly the same thing.

I too probably wouldn’t still be alive today if I hadn’t stopped smoking. I know from bitter experience. I watched my one-and-only brother Jon die from throat cancer caused by smoking. Jon had only just reached his sixtieth birthday.

But that’s all history now. Let’s return to the present…You are on a different path, a path that can lead to health, increased quality of life, and happiness.

What You Need To Stop Smoking Now
You have taken the first precious step on the path to changing your smoking habit. You have within your hands a powerful and unique system designed to enable you to reach this important goal to stop smoking. You have the desire. You have the motivation. You have the ability. In this book, you have the strategies, the know-how you need to do it, to Stop Smoking Now. Follow the guidance in this book, and you will stop smoking in just a few days, and, think about it, you will never need to smoke again!

This will be the most important step to improve your health that you can take in the whole of your life. Experiencing the process from beginning to end is something you will never forget. You will be a changed person, a New You.

You already realize that smoking is the most stupid, addictive and harmful habit known to humankind. It is predicted that one billion people will die in the 21st Century as a consequence of smoking. One way of solving the world’s population explosion, I suppose… But a smoking-related death it’s not normally a quick death. Smoking-related illnesses are nasty, protracted and painful and require thousands of health care dollars. Having watched my brother slowly die in great pain, it’s something I wouldn’t wish on anybody.

Stop Smoking Now offers you the best chance to overcome your smoking habit without any help from Big Pharma. It offers you a way to extinguish the habit, once and for all. And that’s without taking a shed load of gut-busting drugs. The methods in this book have been evaluated with hundreds of smokers in randomized controlled trials. Tens of thousands of people like you have successfully overcome their smoking habit using these methods.

If you use all of the procedures with commitment and perseverance, you will overcome your smoking habit for ever. You twill be a Calm and Confident Non-Smoker.

Stop Smoking Now is in three stages.

Part One is all about Theory. I discuss the psychology of smoking and quitting. I introduce Cognitive Behaviour Therapy (CBT) and its cousin, ‘Mindfulness’, explain how they work, and how they can help you to give up smoking once and for all. It will help you to think about and become acutely aware of what you do when you smoke, why you do it, and what smoking really means to you.

If you’re not much interested in Theory and want to cut straight to the nitty-gritty, you can skip Part One and move directly to Part Two. Part Two is the Practical stuff, the guts of the whole system. It guides you, step by step, from the addicted smoker you are now to a new healthful life as a non-smoker. The process takes 7 to 10 days. This will be your new beginning, a brand new life, the most dramatic way to improve your quality of life, extend your lifespan and make you better off financially in one smart move.

Part Three is also Practical. It’s about Regaining your Life as a Non-smoker. It guides you over the pitfalls of being a recent quitter and helps you to prevent relapse and maintain your non-smoking permanently.

Why You Should Stop Smoking Now
Stopping smoking is, without any doubt, the most important thing you can do to improve your health. If you stop smoking:

• You will live longer and live a healthier life.
• You will significantly reduce your chance of having a heart attack, stroke, or cancer.
• Your skin, hair, body and clothes will no longer reek of tobacco.
• Your fingers will stop turning yellow.
• Your sex life will show a significant improvement.
• If you are pregnant, you will improve your chances of having a healthy baby.
• The people you live with, your loved ones and your children, will have a healthier, less polluted environment.
• You will save a lot of extra money to spend on luxuries and holidays.

How This Method Can Help You
There are thirty different procedures that have helped thousands of smokers give up the habit. Nobody can predict which particular procedures will work best for you – everybody is different. However, by trying this wide range of different procedures, you are giving yourself your best chance of success. Please try them all.

Believe it or not, you can possibly enjoy certain aspects of the process of stopping smoking. It is part of the design to make this method as an enjoyable and fun experience as possible. You will learn a lot about yourself and the potential you have to change yourself for the better. Yes, to actually make yourself a better and more aware and fully functioning person. But I would not be telling you the whole truth, if I didn’t tell you that it can be very, very difficult. You already know that.

An addicted smoker is always, to a degree, dysfunctional. The changes that make you will make will help you to be a fully functional human being again. Like you used to be before you took up the habit, or rather, before the habit took over you.

Drinking, eating, Internet surfing, shopping, chilling, watching TV, gaming, gambling – anything to excess can quickly turn into an addiction. Smoking is a habit which seems extremely difficult to change. As an ex-smoker I know. But smoking can be brought under control easily and permanently by applying this systematic programme.

The book can be used as a stand-alone, self-help, how-to method of quitting or it can be combined with the treatment offered by your local health service providers. Two or more smokers can also Stop Smoking Now together to generate an element of cooperation, or even competition. Who gets there first, is always an interesting challenge, as is Who stays there the longest?

I wish you absolute and complete success in becoming a happy and successful non-smoker.