How Allen Carr saved my lungs
Millions of converts claim the 'Easy Way' is the most effective method of stopping smoking. So why does the NHS not get behind it? Former smoker Laurence Phelan reports
Tuesday 13 March 2012
Without wishing to overgeneralise, people like me – well read, sceptical, snobbish – think that self-help manuals are lame and the people who read them are losers. But ask which book I most regularly recommend to others, or which has had the most significant influence on my thinking and lifestyle, and I'll have to admit that it's my well-thumbed charity-shop find The Only Way to Stop Smoking Permanently by the late Allen Carr – an extended recapitulation of his 11-million-selling 1985 hit The Easy Way to Stop Smoking.
What I discovered in its pages was a deeply shocking truth: that I'd neither enjoyed nor depended upon cigarettes to the extent I'd thought. In fact, I hadn't enjoyed or depended upon cigarettes at all – I'd merely convinced myself otherwise so as to assuage the cognitive dissonance between the rational part of my brain, which knows smoking is an ill-advised, expensive and dangerous hobby, and the short-sighted, nicotine-addicted pre-mammalian parts of my brain that didn't care, and just wanted another cigarette.
Upon turning the final page, I felt like Keanu Reeves after he's been unplugged from the Matrix. I saw nicotine as it really is: a malevolent Wizard of Oz frantically manipulating the levers of my neural machinery in order to aggrandise itself. And Allen Carr was Toto, tugging back the curtain to reveal the true, pathetic nature of what he called "the little monster".
Or Carr was the little boy who noticed the emperor's state of undress. There are lots of suitable analogies, because there have always been those who feel they've noticed a new truth about reality. If it was divine revelation (and Carr did refer to the day in 1983 that he gave up his own five-packs-a-day habit as "the moment of revelation"), then they're called prophets; otherwise, visionaries or gurus – or conspiracy theorists. To learn which of these he was, I went to meet the present heads of the Easyway organisation that Carr founded in order to spread his gospel, and heard that perhaps he was something of each.
"A lot of people who use the method to stop smoking have a real connection with Allen," one of the company's directors, John Dicey, tells me in Easyway's unassuming flagship treatment centre in suburban south London. Meanwhile, in his office one road along from Harley Street, Robin Hayley, the managing director of Easyway, tells the story of an ex-smoker who'd read Carr's book and was offered the chance to meet the man himself, but trembled: "Oh no, I couldn't... He's seen inside my soul."
As astute as he was on the matter of the smoker's psychology, however, it's possible Carr miscalculated during his initial efforts to spread the word. "We deliberately de-medicalise our method," Hayley says. "We try to get away from that preachy, judgemental, white-coat image." On top of which, the active ingredient in Carr's cure is a paradigm shift; an upending of perceived wisdoms. His last, posthumously published book was 1998's The Nicotine Conspiracy, in which he set out to expose "the greatest scandal in the history of mankind": a collusion between governments and the pharmaceutical industry that resulted in expensive and ineffective nicotine-replacement therapies, rather than his own treatment, forming the cornerstone of the NHS's smoking-cessation strategy.
"Allen enjoyed being controversial," Hayley admits. "But people don't like being told that they're going about something the wrong way. Particularly by somebody who appears to them to be an upstart; who has no training in the field and no qualifications." Take initiatives such as tomorrow's national No Smoking Day: "Allen used to say it's the day on which all the experts say smokers stop smoking, but on which any self-respecting smoker will point-blank refuse to stop, because they don't like being told what to do. He was very frustrated, because here he was with this method which he knew could help millions, and the government wasn't paying any attention to him. Now, we feel that we do have credibility, and we do have evidence of our effectiveness. We are trying to build bridges."
"We're not a commercial organisation through choice," explains Dicey, who has overseen the distribution of the Easyway method via comic book, webcast and Nintendo DS, and through Groupon and Tesco Clubcard. "We've tried to give the method away any number of times, and to successive Departments of Health, and been rebutted. We haven't had a single penny of funding from anybody, so we realised pretty early on that the only way was for us to be commercially strong." The result is an organisation that has expanded into 45 countries without needing to advertise and, as Hayley adds, "organically, through word of mouth, because the method works".
But, says Robert West, professor of health psychology at University College London, "the difficulty that Allen Carr's organisation has is precisely that it's a private organisation. Obviously it needs to make strong claims, otherwise no one's going to spend money on it. And unfortunately, in the past, it's made quite ridiculous claims for its effectiveness, based on such things as the proportion of people who ask for their money back."
Less than 10 per cent of smokers who attend an Easyway clinic ask for a refund of their £240 under the three-month guarantee, but these days the organisation still makes only the more sober boast of a 50 per cent success rate – a figure corroborated by two studies published in peer-reviewed journals. And it's worth noting that a success rate of 50 per cent after 12 months would be a significant, two- or threefold improvement on the successes currently reported by NHS smoking-cessation services.
What's needed before the National Institute for Health and Clinical Excellence can recommend Easyway be made available on the NHS, however, is an independent comparative study of these success rates, and Professor West has advised Hayley on how to devise just such a study. "Until it does that, it's always going to be on the outside looking in. At the moment, it has its reputation, and as with a drug company that puts new drugs into a clinical trial, there's always a risk it isn't going to work," he cautions. "But it has a clear theoretical position which looks sensible. It has confidence in its method, and it thinks it would be more cost-effective. So I would encourage it to take the risk."
In the meantime, the word-of-mouth recommendations continue to spread. Incidentally, if you're a smoker, might I recommend my favourite book...?
For help quitting, see allencarrseasyway.co.uk or smokefree.nhs.uk
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