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A White Paper Evidence based Study presenting Results Achieved in a Malaysian Factory The Science To Quit Smoking Technology Training done in JB Cocoa, Tanjong Pelapas, Johor, Malaysia and moderated by The Institute of Behavioral Research, Ministry of Health of Malaysia


The Science to Quit Smoking (S2QS) – An Evidence based Study done on how a Corporate Social Responsibility Seminar that employ Internet and Telecommunication Technology to teach cigarette cessation to Smokers in a Factory Work Place.

Authors: Julian Aloysius Leicester, S Thavaraj , Bart Alex Lameijer ABSTRACT

Background There are many clinical stop smoking techniques using either products, consultation or in combination with counseling techniques. The majority of these methods are achieved via a one to one clinical approach. While it has been shown that these methods can be effective in the treatment of cigarette smoking, it is not known whether such methods can be conducted or applied in groups. This study is a study on systems of combined education, advanced  subconscious  techniques  for 

change, music and sound impacts and using internet interaction technologies  Methods This was a study done with two sets of smokers who wanted to quit and those who did not want to quit. The participants were provided a week of the S2QS seminar education and group therapies and were further given educational and therapy support via the internet. Daily counts of their cigarettes were taken with initial video and audio testimonies done for authenticity of the evidence and monitoring process. At the end of the week seminar the cigarette count was done and documented. After a lapse of ten months where these participants were left without any support what so ever, a final count of their cigarettes was done to conclude the study evidence. Results The evidence of this seminar study has shown that the S2QS program is a resilient program as it employs some of the world’s best of breed techniques in education, experiential, holistic, entertainment and, with mind techniques for rapid and lasting change. In the study it has shown stability in process of delivery, handling challenges with minimal format changes, receiving reasonable consistency in result and objectives. It shows its superior potential as a national quit smoking program that can be scaled and rollout effectively in a multi language, cultural and corporate society as Malaysia. It has the potential to scale effectively and brand antismoking in Malaysia. Conclusions It inspires to be the world’s leading corporate group program that not only teaches smokers to be a ‘non-smoker’ but provide a rapid solution to quit smoking at the workplace or in schools. •

It’s a group program which teaches as well as provides a quit solution in it.

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• • • • • • • • • • •

It complements the Government of Malaysia’s Anti-tobacco programs. It is the first of its type in the world in terms of design and uses education, therapy and technology. It is a sophisticated drug-free anti-tobacco structured training system. It breaks smoking beliefs using mind techniques and uses structured quit habit education to empower change. It is leveraging the subconscious coaching and health, food and therapy programs to implement a quit smoking habit. It is making a healthy and tobacco free organization within. It is attaining healthier working lifestyles. It stands for less “smoking breaks” and better productivity. It is protecting the health of passive smokers from the carelessness of smokers. It teaches smokers who don’t want to currently quit with a system that they can use and quit someday. It can scale effectively into Corporate Malaysia and eventually provide a marketing mechanism to effectively change mindset eventually over a few years on its branding effect of anti-tobacco and good healthy lifestyles.

INTRODUCTION

Unlike many anti tobacco programs in the marketplace, this study program is focused towards motivating the pattern of the subconscious mind conditions to achieve a long term stop smoking goal. The approach was using a trained subconscious specialist and trainer to bring a group of smokers regardless if they wanted to quit smoking or not, to a state of heightened awareness in which they are more articulate, more relaxed and are better able to decide and make that change to quit their smoking habit. The S2QS systematic method use in this study is designed towards a stop smoking goal for a change that can work long term. It uses a revolutionary combination of techniques and approach to combat the “mental addiction” while decreasing the chance of a relapse. The S2QS key goals are to interact with the subconscious mind of the smoker to ensure a synergy of internal beneficial experiences that will make them better composed and more motivated for a long term quit. The S2QS seminar uses mind-body knowledge to increase self performance and energy. The candidates were taught to become more articulate and geared to learn and take massive appropriate action for immediate commitment for their health daily. The overall core method used advanced subconscious techniques which is a powerful tool as a foundation for change and motivation. The uniqueness of the S2QS seminar is its parallel online educational coaching and therapy intervention provided concurrently with the training seminars using sophisticated web base education and monitoring technology. The impact of group psychosocial interventions in combination with the usage of supporting internet and electronic based education for cigarette smoking cessation is unknown and this study is a first of it kind to evaluate its impact.

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SUBJECTS AND METHODS

SUBJECTS When we first approached JB Cocoa management, on initial discussion the management of JB Cocoa had set an expectation that 30% of the participants should end as non-Smokers after 4 days of 3 hours seminar. Two seminars were conducted and they were based on participants who wanted to quit and those who did not want to quit. These subjects were mainly of Malay origin and from the factory operation shift teams. The initial plan for the seminar was to be conducted in English. However, because the majority of the participants were not fluent in English and mainly production crews, the seminar was quickly adapted into a combination of English and Bahasa Malaysia which suited the mixed group of production and management team of smokers. The study took note of the challenges faced especially of the participants who were coming to the seminar right after work mainly in an exhausted state and hungry, causing lack of focus and attention. In the second seminar the expectation on the second batch of participants were even higher. While the company now had a benchmark result of 50% to compare our results, the Managing Director of JB Cocoa still maintained expectation at 30% success rate as a minimal proof of the effectiveness of the second seminar. The majority of the second seminar participants had already initially been briefed on their expectation by the previous seminar participants. Thus, these participants were more challenging because they were already expecting any “surprise elements” in the training. These were the group that did not volunteer for the first seminar because they still enjoyed smoking. The HR Manager mentioned that many did not want to quit and had query why JB Cocoa management had forced them to attend the training. In the initial response of their willingness to quit in the program, about 70% mentioned that they were not sure or did not want to quit, indicating a high internal resistant to the program. PROCEDURES The study on the two Cigarette Slayer Seminars was done and observed by MOH Health Research Institute Director, in Skudai, Johor Bahru, Malaysia. These two seminars was organized in collaboration with JB Cocoa, a cocoa processing factory in Tanjong Pelepas Port Zone. The seminar dates and location are: 1. 26 of April 2007 – 7th of May 2007 Goodhope Hotel, Johor Bahru, Skudai Number of participants: 21 2. 24 of May 2007 – 4th of June 2007 Goodhope Hotel, Johor Bahru, Skudai Number of participants: 23 The method used for the S2QS seminar training involved a dedicated crew, a security officer and the consultant trainer. The training was a joint working and

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cooperative venture between JB Cocoa, Beat Fear and the Ministry of Health Research Institute In the study the methods of documentation, recording of events and sampling document records to monitor evidence were properly supervised and validated. In the seminar many key areas of evidence and proof points were controlled and recorded daily. This was done in various ways: 1. Video testimony before and after the total seminar to proof the effect 2. Audio recording of the entire seminar to review 3. Pictures of both the seminars 4. Questionnaires in which the attitude, feeling and response were asked to measure results During the whole duration of the seminars, the human resource manager of JB Cocoa and the safety officer of Beat Fear collected the records of the cigarette consumption (if any) of the participants. We presented to the official of Ministry of Health Institute of Research for authentication and moderation on sight on each seminar day. MEASURES

Statistic Collection and measure

(A) Amount of Cigarettes taken by the participants each day CS‐ 26  27  28  29  30  1‐ 2‐ 3‐ ID  Apr.  Apr.  Apr.  Apr.  Apr.  May May May 1  8  3  0  0 0 0 0 0 2  14  10  7  3 0 0 0 0 3  18  3  0  0 7 0 0 3 4  14  0  0  0 0 0 0 0 5  17  7  7  7 0.5 0.5 1 0.5 6  5  3  1  1 0 0 0 0 7  12  8  5  5 5 4 3 2 8  14  6  5  4 3 1 1 1 9  20  10  10  14 9 6 10 8 10  14  10  9  9 9 7 7 7 11  16  2  3  3 0 2 2 2 12  9  1  0  2 2 ‐  ‐  ‐  13  14  0  0  0 0 0 0 0 14  10  5  4  4 0 1 1 1 15  4  2  0  0 0 0 0 0 16  17  5  5  5 5 5 5 5 17  15  5  5  4 3 2 2 1 18  14  4  4  4 4 3 4 3 19  20  5  5  5 5 5 5 5 20  14  10  10  10 10 0 0 0 21  20  17  15  15 10 ‐  ‐  ‐  22  10  7  5  5 5 ‐  ‐  ‐ 

for S2QS Seminar One 4‐ 5‐ May May  6‐May 7‐May 0 0  0 0 0 0  0 0 3 3  2 2 0 0  0 0 0 0  0 0 0 0  0 0 2 2  2 3 1 1  1 1 10 6  6 8 7 7  7 7 2 1  0 2 ‐  ‐  ‐  ‐  0 0  0 0 1 1  1 1 0 0  0 0 5 5  5 5 0 0  0 0 3 3  3 3 4 3  0 0 0 0  0 0 ‐  ‐  ‐  ‐  ‐  ‐  ‐  ‐ 

  Before each seminar day the participants filled a form on whether they were still non-Smokers to check the effectiveness of their progress. The results can be found below.

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S2QS Seminar JB Cocoa 1 results - Are you still a non-Smoker today? Day 2;

                 

Day 3;

Day 4.

5% 33% yes

yes

50%

no

yes

50%

no

no

67%

95%

(B) Amount of Cigarettes taken by the participants each day S2QS Seminar Two

CS‐ ID  1  2  3  4  5  6  7  8  9  10  11  12  13  14  15  16  17  18  19       20  21  22  23 

24‐ 25‐ 26‐ 27‐ May  May  May  May 8  4  3  3 13  10  3  1 10  8  6  3 8  5  4  8 7  5  5  4 14  7  5  5 10  5  4  5 8  5  2  0 11  7  7  5 4  2  2  2 7  6  7  7 3  2  0  0 6  3  3  2 2  2  7  6 6  5  3  2 7  7  3  3 9  7  6  7 10  8  5  7 6  7  8  4  7 

 

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0  5  9  1  6 

2  5  6  1  5 

2 5 5 1 4

28‐ May 2 1 3 3 2 3 3 0 5 2 3 0 2 4 1.5 2 2 4

29‐ May 1 2 3 3 3 ‐  ‐  1 4 ‐  2 3 ‐  4 3 2 4 ‐ 

30‐ May 1 2 3 2 3 ‐  ‐  1 4 ‐  2 2 ‐  3 0 2 3 ‐ 

31‐ May 1 1 2 0 3 ‐  ‐  0 5 ‐  2 2 ‐  2 3 2 2 ‐ 

1‐ Jun  1  0  2  0  2  ‐  ‐  0  3  ‐  2  2  ‐  2  0  2  2  ‐ 

2‐ Jun  0  0  1  0  2  ‐  ‐  0  3  ‐  2  1  ‐  1  0  2  1  ‐ 

3‐ Jun 0 0 1 0 2 ‐  ‐  0 3 ‐  2 1 ‐  1 0 2 0 ‐ 

4‐ Jun 0 0 0 0 2 ‐  2 0 3 ‐  2 1 ‐  1 0 1 2 ‐ 

1 4 3 1 3

3 1 4 1 1

3 1 4 0 1

2 1 1 0 1

1  1  0  0  1 

0  1  0  0  1 

1 1 0 0 1

2 1 0 0 1


S2QS Seminar JB Cocoa 2 results - Are you still a non-Smoker today? Day 2;

Day 3;

Day 4.

  4%

9%

35% yes

yes

yes

no

no

no

65% 91%

96%

SEMINAR INTERVENTIONS Day 1 1. 2. 3.

- Thursday Registration of Participants – Voluntary Release Forms, Questionnaires Video documentation on Smoker’s profile Cigarette Slayer Program – Day 1 Becoming a Non Smoker

Day 2- Friday 1. Participants review 2. Cigarette Slayer Program - Handling Emotions and Limiting Beliefs 3. Cigarette Slayer Program – Day 2 Remaining a Non Smoker Day 3- Monday 1. Participants review 2. Cigarette Slayer Program - Handling Cravings and Peer Pressure. 3. Cigarette Slayer Momentum – The weeks to come 4. Cigarette Slayer Program – Risk Management Day 4- Tuesday 1. Participants review and video testimonies 2. Cigarette Slayer - What next from here? 3. You are the Cigarette Slayer. 4. Health and You – Perfecting the Edge. INTERNET INTERVENTIONS 7 Power Online Momentum Days 1. Online Assessment and Tips 2. Online Daily Coaching. 3. Online Help 4. Helpdesk Support 5. One-to-One Support 6. Online Media therapy 7. Download media therapy 8. Download daily assignments and information 

 

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STATISTICAL METHODS The principal data analysis method was the daily computation of participant’s records into MS Excel spreadsheet where the source was done through document form filling and, online form filing. The data on the forms were used to populate daily group pie charts to reflect the team percentage achieved in each seminars. Bar charts provided below were used to reflect the daily reduction efforts of each participant in the seminars. RESULTS

PARTICIPANT CHARACTERISTICS

Amount of Cigarettes smoked

Progress amount of Cigarettes smoked by CS participants 25 20 15 10 5 0 26 Apr. 27 Apr. 28 Apr. 29 Apr. 30 Apr. 1‐May 2‐May 3‐May 4‐May 5‐May 6‐May 7‐May CS 1

CS 2

CS 3

CS 4

CS 5

CS 6

CS 7

CS 8

CS 9

CS 10

CS 11

CS 12

CS 13

CS 14

CS 15

CS 16

CS 17

CS 18

CS 19

CS 20

CS 21

CS 22

  The first Seminar study shows the participants had been briefed by JB Cocoa management on their goal to be a smoke free organization. The selection had brought in volunteer smokers who wanted to quit smoking. The responses of the participants had been positive and their results as reflected in the pie charts and graph show a dramatic reduction of 100% and a high quit rate of 50% in the participants. It is to be noted that these all were achieved within four seminars lasting three hours each i.e. a total of only 12 hours of seminar training. The human resource manager has noticed that the normal place where these smokers use to smoke at the guard house was lessening dramatically and even a inspired participant was there to tell the other staff not to smoke.

   

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Progress amount of Cigarettes smokes by CS participants Amount of Cigarettes smoked

16

  14  12    10   8   6  4    2   0              

5/24/07 5/25/07 5/26/07 5/27/07 5/28/07 5/29/07 5/30/07 5/31/07 6/1/07

6/2/07

6/3/07

6/4/07

CS 1

CS 2

CS 3

CS 4

CS 5

CS 6

CS 7

CS  8

CS 9

CS 10

CS 11

CS 12

CS 13

CS 14

CS 15

CS 16

CS 17

CS 18

CS 19

CS 20

CS 21

CS 22

CS 23

The second seminar study showed the majority of the participants were more challenging because they were already expecting “surprise elements” in training. In the initial response of their willingness to quit in the program, about 70% mentioned that they were not sure or did not want to quit, indicating an internal resistant to the program. These participants had not been positive and their results showed a great fluxation in the pie charts and graph but eventually as the seminars progress a dramatic reduction of 100% cessation and a high quit rate of 35% in the participants was noted. The majority of these participants were showing resistance, lack of commitment and participation the training program, but still, the seminar achieved the desired rapid result and more. This is a great indication on the fantastic potential of the program to teach and perhaps reassess the views of a smoker who does not want to quit making that turnaround change to begin to quit and eventually achieve the result. JB Cocoa management, inspired by the seminar, has been circulating World Health Organization (WHO) reports on stop smoking in the workplace and even contemplating a directive not to hire a smoker in future as a commitment towards a smoke free organization. This is a true benchmark of a management that supports the corporate social responsibility for their smoking staff and other non smoking staff on the risk exposure of smoking.

  The initial agreed expected result set by JB Cocoa: 30% success rate The actual result: S2QS Seminar JB Cocoa 1…………………………………..50% S2QS Seminar JB Cocoa 2…………………………………..35%

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COMMENT

The evidence of the two seminar study has shown that the S2QS program is a resilient program as it has shown stability in process of delivery, handling challenges with minimal format changes, and receiving reasonable consistency in result and meeting objectives. It has shown its superior potential as a national quit smoking program that can be scaled and rolled out effectively in a multi language and cultural society like Malaysia. It methods can be employed to brand anti-smoking in the corporate companies of Malaysia. The program is suitable as a highly effective group training program that teaches a smoker to be a ‘non-smoker’ at the workplace or in schools.  To our knowledge, this is the first corporate stop smoking seminar with internet technologies to report the use of group subconscious techniques. We found a high rate of willingness to quit on attending S2QS seminar (50% quit for willing smokers and 35% quit for unwilling smokers) in a week.

    ABSTINENCE The JB Cocoa Management conducted an official count of cigarette smoking with the same participants of both the seminar. The official attendance of the Director of Institute of Health Research was there to moderate and receive the results which was verified and endorsed by the JB Cocoa HR Management. This official count was done (10) ten months later on the 20th February 2008. During this lapse period the participants have not been contacted or encouraged to quit smoking and had maintained or relapse on their own accord. The ten months sustainable blind result: S2QS Seminar JB Cocoa 1 & 2 …………………………………..18% Important Note: The figure above is very encouraging as if such seminars was conducted and the percentage below was applied to Malaysia’s population of 2,000,000-00 smokers a number of 360,000-00 would be assumed to not be smoking after ten months. The study makes an assumption that RM100, 000-00 is spent on cancer treatments by the government and, will make a saving or avoid a risk of paying RM36, 000,000,000 on cancer treatments and medical bills.

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AUTHOR INFORMATION

Submitted for publication March 1, 2008; final revision received March 15, 2008; accepted March 30, 2008. This study was supported by Datuk M.S. Pillai, Deputy Director of Health who recommended and approved the presence of Malaysian Ministry of Health during the course of this seminar. Mr. S Thavaraj, The Director of Health Behavior Research of the Malaysian Ministry of Health. We thank Julian Aloysius Leicester, of Beat Fear for his five years of research and development in group anti tobacco methods and as the designer, author and specialist consultant for his patented S2QS systems. We thank Bart Alex Lameijer, of Hanzel University, Groningen in Netherlands for his statistical manuscript preparation and role as Beat Fear music and liaison officer in the seminars. We thank Ahmad Sharil for his role in the Internet development of S2QS and Joseph Miranda for his role as Beat Fear sales and safety officer in the seminar. We thank Maria Prior, UK Educationist and Psychologist for her support and dedicated time in editing this document. We thank the JB Cocoa Management and their staffs for their committed full support and corporation to fund and coordinate the S2QS trainings in their organization. Corresponding author and reprints: Julian Aloysius Leicester, Beat Fear (e-mail: julian@beatfear.com) REFERENCES

  1. Hypnosis mobilizes this ability to move into or away from sensory experience. Sensation can be made to expand or recede – Appel 1992, Warner 1988 2. “…hypnosis is not mind control. It's a naturally occurring state of concentration; It's actually a means of enhancing your control over both your mind and your body.” 3. Dr. David Spiegel, Assoc. Chair of Psychiatry Stanford University School of Medicine,9/04 4. “The technique has been accepted by the American Medical Association, the American Psychiatric Association and the American Psychological Association”

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5. Martin Orne, M.D. Professor of psychiatry, University of Pennsylvania Newsweek, 11/86 6. “Hypnosis is the most effective way of giving up smoking, according to the largest ever scientific comparison of ways of breaking the habit.” -New Scientist, 10/92 7. “Hypnosis seems helpful in treating addictions, and the depression and anxiety associated with them…” -Psychology Today, 9/96 Bibliography 1. Graff, H et al. (1966) ‘Results of Four Anti-Smoking Therapy Methods’, Pennsylvania Medical Journal, February. Pp39-43. 2. Grosz, H. (1978). ‘Nicotine addiction: Treatment with Medical Hypnosis’, Journal of Indiana State Medical Association, 71, pp1074-1075 and pp1136-1137. 3. Nuland, W. and Field, P. (1970). ”Smoking and Hypnosis: A systematic clinical approach”, International Journal of Clinical and Experimental Hypnosis, 18, pp290-306. 4.

Watkins, H (1976) ‘Hypnosis and Smoking. A five session approach’, International Journal of Clinical and Experimental Hypnosis, 24 pp381390. 

S2QS* – THE SCIENCE TO QUIT SMOKING – EVIDENCE BASED SEMINAR

  

 

 

  

 

 

*S2QS Seminar was formerly known as The Cigarette Slayer seminar

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S2qs a smoke free workplace evidence white paper with moh