The statistics are staggering. In the United States alone, smoking is responsible for 350,000 deaths per year. One out of four regular smokers dies of a smoking-related disease such as cancer, chronic obstructive lung disease, heart disease, and pregnancy complications. Smokers run a risk of death from coronary heart disease 59% greater than nonsmokers, longtime ex-smokers, or cigar or pipe smokers. Even passive smoking is estimated to kill 46,000 nonsmokers in the United States each year, including 3,000 deaths from lung cancer, 11,000 deaths from other cancers, and 32,000 deaths from heart disease (see Price & Lynn, 1986).The negative sequelae of smoking are not so surprising when we consider that each puff of a cigarette delivers nicotine and perhaps 3,000 toxic chemicals into the bloodstream. Nicotine, the most active agent in tobacco, is a poisonous alkaloid more toxic than heroin and is sometimes used as an insecticide. The carbon monoxide content of cigarette smoke is considerably higher than that of Los Angeles smog at its worst.

This study examined the effects of direct wording (authoritative language, specific responses) versus indirect wording (permissive language, choice of responses) of hypnotic inductions and suggestions on measures of behavioral and subjective responding. Subjects experienced suggestion-related involuntariness and suggested effects to a greater degree in response to direct-worded suggestions (Harvard Group Scale of Hypnotic Susceptibility: Form A; Shor & Orae, 1962) than in response to indirect-worded suggestions (Alman-Wexler Indirect Hypnotic Susceptibility Scale; Pratt, Wood, & Alman, 1984). No difference in behavioral responding was observed. Furthermore, induction wording did not have an effect on these measures, nor did the wording of the induction and the wording of the suggestion types interact with each other. Female subjects attributed less of their responsiveness to their own efforts when they received direct suggestions, and male subjects were less likely to attribute their responsivity to the hypnotist's ability when they received indirect suggestions. Rapport with the hypnotist did not vary as a function of induction or suggestion wording.More than a decade ago, T. Barber, Spanos, and Chaves (1974) argued that the wording of suggestions played an important role in determining subjects' hypnotic responding. Indeed, early studies indicated that permissively worded suggestions were more effective than those worded authoritatively (T. Barber, 1969; T. Barber & Calverly, 1966). In recent years, indirect suggestions have come to be widely recognized as a hallmark of Ericksonian hypnosis (Erickson & Rossi, 1979;Lankton & Lankton, 1983; Yapko, 1983). T. Barber (1985) contrasted direct and indirect suggestions on two dimensions: (a) Indirect suggestions use permissive language as contrasted to the authoritarian, directive language of direct suggestions, and (b) indirect suggestions offer a choice of responses, whereas direct suggestions usually prescribe a specific response. impressive claims have been made for the success of indirect hypnotic procedures. For example, J. Barber (1977) reported that 99 out of 100 dental patients who received the "indirect" rapid induction analgesia (RIA) procedure were able to undergo dental operations while using hypnosis as the only anesthesia. Although Frichton and Roth (1985) were able to show that the RIA was effective in producing analgesia, other studies using the RIA in podiatric surgery (Crowley, 1980), with pain in paraplegics (Snow, 1978), and in dental procedures (Gillett & Coe, 1984) secured far less impressive results. Recently, Van Gorp, Meyer, and Dunbar (1985) conducted a well-controlled study that not only failed to replicate the effectiveness of the RIA but also found that an analgesic effect was limited to traditional hypnotic procedures. These conflicting findings are not unrepresentative of the broader literature on the effects of suggestion wording. Indeed, procedural differences across studies and methodological short-Correspondence concerning thi...

The article reviews the literature on the effects of direct versus indirect hypnotic suggestions. A conceptual and methodological analysis of direct versus indirect suggestions is also provided. Three conclusions follow from the review: (a) Contrary to views of Ericksonian hypnotists, suggestion style has little effect on objective responding to hypnotic test items; (b) studies of clinical- and laboratory-induced pain and other measures of subjective experience have yielded contradictory results--however, the best controlled studies have not indicated that indirect suggestions are superior to direct suggestions; and (c) there is insufficient evidence to conclude that hypnotizability level and suggestion wording interact, such that low hypnotizable subjects are particularly responsive to indirect suggestions. Methodological and conceptual problems in defining and studying hypnotic communications, the lack of rigorous experimental controls, and research issues and directions are highlighted.

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