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Treatment of tobacco addiction using the Feeling-State Addiction Protocol (FSAP) of the Eye Movement Desensitization and Reprocessing (EMDR) treatment


Compulsions and cravings for smoking have been the subject of behavioral treatment. EMDR [1] is an established, effective treatment of trauma-based disorders [2]. Its use in the treatment of addictions and compulsions is relatively new. Although there are ways of targeting irrational positive affect via EMDR [3]. Merging the Feeling-State Theory of Compulsions and EMDR, the Eye Movement Compulsion Protocol (EMCP) was developed. EMCP is used for fading both feelings and un-wanted behavior related to smoking. The FSAP hypothesizes that the pleasure during smoking is imprinted in the brain generating feelings like comfort, contentment and happiness [4].Thus, when craving resurges, the Feeling-State (FS) behavior is re-enacted. The EMCP incorporates the standard eye movement technique of EMDR to reduce the FS associated with impulsion to smoke. This study aims to assess the efficacy of the FSAP in the treatment of tobacco addiction of relapsed smokers with persistent compulsions to smoke

Materials and methods

We studied 2 groups (12 smokers in each), that relapsed (at least 1 m after smoking cessation). Smokers were matched for age, sex, Fagerstrom Test for Nicotine Dependence & pack/d.


The FSAP although brief, results in profound changes in behavior [4]. Consequently, the 1st group was administered 6 sessions of the FSAP protocol. The 2nd group had 6 sessions of Cognitive Behavior Therapy. The 2 groups were compared for smoking cessation (self-reported questionnaire, CO-measurements). The 1st group had a succession rate of 50% vs the second that had only 25%.


Thus, we conclude that EMDR could be a very helpful tool in managing smoking relapses.


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The research was sponsored by Evaggelismos Hospital.

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Correspondence to Aikaterini Tsoutsa.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Tsoutsa, A., Fotopoulos, D., Zakynthinos, S. et al. Treatment of tobacco addiction using the Feeling-State Addiction Protocol (FSAP) of the Eye Movement Desensitization and Reprocessing (EMDR) treatment. Tob. Induced Dis. 12, A25 (2014).

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  • Nicotine
  • Smoking Cessation
  • Positive Affect
  • Cognitive Behavior Therapy
  • Nicotine Dependence