Twenty survivors of the February 2023 earthquakes that killed more than 50,000 people across southern Turkiye and northern Syria were given an unusual instruction: record 60 seconds of laughter, then play it back and laugh along with it, three times a day, for two weeks.
The technique is called the Laughie, short for Laugh Intentionally Everyday. It requires no joke, no comedian, and no reason to be amused. Participants laughed on command, alone or with others, using a recording as a prompt. The pilot results were published in Issues in Mental Health Nursing, and this year the study was added to ClinicalTrials.gov as the research group expanded the method into randomized trials.
Sixty Seconds of Laughter, Played Back Three Times a Day
The intervention was delivered by Nilgun Kuru Alici, a public health nursing academic at Hacettepe University in Ankara, working with Freda Gonot-Schoupinsky of the University of Bolton, who developed the Laughie, and Gulcan Garip of the University of Derby.
The mechanics were deliberately minimal. Over 14 consecutive days, participants laughed together for roughly one minute in a facilitated group session, which was recorded. They then used that recording twice more on their own during the day, alone or with people of their choosing. That worked out to three minutes of intentional laughter daily and 42 minutes across the two weeks.
Twenty adults took part, with a mean age of about 35, and 14 were women. The design was within-subject, meaning every participant received the intervention and each person's scores before were compared to their scores after. A companion brief report in The Journal for Nurse Practitioners published a nine-step protocol for clinicians so that other nurses could run the same session.
What the Turkiye Pilot Actually Measured
The primary outcome was well-being, measured with the World Health Organization's five-item index. Average scores rose from 2.16 before the intervention to 4.08 after, a difference the authors reported as statistically significant at p less than 0.001. On an 11-point measure of perceived post-intervention impact, participants averaged 7.62.
The study also tracked things that rarely make headlines but decide whether an intervention is usable at all: whether people could be recruited, whether they kept doing it, and whether it was delivered as designed. Checklists indicated high fidelity. That matters in a displaced population where attendance is the hardest variable to control.
What the study did not measure is equally important. It did not assess post-traumatic stress disorder, depression or anxiety as clinical outcomes. It was not a treatment trial for trauma, and the authors did not present it as one.
No Control Group and a Sample of Twenty
The design has a hole in it that the authors acknowledge by calling this a pilot. There was no control group. Every participant knew they were receiving an intervention, joined daily group sessions with a facilitator, and then reported on their own well-being.
That structure cannot separate the effect of laughing from the effect of two weeks of scheduled social contact, attention from a health professional, and the expectation that something is supposed to help. In a population recovering from a disaster, daily contact alone is a plausible explanation for improved mood.
The broader laughter evidence base is stronger than skeptics assume but narrower than proponents suggest. A 2023 systematic review and meta-analysis in PLOS ONE pooled a meta-analysis of eight interventional studies covering 315 adults and found laughter interventions reduced cortisol by 31.9 percent compared with controls, though the authors graded the overall quality of that evidence as moderate to low. Those studies examined spontaneous laughter, mostly triggered by comedy videos or laughter therapists. The Laughie asks for intentional laughter without humor, which is a different exposure, and the meta-analysis explicitly excluded simulated laughter partly because imaging work suggests spontaneous and stimulated laughter run on different neural pathways.
The Method Is Now Being Tested Against Comparison Groups
The research program has moved past uncontrolled pilots. A completed randomized controlled trial at Hacettepe University assigned nursing students affected by the earthquakes to a Laughie prescription or a no-intervention control, measuring well-being, happiness and post-traumatic stress scores. The trial planned for 60 participants and registered on ClinicalTrials.gov, with an actual enrollment of 50, with outcome assessors blinded and the protocol following the CONSORT-SPI checklist for social and psychological interventions.
A second registered trial in burn patients at the same university will test whether a Laughie performed before a dressing change reduces pain anxiety and pain intensity in adults with second-degree burns. Neither trial has published results.
The original earthquake pilot was itself registered retrospectively, first posted in May 2026, more than two years after the two-week intervention was delivered in February 2024. Retrospective registration is common in small nursing research and is not misconduct, but prospective registration is the norm precisely because it locks in outcome measures before results are known.
None of this means intentional laughter does nothing. It means the honest current answer is that a two-week laughter prescription was feasible, acceptable, and associated with higher self-reported well-being in 20 people, and that whether the laughing itself did the work remains unproven. Anyone experiencing trauma symptoms after a disaster should seek care from a qualified clinician rather than substituting a self-administered exercise for treatment.
Key Questions Answered
What is a Laughie? A one-minute recording of laughter, played back and laughed along with as a prescribed daily exercise. The name stands for Laugh Intentionally Everyday, and it does not rely on humor.
Who was studied? Twenty adult survivors of the February 2023 earthquakes in southern Turkiye, mean age about 35, 14 of them women. Sessions ran daily for 14 consecutive days.
What improved? Self-reported well-being on the WHO five-item index improved from an average of 2.16 before to 4.08 after, reported as statistically significant.
Did it treat PTSD? No. The pilot did not measure post-traumatic stress disorder, depression or anxiety as clinical outcomes, and the authors did not claim it treated trauma.
What is the biggest weakness? No control group. Daily facilitated group contact and the expectation of benefit could account for the improvement independently of the laughing.
What happens next? A completed randomized trial in 50 earthquake-affected nursing students has not yet published results, and a second trial in burn patients is registered without results.
