Effects of Acupuncture on Smoking Cessation or Reduction for Motivated Smokers

doi:10.1006/pmed.1996.0125

Preventive Medicine

Volume 26, Issue 2, March 1997, Pages 208-214

https://doi.org/10.1006/pmed.1996.0125 Get rights and content

Abstract

Background.This study was undertaken to examine the effects of acupuncture on smoking reduction and possibly also cessation and to examine whether some acupoints are more effective than others for smoking cessation.

Methods.A total of 46 healthy men and women, 39 ± 9 years of age (mean ± SD), who smoked 20 ± 6 cigarettes per day and had smoked for 23 ± 8 years, and who wanted to quit smoking, volunteered to participate. The subjects were randomly assigned to two groups. One group was given acupuncture treatment at points previously used for anti-smoking (test group, TG). The other group was given acupuncture treatment at points assumed to have no effect for smoking cessation (control group, CG). Before each treatment and after the last treatment each subject answered questionnaires about his or her smoking habits and attitudes. In addition the concentrations of serum cotinine, serum thiocyanate, serum peroxides, and plasma fibrinogen were measured before the first and after the last acupuncture treatment.

Results.The daily cigarette consumption fell during the treatment period in both groups, but the reduction was larger for TG than for CG (P< 0.002). Altogether 31% of subjects in TG had quit smoking completely at the end of the treatment, compared with none in CG. For TG the concentrations of cotinine and thiocyanate were reduced significantly after the treatment period (P< 0.001), but no significant reductions were observed for CG. For both groups the taste of tobacco worsened during the treatment period, but the effect was more pronounced for TG than for CG (P< 0.05). The desire to smoke fell significantly in both groups after treatment, and the reduction was larger for TG than for CG (P< 0.001). No significant changes in serum peroxides and plasma fibrinogen concentrations were observed during the treatment period for either group.

Conclusions.This study suggests that acupuncture may help motivated smokers to reduce their smoking or even quit smoking completely. Different acupoints appear to have different effects for smoking cessation and reduction.

References (31)

JL Schwartz
Methods of smoking cessation
Med Clin North Am
(1992)
D SJ Choy et al.
Effective treatment for smoking cessation
Am J Med
(1983)
D Borgers et al.
Thiocyanate as an indicator of tobacco smoking
Prev Med
(1979)
D Harats et al.
Fish oil ingestion in smokers and nonsmokers enhances peroxidation of plasma lipoproteins
Atherosclerosis
(1991)
Ann Intern Med
(1986)
The Norwegian Council on Tobacco and Health, 1994, The report of tobacco consumption in Norway during twenty years...
GI Hackett et al.
An anti-smoking clinic in general practice
Practitioner
(1984)
JA Fuller
Smoking withdrawal and acupuncture
Med J Aust
(1982)
F Clavel et al.
Helping people to stop smoking: randomized comparison of groups being treated with acupuncture and nicotine gum with control group
Br Med J
(1985)
VN Zalesskiy et al.
Laser-acupuncture reduces cigarette smoking: a preliminary report
Acupunct Electrother Res
(1983)

RP Steiner et al.

Acupuncture therapy for the treatment of tobacco smoking addiction

Am J Chin Med

(1982)

LN Parker et al.

The use of acupuncture for smoking withdrawal

Am J Acupunct

(1977)

J Gillams et al.

Acupuncture and group therapy in stopping smoking

Practitioner

(1984)

F Clavel-Chapelon et al.

A randomised 2 × 2 factorial design to evaluate different smoking cessation methods

Rev Epidemiol Sante Publique

(1992)

H Waage et al.

Discrimination of smoking status by thiocyanate and cotinine in serum, and carbon monoxide in expired air

Int J Epidemiol

(1992)

Cited by (37)

A multiverse analysis of meta-analyses assessing acupuncture efficacy for smoking cessation evidenced vibration of effects
2022, Journal of Clinical Epidemiology
Citation Excerpt :
The main characteristics of the 39 primary studies included are set forth in Web Appendix 4 and summarized in Table 1. Among them, 30 clinical trials were published in English [26–55], four in Chinese [56–59], four more in French [60–63], and one in Italian [64]. Twenty four studies used auriculotherapy alone, six used facial acupuncture, and eight a mixture of points, located both on the ear and elsewhere on the body.
To explore the impact of methodological choices on the results of meta-analyses (MAs), with acupuncture for smoking cessation as a case study.
After performing an umbrella review (using MEDLINE, the COCHRANE Library, the Wan Fang database, and the Chinese Journal Full-text Database/March 2018) of MAs exploring the use of acupuncture for smoking cessation, we extracted all randomized controlled trials. Numerous MAs were performed as per every possible combination of various methodological choices (e.g., characteristics of the intervention and control procedures, outcome, publication status, language) to assess their vibration of effects or more precisely the existence of a Janus effect, that is, whether the 10th and 90th percentiles in the distribution of effect sizes were in opposite directions.
After including 7 MAs and 39 randomized controlled trials, we performed 496,528 MAs. The effect size was negative at the 10th percentile (-0.1, favoring controls) and positive at the 90th percentile (1.17, favoring acupuncture). In all, 104,491 MAs showed a statistically significant difference in favor of acupuncture, whereas 392,037 failed to demonstrate the efficacy of acupuncture (including 96 that showed a statistically significant difference in favor of the control).
The methodological choices made in performing pairwise MAs can result in substantial vibration of effects, occasionally leading to opposite results.
A meta-analysis of ear-acupuncture, ear-acupressure and auriculotherapy for cigarette smoking cessation
2014, Drug and Alcohol Dependence
Citation Excerpt :
In most studies that used ear press-needles or EAPR, participants were instructed to stimulate the points when cravings occurred (Gilbey, 1977; Gillams et al., 1984; Han, 2006; Li et al., 2009; Tian and Krishnan, 2006; Waite and Clough, 1998; White et al., 2007; Wing et al., 2010; Zhang et al., 2013a,b). One study specified the number of stimulations a day (He et al., 1997). Although there was considerable diversity in the points used in the 25 studies, this was reduced in the 12 studies that were judged to include ‘valid comparisons’.
This systematic review evaluated the effects of ear acupuncture, ear acupressure and auriculotherapy for cigarette smoking cessation (SC) at end-of-treatment (EoT), three, six and 12 months follow-up.
Searches of six English and Chinese databases located 25 randomized controlled trials (3735 participants). Methodological quality was assessed using Cochrane Risk of Bias. Meta-analyses were conducted in two pools: 1. SC-specific ear acupuncture/acupressure or auriculotherapy (EAP/R) vs. non-specific/inactive control; and 2. SC-specific EAP/R vs. other SC-specific treatment. Sensitivity analyses were conducted based on the validity of interventions as SC-specific treatments or non-specific/inactive interventions; and the use of biochemical SC confirmation.
Pool 1: the 12 valid SC-specific EAP/R interventions were superior to inactive EAP/R controls at EoT (RR = 1.77 [1.39, 2.25]), three months follow-up (RR = 1.54 [1.14, 2.08]), and six months follow-up (RR = 2.01, [1.23, 3.28]) but data were insufficient at 12 months. In Pool 2: there was no superiority or inferiority for EAP/R at EoT or at 3 and 6 month follow-ups compared to SC-specific behavioural therapy or SC-specific body acupuncture.
Pool 1 data appeared most consistent for studies of ear acupressure (EAPR) vs. non-specific EAPR controls, with confirmed SC rates at 3 months post-treatment of 20.0% for test groups vs. 7.5% for controls. In Pool 2 the EAP/R interventions appeared neither inferior nor superior to the behavioural interventions at 3 and 6 month follow-ups. However, meta-analysis results derived from relatively small-sized trials with no biochemical validation of SC in Pool 2. Larger, well-controlled studies using biochemical confirmation of SC are needed.
Acupuncture attenuates autonomic responses to smoking-related visual cues
2011, Complementary Therapies in Medicine
Citation Excerpt :
Based on these results, we used point HT7 as the active point in the RA group. To minimise the possible physiologic effect of the sham needle, we used point LI10 as the control point in the SA group.33,34 The distress states accompanied by an increase in sympathetic nerve activity are characterised by a shift in the LF/HF balance favouring the LF component; the opposite happens during a presumed increased in vagal activity.35
In smokers, smoking-associated cues produce smoking urges and cravings, which are accompanied by autonomic dysfunction in response to these cues. We investigated whether or not acupuncture ameliorated cigarette withdrawal symptoms, as well as attenuated the autonomic responses to smoking-related visual cues in smokers using a power spectrum analysis of heart rate variability (HRV).
Fifteen subjects were treated with real acupuncture (RA) at HT7 and 14 subjects received sham acupuncture (SA) at LI10 using the Park Sham Device.
The cigarette withdrawal scale (CWS) was measured on the third day after the subjects had quit smoking. We compared the low-frequency/high-frequency (HF/LF) ratio in the HRV of the RA and SA groups during a distraction task using neutral and smoking visual cues.
The CWS of the RA group was significantly lower than that of the SA group. The increase in the LF/HF ratio of HRV induced by the smoking-related visual cues was also significantly lower in the RA group when compared with the SA group. Acupuncture not only ameliorated cigarette withdrawal, but also weakened the autonomic responses to smoking cues during withdrawal.
These findings suggest that acupuncture might help in smoking cessation by attenuating withdrawal symptoms and smoking cues-induced autonomic responses.
Electroacupuncture Reduces Uterine Artery Blood Flow Impedance in Infertile Women
2009, Taiwanese Journal of Obstetrics and Gynecology
To evaluate the effects of electroacupuncture (EA) on pregnancy rate and uterine artery blood flow impedance in patients undergoing in vitro fertilization (IVF).
This prospective, randomized trial was carried out in the IVF center of China Medical University Hospital in Taiwan, from February 1, 2004 to January 30, 2005. A total of 44 patients were enrolled in the study. Of these, 30 were allocated to acupuncture, and 14 were allocated to no acupuncture. EA was performed four times, twice a week for 2 weeks, from day 2 of the study to the day before oocyte retrieval. After patients felt the needle reaction, the needles were attached to an electrical stimulator for 30 minutes. Clinical pregnancy and pulsatility index (PI) of right and left uterine arteries before and after EA were measured.
There was no significant difference in pregnancy rate between the two groups (acupuncture group, 30%; non-acupuncture group, 28.6%). The mean PI of both uterine arteries was significantly reduced after EA (left uterine artery, 2.3 to 2.0; right uterine artery, 2.4 to 2.2). There was no significant change in PI in the group with no acupuncture (left uterine artery, 2.5 to 2.3; right uterine artery, 2.4 to 2.3).
EA could be useful for reducing uterine artery blood flow impedance, but did not increase the pregnancy rate in patients undergoing IVF.
Informing nurses of the lived experience of acupuncture treatment: A phenomenological account
2005, Complementary Therapies in Clinical Practice
Acupuncture is a component of Traditional Chinese Medicine, focusing on a holistic, energy-based approach to the individual, rather than a disease-oriented, diagnostic, and treatment model. Nurses are increasingly involving themselves in the use of acupuncture as practitioners and as supporters of acupuncture in mainstream health care. This project described the lived experience of acupuncture treatment, with specific objectives to: inform nurses of people's experiences of having acupuncture; give nurses the language to explain to patients the experience of having acupuncture; and create possibilities for offering acupuncture as an informed choice of treatment in nursing and health care. The phenomenon of experiencing acupuncture was located within the participants’ accounts of what it was like for them before, during, and after treatment.
Alcohol and Chemical Dependency
2003, Complementary and Alternative Medicine: An Evidence-Based Approach

View all citing articles on Scopus

^☆: This work was supported by The Research Council of Norway.

²: To whom correspondence and reprint requests should be addressed at the Institute of General Practice and Community Medicine, Department of Preventive Medicine, University of Oslo, Box 1130 Blindern, N-0317 Oslo, Norway. Fax: + 47 22 85 06 20.

View full text

Regular ArticleEffects of Acupuncture on Smoking Cessation or Reduction for Motivated Smokers☆

Abstract

Med Clin North Am

Am J Med

Prev Med

Atherosclerosis

Ann Intern Med

An anti-smoking clinic in general practice

Practitioner

Smoking withdrawal and acupuncture

Med J Aust

Helping people to stop smoking: randomized comparison of groups being treated with acupuncture and nicotine gum with control group

Br Med J

Laser-acupuncture reduces cigarette smoking: a preliminary report

Acupunct Electrother Res

Acupuncture therapy for the treatment of tobacco smoking addiction

Am J Chin Med

The use of acupuncture for smoking withdrawal

Am J Acupunct

Acupuncture and group therapy in stopping smoking

Practitioner

A randomised 2 × 2 factorial design to evaluate different smoking cessation methods

Rev Epidemiol Sante Publique

Discrimination of smoking status by thiocyanate and cotinine in serum, and carbon monoxide in expired air

Int J Epidemiol

Regular Article
Effects of Acupuncture on Smoking Cessation or Reduction for Motivated Smokers☆