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Acupuncture for smoking cessation

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Abstract

Background

Acupuncture and related techniques are promoted as a treatment for smoking cessation in the belief that they may reduce nicotine withdrawal symptoms.

Objectives

The objective of this review is to determine the effectiveness of acupuncture and the allied therapies of acupressure, laser therapy and electrostimulation, in smoking cessation in comparison with: a) sham treatment, b) other interventions, or c) no intervention.

Search methods

We searched the Cochrane Tobacco Addiction Group trials register, Cochrane Controlled Trials Register, Medline, Embase, BIOSIS Previews, PsycINFO, Science and Social Sciences Citation Index, AMED and CISCOM. Date of last search January 2002.

Selection criteria

Randomised trials comparing a form of acupuncture, acupressure, laser therapy or electrostimulation with either sham treatment, another intervention or no intervention for smoking cessation.

Data collection and analysis

We extracted data in duplicate on the type of smokers recruited, the nature of the acupuncture and control procedures, the outcome measures, method of randomisation, and completeness of follow‐up.

We assessed abstinence from smoking at the earliest time‐point (before 6 weeks), at six months and at one year or more follow‐up in patients smoking at baseline. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. Those lost to follow‐up were counted as continuing to smoke. Where appropriate, we performed meta‐analysis using a fixed effects model.

Main results

We identified 22 studies. We failed to detect an effect of acupuncture on smoking cessation when compared to sham acupuncture at any time point. The odds ratio (OR) for early outcomes was 1.22 (95% confidence interval 0.99 to 1.49); the OR after 6 months was 1.50 (95% confidence interval 0.99 to 2.27) and after 12 months 1.08 (95% confidence interval 0.77 to 1.52).

Similarly, when acupuncture was compared with other anti‐smoking interventions, we failed to find differences in outcome at any time point. Acupuncture appeared to be superior to no intervention in the early results, but this difference was not sustained.

The results with different acupuncture techniques do not show any one particular method (i.e. auricular acupuncture or non‐auricular acupuncture) to be superior to control intervention.

Based on the results of single studies, acupressure was found to be superior to advice; laser therapy and electrostimulation were not superior to sham forms of these therapies.

Authors' conclusions

There is no clear evidence that acupuncture, acupressure, laser therapy or electrostimulation are effective for smoking cessation.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

Acupuncture does not appear to help smokers who are trying to quit

Acupuncture is a traditional Chinese therapy, generally using needles to stimulate particular energy points in the body. Acupuncture is used with the aim of reducing the withdrawal symptoms people experience when they try to quit smoking. The review looked at trials comparing active acupuncture with sham acupuncture (using needles at other places in the body not thought to be useful). However, there was no evidence that active acupuncture increased the number of people who could successfully quit smoking. Acupuncture may be better than doing nothing, at least in the short term, but this is likely to be a placebo effect.