Acupuncture and related therapies do not appear to help smokers who are trying to quit.

White AR, Rampes H, Liu JP, Stead LF, Campbell J

Published Online:

May 11, 2011

Acupuncture is a traditional Chinese therapy, generally using needles to stimulate particular points in the body. Acupuncture is used with the aim of reducing the withdrawal symptoms people experience when they try to quit smoking. Related therapies include acupressure, laser therapy and electrical stimulation. The review looked at trials comparing active acupuncture with sham acupuncture (using needles at other places in the body not thought to be useful) or control conditions. The review did not find consistent evidence that active acupuncture or related techniques increased the number of people who could successfully quit smoking. However, acupuncture may be better than doing nothing, at least in the short term; and there is not enough evidence to dismiss the possibility that acupuncture might have an effect greater than placebo.

Abstract (click to read)

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 objectives of this review are to determine the effectiveness of acupuncture and the related interventions of acupressure, laser therapy and electrostimulation in smoking cessation, in comparison with no intervention, sham treatment, or other interventions.

Search strategy:

We searched the Cochrane Tobacco Addiction Group specialized register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, BIOSIS Previews, PsycINFO, Science Citation Index, AMED, Acubriefs in November 2010; and four Chinese databases: Chinese Biomedical Database, China National Knowledge Infrastructure, Wanfang Data and VIP in November 2010.

Selection criteria:

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

Data collection and analysis:

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

We assessed abstinence from smoking at the earliest time-point (before six weeks), and at the last measurement point between six months and one year. 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 smokers. Where appropriate, we performed meta-analysis using a fixed-effect model.

Main results:

We included 33 reports of studies. Compared with sham acupuncture, the fixed-effect risk ratio (RR) for the short-term effect of acupuncture was 1.18 (95% confidence interval 1.03 to 1.34), and for the long-term effect was 1.05 (CI 0.82 to 1.35). The studies were not judged to be free from bias. Acupuncture was less effective than nicotine replacement therapy (NRT). There was no evidence that acupuncture is superior to waiting list, nor to psychological interventions in short- or long-term. The evidence on acupressure and laser stimulation was insufficient and could not be combined. The evidence suggested that electrostimulation is not superior to sham electrostimulation.

Authors' conclusions:

There is no consistent, bias-free evidence that acupuncture, acupressure, laser therapy or electrostimulation are effective for smoking cessation, but lack of evidence and methodological problems mean that no firm conclusions can be drawn. Further, well designed research into acupuncture, acupressure and laser stimulation is justified since these are popular interventions and safe when correctly applied, though these interventions alone are likely to be less effective than evidence-based interventions.

This record should be cited as:

White AR, Rampes H, Liu JP, Stead LF, Campbell J. Acupuncture and related interventions for smoking cessation. Cochrane Database of Systematic Reviews 2011, Issue 1. Art. No.: CD000009. DOI: 10.1002/14651858.CD000009.pub3

Assessed as up to date:

November 24, 2010

Find the research

Get full text at The Cochrane Library

Primary Review Group:

Tobacco Addiction Group

PEARLS - Practical Evidence About Real Life Situations (click to read)

Clinical question:

How effective are acupuncture and the related interventions of acupressure, laser therapy and electrostimulation in smoking cessation?

Bottom line:

There was no bias-free, consistent evidence that acupuncture, acupressure, laser therapy or electrostimulation were effective interventions for smoking cessation. There was no evidence that acupuncture was superior to waiting list or psychological interventions in the short term (6 weeks) or long term (6 months to 1 year). The evidence on acupressure and laser stimulation was insufficient and could not be combined. The evidence suggested that electrostimulation was not superior to sham electrostimulation.

Caveat:

Lack of evidence and methodological problems meant no firm conclusions could be drawn. There was not enough evidence to dismiss the possibility that acupuncture might have an effect greater than placebo.

Context:

Acupuncture is used with the aim of reducing the withdrawal symptoms people experience when they try to quit smoking. Related therapies include acupressure, laser therapy and electrical stimulation.

Cochrane Systematic Review:

White AR et al. Acupuncture and related interventions for smoking cessation. Cochrane Reviews, 2011, Issue 1. Article No. CD000009. DOI: 10.1002/14651858.CD000009.pub3. This review contains 33 studies involving 6558 participants.

Authored by:

Brian R McAvoy

Cochrane Primary Health Care Field

Health topics:

Lungs & airways > Smoking cessation > Complementary & alternative therapy

Lungs & airways > Smoking cessation > Interventions in specific settings

Tobacco, drugs, & alcohol dependence > Tobacco > Complementary & alternative therapy

Tobacco, drugs, & alcohol dependence > Tobacco > Interventions in specific settings

Complementary & alternative medicine > Lungs & airways > Smoking cessation

Complementary & alternative medicine > Tobacco, drugs, & alcohol dependence > Tobacco

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Acupuncture and related therapies do not appear to help smokers who are trying to quit.

More like this

Copyright © 2011 - The Cochrane Collaboration