Journal of the Chinese Medical Association
Volume 70, Issue 8 , Pages 331-338, August 2007

A Randomized Controlled Clinical Trial of Auricular Acupuncture in Smoking Cessation

  • Ta-Peng Wu

      Affiliations

    • Center for Traditional Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Fang-Pey Chen

      Affiliations

    • Center for Traditional Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Jui-Yao Liu

      Affiliations

    • Department of Family Medicine, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Ming-Hsien Lin

      Affiliations

    • Department of Family Medicine, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Shinn-Jang Hwang

      Affiliations

    • Department of Family Medicine, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Shinn-Jang Hwang, Department of Family Medicine, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 13 December 2006; accepted 6 July 2007.

Article Outline

Background

Tobacco smoking is responsible for human diseases of the lung, heart, circulatory system and various kinds of cancers, and is a serious public health problem worldwide. Acupuncture has been promoted as a treatment modality for smoking cessation. However, its efficacy still remains controversial.

Methods

We conducted a prospective, randomized, controlled trial using auricular acupuncture for smoking cessation in 131 adults who wanted to stop smoking. Thirteen subjects withdrew from the study and 118 subjects were included in the final analyses (mean age, 53.7 ± 16.8 years; 100 males, 18 females). The treatment group (n = 59) received auricular acupuncture in Shen Men, Sympathetic, Mouth and Lung points for 8 weeks. The control group (n = 59) received sham acupuncture in non-smoking-cessation-related auricular acupoints (Knee, Elbow, Shoulder and Eye points). The enrolled subjects were then followed monthly for 6 months after stopping the acupuncture treatment.

Results

Between both groups before acupuncture treatment, there was no significant difference with regard to gender, mean age, education level, and mean values for the age at which smoking started, smoking duration, daily number of cigarettes smoked and nicotine dependent score. At the end of treatment, cigarette consumption had significantly decreased in both groups, but only the treatment group showed a significant decrease in the nicotine withdrawal symptom score. Smoking cessation rate showed no significant difference between the treatment group (27.1%) and the control group (20.3%) at the end of treatment. There was also no significant difference in the smoking cessation rate between the treatment group (16.6%) and the control group (12.1%) at the end of follow-up. There were no major side effects of auricular acupuncture in both groups.

Conclusion

Our results showed that auricular acupuncture did not have a better efficacy in smoking cessation compared to sham acupuncture. Combined acupuncture with behavior counseling or with nicotine replacement therapy should be used in further smoking cessation trials to enhance the success rate of smoking cessation.

Key words:  acupuncture , nicotine dependent score , randomized controlled trial , smoking cessation , withdrawal symptoms

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Miller LS , Zhang X , Rice DP , Max W . State estimates of total medical expenditures attributable to cigarette smoking . Public Health Rep . 1998;113:447–458
  2. Centers for Disease Control and Prevention  . Perspectives in disease prevention and health promotion smoking-attributable mortality and years of potential life lost—United States, 1984 . MMWR . 1997;46:444–451
  3. Centers for Disease Control and Prevention  . Incidence of initiation of cigarette smoking—United States, 1965-1996 . MMWR . 1998;47:837–840
  4. World Health Organization  . Policy Recommendations for Smoking Cessation and Treatment of Tobacco Dependence . Geneva: WHO; 2003; Available at http://www.whoint/tobacco
  5. National Health Bureau  , Department of Health  . Taiwan Tobacco Control Annual Report, 2005 . Available at http://tobacco.bhp.doh.gov.tw:8080/doc/2005en.pdf
  6. Fielding JE , Phenow KJ . Health effects of involuntary smoking . N Engl J Med . 1988;319:1452–1460
  7. Richards D, Toop L, Brockway K, Graham S, McSweeney B, MacLean D, et al  Improving the effectiveness of smoking cessation in primary care: lessons learned . N Z Med J . 2003;116:U417
  8. Anonymous  . Summary of the national guidelines for the diagnosis and management of lipid disorders in Taiwan. The experts' panel . J Chin Med Assoc . 1995;55:1–14
  9. Rigotti NA , Arnsten JH , McKool KM , Wood-Reid KM , Pasternak RC , Singer DE . Efficacy of a smoking cessation program for hospital patients . Arch Intern Med . 1997;157:2653–2660
  10. US Public Health Services  . Treating Tobacco Use and Dependence: Clinical Practice Guideline Agency for Health Care Policy and Research . Available at http://www.surgeongeneral.gov/tobacco
  11. Recommendations regarding interventions to reduce tobacco use and exposure to environmental tobacco smoke . Am J Prev Med . 2001;20(Suppl):10–15 Also available at http://www.thecommunityguide.org
  12. Rigotti NA . Treatment of tobacco use and dependence . N Engl J Med . 2002;346:506–512
  13. Thorndike AN , Rigotti NA , Stafford RS , Singer DE . National patterns in the treatment of smokers by physicians . JAMA . 1998;279:604–608
  14. Lancaster T , Stead L , Silagy C , Sowden A . Effectiveness of interventions to help people stop smoking: findings from the Cochrane Library . BMJ . 2000;321:355–358
  15. Avants SK , Margolin A , Chang P , Kosten TR , Birch S . Acupuncture for the treatment of cocaine addiction: investigation of a needle puncture control . J Subst Abuse Treat . 1995;12:195–205
  16. Margolin A , Avants SK , Birch S , Falk CX , Kleber HD . Methodological investigations for a multisite trial of auricular acupuncture for cocaine addiction: a study of active and control auricular zones . J Subst Abuse Treat . 1996;13:471–478
  17. Otto KC , Quinn C , Sung YF . Auricular acupuncture as an adjunctive treatment for cocaine addiction: a pilot study . Am J Addict . 1998;7:164–170
  18. Steiner RP , Hay DL , Davis AW . Acupuncture therapy for the treatment of tobacco smoking addiction . Am J Chin Med . 1982;10:107–121
  19. Gillams J , Lewith GT , Machin D . Acupuncture and group therapy in stopping smoking . Practitioner . 1984;228:341–344
  20. Schwartz JL . Evaluation of acupuncture as a treatment for smoking . Am J Acupunct . 1988;16:135–142
  21. Waite NR , Clough JB . A single-blind, placebo-controlled trial of a simple acupuncture treatment in the cessation of smoking . Br J Gen Pract . 1998;48:1487–1490
  22. White AR , Resch KL , Ernst E . Randomized trial of acupuncture for nicotine withdrawal symptoms . Arch Intern Med . 1998;158:2251–2255
  23. He D , Medbo JI , Hostmark AT . Effect of acupuncture on smoking cessation or reduction: an 8-month and 5-year follow-up study . Prev Med . 2001;33:364–372
  24. Bier ID , Wilson J , Studt P , Shakleton M . Auricular acupuncture, education, and smoking cessation: a randomized, sham-controlled trial . Am J Public Health . 2002;92:1642–1647
  25. White AR , Rampes H , Campbell JL . In: Acupuncture and Related Interventions for Smoking Cessation . New York: The Cochrane Collaboration, John Wiley & Sons Ltd; 2006; CD000009.
  26. Chou P , Lai MY , Chung C , Chen JM , Chen CF . Acupuncture utilization in Taiwan . J Chin Med Assoc . 1998;61:151–158
  27. Perng RP , Hsieh WC , Chen YM , Lu CC , Chiang SJ . Randomized, double-blind placebo-controlled study of transder-mal nicotine patch for smoking cessation . J Formos Med Assoc . 1998;97:547–551
  28. Fagerstrom KO . Measuring degree of physical dependence to tobacco smoking with reference to individualization of treatment . Addict Behav . 1978;3:235–241
  29. Irving JM , Phil M , Clark EC . Evaluation of a portable measure of expired-air carbon monoxide . Prev Med . 1988;17:109–115
  30. Glasgow RE, Mullooly JP, Vogt TM, Stevens VJ, Lichtenstein E, Hollis JF, et al  Biochemical validation of smoking status: pro, cons, and data from four low-intensity intervention trials . Addict Behav . 1993;18:511–527
  31. Hughes JR , Hatsukami D . Signs and symptoms of tobacco withdrawal . Arch Gen Psychiatry . 1986;43:289–294
  32. Smoking cessation during previous year among adults—United States, 1990 and 1991 . MMWR . 1993;42:504–507
  33. Peto R , Darby S , Deo H , Silcocks P , Whitley E , Doll R . Smoking, smoking cessation and lung cancer in the UK since 1950: combination of national statistics with two case-control studies . BMJ . 2000;321:323–329
  34. Schwartz JL . Methods of smoking cessation . Med Clin N Am . 1992;76:451–476
  35. Fiore MC . Treating tobacco use and dependence: an introduction to the US Public Health Service Clinical Practice Guideline . Respir Care . 2000;45:1196–1199
  36. Coleman T . ABC of smoking cessation. Use of simple advice and behavioural support . BMJ . 2004;328:397–399
  37. Abdullah AS, Rahman AS, Suen CW, Wing LS, Ling LW, Mei LY, et al  Investigation of Hong Kong doctors' current knowledge, beliefs, attitudes, confidence and practices: implications for the treatment of tobacco dependence . J Chin Med Assoc . 2006;69:461–471
  38. Nogier PEM . Handbook to Auriculotherapy . Maisonneuve: Moulins-les-Metz; 1969;
  39. Martin GP , Waite PME . The effect of acupuncture as an aid to stopping smoking . N Z Med J . 1981;93:421–423
  40. Vandevenne A , Rempp M , Burghard G . Study of the specific contribution of acupuncture to tobacco detoxication . Sem Hopital Paris . 1985;61:2155–2160
  41. Leung JP . Smoking cessation by auricular acupuncture and behavioral therapy . Psychologia . 1991;34:177–187
  42. Molyneux A, Lewis S, Leivers U, Anderton A, Antoniak M, Brackenridge A, et al  Clinical trial comparing nicotine replacement therapy (NRT) plus brief counseling, brief counseling alone, and minimal intervention on smoking cessation in hospital inpatients . Thorax . 2003;58:484–488
  43. Bing Z , Cesselin F , Bourgoin S , Clot AM , Hamon M , Le Bars D . Acupuncture-like stimulation induces a heterosegmental release of Met-enkephalin-like material in the rat spinal cord . Pain . 1991;47:71–77
  44. Margolin A , Avants SK , Chang P , Birch S , Kosten TR . A single-blind investigation of four auricular needle puncture configurations . Am J Chin Med . 1995;23:105–114
  45. Itaya K , Manaka Y , Ohkubo C , Asano M . Effects of acupuncture needle application upon cutaneous microcirculation of rabbit ear lobe . Acupuncture Electro . 1987;12:45–51
  46. Ng LKY , Douthitt TC , Thoa NB , Albert CA . Modification of morphine-withdrawal syndrome in rats following transauricular stimulation: an experimental paradigm for auricular acupuncture . Biol Psychiat . 1975;10:575–580
  47. Clement-Jones V , McLoughlin L , Lowry PL , Besser GM , Rees LH , Wen HL . Acupuncture in heroin addicts: change in met-enkephalin and beta-endorphin in blood and cerebrospinal fluid . Lancet . 1979;2:380–383
  48. Gourlay SG , Forbes A , Marriner T , Pethica D , McNeil JJ . Prospective study of factors predicting outcome of transdermal nicotine treatment in smoking cessation . BMJ . 1994;309:842–846
  49. Kenford SL , Fiore MC , Jorenby DE , Smith SS , Wetter D , Baker TB . Predicting smoking cessation. Who will quit with and without the nicotine patch . JAMA . 1994;271:589–594
  50. Prochaska JO , DiClemente CC . Stages and processes of self-change of smoking: toward an integrative model of change . J Consult Clin Psychol . 1983;51:390–395
  51. Prochaska JO, Velicer WF, Fava JL, Ruggiero L, Laforge RG, Rossi JS, et al  Counselor and stimulus control enhancements of a stage-matched expert system intervention for smokers in a managed care setting . Prev Med . 2001;32:23–32
  52. Henningfield JE . Nicotine medications for smoking cessation . N Engl J Med . 1995;333:1196–1203
  53. Joseph AM, Norman SM, Ferry LH, Prochazka AV, Westman EC, Steele BG, et al  The safety of transdermal nicotine as an aid to smoking cessation in patients with cardiac disease . N Engl J Med . 1996;335:1792–1798
  54. Molyneux A . Nicotine replacement therapy . BMJ . 2004;328:454–456
  55. Roddy E . Bupropion and other non-nicotine pharmacotherapies . BMJ . 2004;328:509–511

PII: S1726-4901(08)70014-5

doi:10.1016/S1726-4901(08)70014-5

Journal of the Chinese Medical Association
Volume 70, Issue 8 , Pages 331-338, August 2007

Article Tools