Acupuncture for smoking cessation: A systematic review and meta-analysis of 24 randomized controlled trials

Abstract

INTRODUCTION We evaluate the effectiveness and safety of transdermal acupuncture by needles for smoking cessation. METHODS A literature search for randomized controlled trials (RCTs) was performed in seven electronic databases from inception to February 2017. Meta-analysis was conducted using Revman 5.3.0 software. We used either a random effects model (REM) or a fixed effects model (FEM) for pooling data according to the result of a heterogeneity test (defined as significant if I 2 >75%). Trial sequential analysis (TSA) was applied by TSA 0.9.5.10 Beta software RESULTS Twenty-four trials involving 3984 participants were included. The methodological quality was generally low. With regard to smoking abstinence, meta-analysis showed acupuncture was more effective compared to no intervention/waiting list for short-term (4 weeks) cessation (1 trial, RR=2.37, 95% 1.41, 3.97) and long-term (longer than 6 months) (2 trials, RR=2.66, 95% CI: 1.50, 4.70). Compared to acupuncture/auricular acupressure alone, acupuncture plus auricular acupressure showed more benefit for short-term cessation (3 trials, RR=1.52, 95% CI: 1.03, 2.25). Acupuncture plus auricular acupressure was more effective compared to sham acupuncture plus sham auricular acupressure for short-term cessation (3 trials, RR=2.50, 95% CI: 1.44, 4.33) and long-term (2 trials, RR=3.61, 95% CI: 1.37, 9.48). Acupuncture in combination with counseling, educational smoking cessation program or moxibustion had more benefit compared to acupuncture for short-term cessation (3 trials, RR=0.75, 95% 0.63, 0.91) and long-term (2 trials, RR=0.77, 95% CI: 0.56, 1.05), and TSA illustrated the cumulative Z-curve of this comparison for long-term across the traditional boundary of 5% significance and monitoring boundaries. No serious adverse events occurred CONCLUSIONS Acupuncture combined with counseling, educational smoking cessation program or moxibustion was more effective than acupuncture as monotherapy with regard to long-term smoking cessation. Further, high quality trials are needed to confirm the result.

Implementation of a free smoking-cessation program in a Lebanese academic medical center

“…In addition, smokers who participated in acupuncture had higher abstinence rates. This result is consistent with a recent systematic review that evaluated the evidence in support of the beneficial effect of acupuncture on smoking cessation 6 . Also, our findings suggest that bupropion may be more effective than NRT in supporting patients to maintain long-term abstinence.…”

“…dysthymia, major depressive disorder) are prescribed bupropion instead of NRT (varenicline is not available in Lebanon). In addition, patients are offered the option of acupuncture due to its therapeutic role in suppressing addiction and reducing withdrawal symptoms 6 .…”

Non-traditional Acupuncture Therapies for Smoking Cessation: A Systematic Review of Randomized Controlled Trials

“…NTA therapies have been widely used for nicotine dependence in several trials worldwide due to convenience and acceptability. The majority of systematic reviews [15][16][17] aimed to evaluate the effectiveness of traditional body acupuncture for smoking cessation, one Cochrane systematic review [18] focused on the effectiveness of both traditional body acupuncture and some NTA therapies on smoking cessation. So far, we have not found any systematic reviews that comprehensively and individually evaluate common NTA therapies for smoking cessation.…”

Remission from nicotine dependence among people with severe mental illness who received help/services for tobacco/nicotine use

“…Prior evaluations of therapeutic interventions for nicotine dependence in people with SMI recommend pharmacological services to aid smoking cessation (Aldi et al, 2018; Anghelescu, 2009; Annamalai, Singh, & O'Malley, 2015; Cather et al, 2013; Cerimele & Durango, 2012; Evins et al, 2014; Jun, Tian‐liang, Bin, & Xian‐wei, 2009; Rüther et al, 2014; Williams et al, 2012). Recent systematic review and meta‐analyses suggest the effectiveness of behavioral services, such as acupressure and acupuncture combined with counseling, in smoking cessation (Wang et al, 2019; Zulkifly & Amin, 2019). These studies also recommend conducting more research to confirm the effectiveness of behavioral services.…”

“…However, evidence from clinical trials suggests that pharmacological services alone or combined with behavioral and psychological support is effective for tobacco/nicotine use and tolerated by smokers with SMI (Aldi, Bertoli, Ferraro, Pezzuto, & Cosci, 2018;Anthenelli et al, 2013;Dubrava & Anthenelli, 2018;Hall et al, 2006;Secades-Villa, González-Roz, García-Pérez, & Becoña, 2017;Tidey & Rohsenow, 2009;Tsoi, Porwal, & Webster, 2013;Williams et al, 2012) Prior evaluations of therapeutic interventions for nicotine dependence in people with SMI recommend pharmacological services to aid smoking cessation (Aldi et al, 2018;Anghelescu, 2009;Annamalai, Singh, & O'Malley, 2015;Cather et al, 2013;Cerimele & Durango, 2012;Evins et al, 2014;Jun, Tian-liang, Bin, & Xianwei, 2009;Rüther et al, 2014;Williams et al, 2012). Recent systematic review and meta-analyses suggest the effectiveness of behavioral services, such as acupressure and acupuncture combined with counseling, in smoking cessation (Wang et al, 2019;Zulkifly & Amin, 2019). These studies also recommend conducting more research to confirm the effectiveness of behavioral services.…”