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Zhang YY, Su YZ, Tian ZY, Liang SB, Liu YJ, Li YF, Qiao HF, Robinson N, Liu JP. Acupuncture and related acupoint therapies for smoking cessation: An umbrella review and updated meta-analysis. Tob Induc Dis 2024; 22:TID-22-64. [PMID: 38638420 PMCID: PMC11025526 DOI: 10.18332/tid/186147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/12/2024] [Accepted: 03/15/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION Acupuncture and related acupoint therapies have been widely used for smoking cessation. Some relevant systematic reviews (SRs) have been published. There is a need to summarize and update the evidence to inform practice and decision-making. METHODS Eight databases were searched from their inception to December 2023. SRs, any randomized controlled trials (RCTs) comparing acupuncture therapies with sham acupuncture, pharmacotherapy, behavioral therapy, or no treatment, were included. The primary outcome was the abstinence rate. AMSTAR-2 was employed to assess the quality of SRs. An updated meta-analysis was conducted based on SRs and RCTs. Data were synthesized using risk ratios (RR) with 95% confidence intervals (CIs). The GRADE approach was employed to assess the certainty of the updated evidence. RESULTS Thirteen SRs and 20 RCTs outside of the SRs were identified. The SRs were of low or very low quality by AMSTAR-2. Sixteen (80%) RCTs were at high risk of performance bias. Eight acupuncture and related acupoint therapies were involved. The short-term (≤6 months) abstinence rate outcome was summarized as follows. Most SRs suggested that filiform needle acupuncture or acupressure had a better effect than sham acupuncture, but the findings were inconsistent. The updated meta-analysis also suggested that filiform needle acupuncture was more effective than sham acupuncture (RR=1.44; 95% CI: 1.02-2.02; I2 = 66%; low certainty; 9 RCTs, n=1358). Filiform needle acupuncture combined with acupressure was comparable to nicotine patches (RR=0.99; 95% CI: 0.74-1.32; low certainty; 6 RCTs, n= 524). Acupressure was superior to counseling (RR=1.46; 95% CI: 1.14-1.87; I2=5%; low certainty; 8 RCTs, n=595). No serious adverse events were reported in these SRs or RCTs. CONCLUSIONS Low certainty evidence suggests that filiform needle acupuncture and auricular acupressure appear to be safe and effective in achieving short-term smoking cessation. However, long-term follow-up data are needed.
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Affiliation(s)
- Ying-Ying Zhang
- College of Acupuncture-Moxibustion and Tuina, Shaanxi University of Chinese Medicine, Xianyang, China
- Key Laboratory of Acupuncture and Medicine in Shaanxi Province, Xianyang, China
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - You-Zhu Su
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zi-Yu Tian
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Shi-Bing Liang
- Clinical Study Center, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yi-Jie Liu
- College of Acupuncture-Moxibustion and Tuina, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Yu-Fei Li
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hai-Fa Qiao
- College of Acupuncture-Moxibustion and Tuina, Shaanxi University of Chinese Medicine, Xianyang, China
- Key Laboratory of Acupuncture and Medicine in Shaanxi Province, Xianyang, China
| | - Nicola Robinson
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- Institute of Health and Social Care, London South Bank University, London, United Kingdom
| | - Jian-Ping Liu
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Sung WS, Choi IS, Moon JH, Chae SY, Jo MG, Kim JH, Park YC, Kim EJ, Baek YH, Kim GW, Seo BK. Efficacy and safety evaluation of adjuvant auricular acupuncture for smoking cessation: A study protocol of randomized, assessor-blinded, pragmatic pilot trial. Medicine (Baltimore) 2022; 101:e31456. [PMID: 36316847 PMCID: PMC9622710 DOI: 10.1097/md.0000000000031456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Smoking negatively impacts public health. There are several treatments to quit smoking, and nicotine replacement treatment (NRT) reportedly doubles the smoking cessation rate, with some limitations. Acupuncture is an alternative option with proven effects on smoking cessation. However, there has been no definite report that indicates the efficacy and safety of auricular acupuncture (AA) combined with NRT on smoking cessation. METHODS This is a randomized, assessor-blind, and pragmatic pilot study. We will recruit 40 participants who want to stop smoking and randomly allocate them into an NRT group and an NRT + AA group with a 1:1 ratio. Participants will receive NRT for 4 weeks and the NRT + AA group will receive additional AA treatment with 5 AA points (Shenmen (TF4), lung (CO14), throat (TF3), inner nose (TG4), and endocrine (CO18)) twice a week for 4 weeks. Follow-up will be conducted 1 and 3 months after intervention completion. The primary outcome will be tobacco consumption and abstinence rate determined by calculating the rate of change in cigarette use and a urine test. Secondary outcomes will be the quality of life (EuroQol-5D and visual analogue scale), nicotine dependence (Fagerstrom test for nicotine dependence), nicotine withdrawal (Minnesota nicotine withdrawal scale), physical effects, satisfaction, and safety measurement (adverse events). RESULTS We will investigate the efficacy and safety of AA combined with NRT treatment for smoking cessation. CONCLUSION Our study will provide additional clinical evidence for AA as an adjuvant treatment for smoking cessation. TRIAL REGISTRATION NUMBER Clinical Research Information Service (registration number: KCT0007212).
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Affiliation(s)
- Won-Suk Sung
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Republic of Korea
| | - In Suh Choi
- College of Korean Medicine, Kyung Hee University Graduate School, Seoul, Republic of Korea
| | - Jeong-Hyun Moon
- College of Korean Medicine, Dongguk University Graduate School, Seoul, Republic of Korea
| | - Soo-Yeon Chae
- College of Korean Medicine, Dongguk University Graduate School, Seoul, Republic of Korea
| | - Min-Gi Jo
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Korean Medicine Hospital at Gangdong, Seoul, Republic of Korea
| | - Jung-Hyun Kim
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University Korean Medicine Hospital at Gangdong, Seoul, Republic of Korea
| | - Yeon-Cheol Park
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, Dongguk University Bundang Oriental Hospital, Seongnam-si, Republic of Korea
| | - Yong-Hyeon Baek
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Geun-Woo Kim
- Department of Neuropsychiatry, Dongguk University Bundang Oriental Hospital, Seongnam-si, Republic of Korea
| | - Byung-Kwan Seo
- Department of Acupuncture and Moxibustion Medicine, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
- *Correspondence: Byung-Kwan Seo, Department of Acupuncture and Moxibustion Medicine, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, 892, Dongnam-ro, Gangdong-gu, Seoul 05278, Republic of Korea (e-mail: )
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Ho LF, Ho WK, Wong LL, Chiu SW, Tang SY, Wong CM, Chan KS, Lam CL, Chen M, Chan KL, Lin G, Ng BFL, Lin ZX. Acupuncture combined with auricular acupressure for smoking cessation and its effects on tobacco dependence and smoking behavior among Hong Kong smokers: a multicenter pilot clinical study. Chin Med 2022; 17:92. [PMID: 35941599 PMCID: PMC9361598 DOI: 10.1186/s13020-022-00649-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acupuncture combined with auricular acupressure has been used as a complementary and alternative treatment for smoking cessation in Hong Kong for over 10 years. This study aimed to investigate the success rates of smoking cessation posttreatment, and to evaluate treatment effects on tobacco dependence, smoking behavior, anxiety levels, and sleep disturbances between successful and unsuccessful quit smokers in Hong Kong. METHODS This prospective, multicenter clinical study conducted between September 2020 and February 2022 in Hong Kong was part of the Guangdong-Hong Kong-Macau Greater Bay Area project on smoking cessation. Thirty eligible current smokers (mean age 47.10 years; 40% female) were recruited and received a combination of standardized acupuncture and auricular acupressure treatments twice weekly for 8 weeks. The primary outcome was the success rate of smoking cessation at week 24. The secondary outcomes were the success rates of smoking cessation at weeks 8 and 16, exhaled carbon monoxide (CO) levels, and changes in scores on the Fagerström Test for Nicotine Dependence (FTND), Autonomy Over Smoking Scale (AUTOS), Hamilton Anxiety Rating Scale (HAM-A), Self-rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI). Adverse events were also recorded. RESULTS Of 30 eligible participants, 28 completed 6 or more treatment sessions; all completed follow-up assessments. At week 24, the success rate of smoking cessation was 46.67%. The successfully quit rates at weeks 8 and 16 were 36.67% and 43.33%, respectively. The overall change in mean FTND scores from baseline improved significantly from weeks 2 to 24 (P < 0.05), with the successful quit group showing significantly greater improvement between weeks 8 and 24 (P < 0.01). Compared with baseline values, there were significant reductions in mean AUTOS scores from weeks 6 to 24 (P < 0.001), with the successful quit group showing greater improvement at weeks 16 (P = 0.04) and 24 (P < 0.001). No significant changes were detected in exhaled CO levels or HAM-A, SAS, and PSQI scores. No study-related adverse events were observed. CONCLUSIONS Acupuncture combined with auricular acupressure could be an effective alternative treatment for smoking cessation and reduction of tobacco dependence among Hong Kong smokers. Trial registration Chinese Clinical Trial Registry, No. ChiCTR2000033650. Registered on June 7, 2020. http://www.chictr.org.cn/showproj.aspx?proj=54866.
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Affiliation(s)
- Lai Fun Ho
- Chinese Medicine Services, Pok Oi Hospital, G/F, Shatin (Taiwai) Clinic, 2 Man Lai Road, Taiwai, Shatin, NT, Hong Kong, SAR, China.
| | - Wai Kwan Ho
- Chinese Medicine Services, Pok Oi Hospital, G/F, Shatin (Taiwai) Clinic, 2 Man Lai Road, Taiwai, Shatin, NT, Hong Kong, SAR, China
| | - Ling Ling Wong
- Chinese Medicine Services, Pok Oi Hospital, G/F, Shatin (Taiwai) Clinic, 2 Man Lai Road, Taiwai, Shatin, NT, Hong Kong, SAR, China
| | - Sze Wan Chiu
- Chinese Medicine Services, Pok Oi Hospital, G/F, Shatin (Taiwai) Clinic, 2 Man Lai Road, Taiwai, Shatin, NT, Hong Kong, SAR, China
| | - Shuk Yu Tang
- Chinese Medicine Services, Pok Oi Hospital, G/F, Shatin (Taiwai) Clinic, 2 Man Lai Road, Taiwai, Shatin, NT, Hong Kong, SAR, China
| | - Chun Ming Wong
- Chinese Medicine Services, Pok Oi Hospital, G/F, Shatin (Taiwai) Clinic, 2 Man Lai Road, Taiwai, Shatin, NT, Hong Kong, SAR, China
| | - Kin San Chan
- Chinese Medicine Services, Pok Oi Hospital, G/F, Shatin (Taiwai) Clinic, 2 Man Lai Road, Taiwai, Shatin, NT, Hong Kong, SAR, China
| | - Chi Lan Lam
- Chinese Medicine Services, Pok Oi Hospital, G/F, Shatin (Taiwai) Clinic, 2 Man Lai Road, Taiwai, Shatin, NT, Hong Kong, SAR, China
| | - Min Chen
- Chinese Medicine Services, Pok Oi Hospital, G/F, Shatin (Taiwai) Clinic, 2 Man Lai Road, Taiwai, Shatin, NT, Hong Kong, SAR, China
| | - Kam Leung Chan
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Guohua Lin
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | | | - Zhi Xiu Lin
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
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