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Acupuncture, along with Advice, May Help Smokers Quit
What the Study Showed
Acupuncture combined with smoker education classes can markedly boost the chance of successfully kicking the nicotine habit. When smokers attended an acupuncture clinic as well as classroom sessions designed to help them overcome their addiction, 40% were able to quit. In contrast, only 22% of those who received education and "sham" acupuncture, and 10% who received acupuncture alone were ultimately successful. The study appeared in the October 2002 issue of the American Journal of Public Health.

How It Was Done
This well designed study, more rigorous than the majority of previous trials that examined the value of acupuncture for smoking cessation, involved 141 smokers. The participants were randomly assigned to one of three groups:

 One third underwent four weeks of acupuncture, which involved visiting an acupuncture clinic five days a week where painless, hair-thin needles were inserted into specific points in the outer ear and wrist. Following the tenets of traditional Chinese medicine, the acupuncture points used are believed to be sensitive to addictive behavior. Needles were left in place for 20 to 30 minutes.

 One third received the same acupuncture treatments as group 1, and also attended classes on smoking cessation once or twice a week. Classes lasted for 90 minutes, and over the course of five weeks, each participant attended a total of 10-1/2 hours of education.

 The final third also received acupuncture and classroom time, but the acupuncture given to this group was "sham," meaning that the participants were needled at random points not thought to have therapeutic benefits.

Participants were regularly interviewed and asked if they were still smoking. They were also assessed for signs of depression and anxiety, frequent complications of the quitting process.

At the end of the five weeks of treatment, the highest quitting rates--40%--were in the group that received both "true" acupuncture and stop-smoking classes. Only 22% of those in the "sham" acupuncture and classes, and 10% of those in the "true" acupuncture but no classes, managed to kick the habit. Eighteen months later, some of the quitters in all three groups had resumed smoking, although abstainers persisted in all three groups.

Interestingly, the longer and more heavily someone had smoked, the greater the chances of success. The scientists graded each participant according to "pack years"--the number of packs smoked daily multiplied by the number of years each person had smoked. For example, someone who smoked 1 pack a day for 10 years was given a grade of 1 times 10, or 10 pack-years. The researchers found that the higher the number of pack years (up to a total of 20 pack years), the more likely they were to quit smoking after receiving acupuncture treatments.

Why It's Important
The study shows that both acupuncture and education can be helpful tools for some people trying to quit smoking, even for long-term heavy smokers and when combined, the two therapies are especially potent.

Acupuncture is a key component of traditional Chinese medicine that is said to work by stimulating the flow of healing energy, or qi, throughout the body Although it has been widely used for smoking cessation, and anecdotal success stories abound, to date the clinical evidence has been mixed. In 1997, the National Institutes of Health concluded that acupuncture "might" be effective against smoking. A 2002 review by the Cochrane collaboration, a research group that pools data from earlier studies, however, concluded that proof of benefit was lacking. The present study adds another piece of support to the puzzle, although investigators agree that more good studies are needed.

By using both "true" and "sham" acupuncture points, the researchers here sought to provide a more effective control group than previous studies had used. Some of the benefits, however, may simply have been due to the concerned attention of the researchers, an effect that was seen in earlier trials. In addition, although the patients did not know if they were receiving "true" or "sham" acupuncture, the practitioners did; this could have influenced the outcome. Still, the results suggest that acupuncture and advice may be good aides to smoking cessation and well worth a try.

Source: Bier ID, Wilson J, Studt P, Shakleton M. Auricular acupuncture, education, and smoking cessation: a randomized, sham-controlled trial. American Journal of Public Health 2002;92:1642-1647.

Date Published: 03/08/2003
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