Acupuncture for smoking cessation
Evidence SummariesLevel of Evidence = B
Acupuncture and related therapies (acupressure, laser therapy, electrostimulation) do not appear effective for smoking cessation.
A Cochrane review 1 included reports of 38 studies. Compared with sham acupuncture, the RR for short-term effect of acupuncture was 1.22 (95% CI 1.08 to 1.38; 19 studies, n=2,588), and for long-term effect 1.10 (95% CI 0.86 to 1.40; 11 studies, n=1,892). Acupuncture was less effective than nicotine replacement therapy (NRT) both in the short term (RR 0.76, 95% CI 0.59 to 0.98; 2 studies, n=914) and in the long term (RR 0.64, 95% CI 0.42 to 0.98; 2 studies, n=914). There was no evidence that acupuncture is superior to waiting list, nor to psychological interventions in short (RR 0.95, 95% CI 0.72 to 1.26; 3 studies, n=396) or long-term (RR 1.34, 95% CI 0.80 to 2.24, statistical heterogeneity I2=64%; 3 studies, n=396). There is limited evidence that acupressure is superior to sham acupressure for short-term outcomes (RR 2.54, 95% CI 1.27 to 5.08; 3 trials, n=325),The evidence on laser stimulation was insufficient and could not be combined. The evidence suggested that electrostimulation is not superior to sham electrostimulation either in the short term (RR 1.13, 95% CI 0.87 to 1.46; 6 studies, n=462)6 trials, n = 634, RR 1.13, 95% CI 0.87 to 1.46 or the long term (RR 0.87, 95% CI 0.61 to 1.23; 2 studies, n=634).
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment, blinding and incomplete outcome data in half of the studies).
1. White AR, Rampes H, Liu JP, Stead LF, Campbell J. Acupuncture and related interventions for smoking cessation. Cochrane Database Syst Rev 2011;(1):CD000009 [Review content assessed as up-to-date: 26 November 2013]. [PMID:21249644].
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