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Smoking Cessation
Complementary Therapies for Smoking Cessation –
A Useful Tool or Merely a Smoke Screen?
Sundari Ampikaipakan,
1
Andrew Wilson
2
and Nicholas Steel
3
1. Clinical Lecturer, and Specialist Registrar, Respiratory Medicine, University of East Anglia; 2. Senior Clinical Lecturer, Respiratory Health,
University of East Anglia, and Honorary Consultant, Respiratory Medicine, the Norfolk and Norwich National Health Service (NHS) Trust;
3. Senior Lecturer, Primary Care, University of East Anglia, and Honorary Consultant, Public Health, Norfolk Primary Care Trust
Abstract
Patients often wish to try complementary therapies to help with smoking cessation; however, many healthcare professionals feel the
evidence for them is largely anecdotal. We have performed a PUBMED and Cochrane database review of the evidence for acupuncture and
hypnotherapy as smoking cessation treatments. Fourteen articles were identified for acupuncture (including one Cochrane review) and 11
articles for hypnotherapy (including one Cochrane review). There was no good evidence for acupuncture. There was an apparent short-
term benefit seen in a meta-analysis. However, differing methodologies and a reliance on a single positive study, which has not been
replicated, made drawing a positive conclusion untenable. There was also little evidence for the role of hypnotherapy. However, a meta-
analysis of 24 studies looking at the data for males and females separately indicated that men may derive a small benefit. We conclude
that there is currently insufficient evidence to use either acupuncture or hypnotherapy as smoking cessation treatment, but that there is
a real need for better clinical studies.
Keywords
Smoking cessation, acupuncture, acupressure, hypnotherapy, hypnosis
Disclosure: The authors have no conflicts of interest to declare.
Received: 5 December 2008 Accepted: 2 June 2009
sundariampi@googlemail.com
There are more than one billion smokers in the world. The World Health There is little evidence for NRT in those smoking fewer than 10–15
Organization (WHO) attributes 5.4 million deaths per year to tobacco cigarettes per day. Current evidence suggests that combination
use and it is anticipated that by 2030 there will be more than 8 million therapy using NRT with another agent leads to better sustained quit
deaths per year. Smoking is the leading preventable cause of death in rates than monotherapy alone.
5
Combining NRT with counselling has
the world.
1
Hence, never has there been a greater need for smoking shown an increased sustained abstinence rate at 12 months.
6
cessation interventions. However, anecdotal evidence has long suggested that there may be a
role for complementary therapies in smoking cessation. Acupuncture
Smoking cessation strategies largely involve pharmacological and hypnotherapy are two modalities that have been mooted as useful
interventions and behavioural therapy, which includes physician adjuncts to conventional smoking cessation therapies, but the
advice, individual/group counselling and telephone counselling. These evidence remains controversial. Evidence for the effectiveness of both
interventions have a clear evidence base and have been proved to of these complementary modalities will be reviewed in this article.
work.
3–6
Nicotine replacement therapy (NRT) and bupropion are proved
to reduce withdrawal symptoms, in addition to the counselling and Methods
behavioural therapies that form an integral part of the smoking A review of the literature employing a search using PubMed and the
cessation pathway that is widely used.
2
Cochrane database was undertaken. The free text or keywords
used were smoking cessation and hypnosis, hypnotherapy or
Among the simplest of behavioural interventions, brief direct physician acupuncture or acupressure. The rationale for including or excluding
advice to quit smoking is effective. Assuming an unassisted quit rate of articles in this review is provided in Figures 1 and 2. In particular, data
2–3%, brief advice intervention from a physician can increase this rate published since the two most recent large meta-analyses
by 1–3% according to a meta-analysis of 28 trials involving 28,000 and data within the two large Cochrane meta-analyses have been
participants by Stead et al.
3
considered in detail.
In itself, NRT increases the chance of stopping smoking by Acupuncture
approximately 50–70% regardless of the setting.
4
In real terms, this The first medical account of acupuncture was the Yellow Emperor’s
equates to a incremental quit rate of 5%, which increases to 12% with Classic of Internal Medicine in 300BCE. In 2007, there were over 2,800
additional intensive behavioural support.
3
This applies to smokers who professionally trained acupuncturists in the UK. Wen and Cheung first
are motivated to quit and have a high level of nicotine dependence. described the effects of acupuncture in opiate withdrawal symptoms.
7
© TOUCH BRIEFINGS 2009 41
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