Ear Acupuncture and Acupressure Modestly Efficacious for Smoking Cessation

Ear acupuncture (EAP) and related treatments are used for smoking cessation but trials have found variable effectiveness, perhaps because treatments and comparisons have also varied widely. Investigators in a systematic review (including Chinese databases) summarized 25 studies of EAP and ear acupressure (EAPR) compared with: sham, placebo, no intervention, body acupuncture, and medical or behavioral treatments. The main report is limited to the 12 most valid comparisons; participant number ranged from 23 to 396 in each study.

• There were no differences in smoking cessation between EAP/R and other active treatments.
• EAP/R increased cessation compared with inactive treatments. The quit rate in 6-week to 3-month follow-up studies for EAP/R was 16% versus 10% in controls; rates were 12% and 6% respectively at 6 months. Only 1 study assessed 12-month effects (and did show efficacy).
• Adverse effects included sore ears, bruising, facial swelling, headache, dizziness, nausea and vomiting, and tape allergy (EAPR).

Comments:

This review highlights how varied interventions and comparisons can be, making determinations about effectiveness difficult. In addition, there was little study of long-term efficacy. The authors also noted that more studies would be useful to compare acupuncture and related treatments with pharmacotherapies. These treatments seem to be reasonable options but comparative effectiveness studies would help clinicians and patients choose among the many options to support smoking cessation.

Richard Saitz, MD, MPH


Reference:

Di YM, May BH, Zhang AL, et al. A meta-analysis of ear-acupuncture, ear-acupressure and auriculotherapy for cigarette smoking cessation. Drug Alcohol Depend. 2014;142:14–23.