Clinical Efficacy Observation Of Acupuncture For Smoking Cessation

1 Background and ObjectiveSmoking is considered as one of the most serious public health problems in the world. It is commonly believed that smoking is dangerous for health. Smoking causes long-term and chronic damage, which is usually taken as pathogenic factor for many diseases. With China joining Framework Convention on Tobacco Control (FCTC), the government pays more and more attention on the smoking control. China has the most smoking population in the world, and the morbidity and mortality rates of related diseases are increasing gradually. Smoking is a behavior that would cause serious danger for our health. Acupuncture is a new method for smoking cessation, which is safe, effective and affordable. As a feature and an advantage of Chinese medicine, more attention is paid on acupuncture, for example, on December 1st of 2011, Madam Rosie Henson led to delegation to China and made communication with state administration of traditional Chinese medicine regarding acupuncture for smoking cessation. Acupuncture for smoking cessation is a new area of international communication and cooperation of Chinese medicine. Therefore, study regarding acupuncture for smoking cessation has important practical significance.In recent years, progress of acupuncture for smoking cessation is achieved. Although acupuncture has superior efficacy and less adverse effect, but the literature in China is mostly observational study, no RCT, and lack of specific description on acupuncture technique. So, this study adopts strict RCT method, with acupuncture combined auricular pressing as treatment group, NRT as control group, to analyze the efficacy of acupuncture for smoking cessation.2 MethodsThis study recruited 90 participants who voluntarily quit smoking from Acupuncture-Moxibustion Hospital, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences from September of 2013 to November of 2014. After signing the informed consent, the participants were randomly divided (1:1) into a treatment group and a control group,45 cases in each one.In the treatment group, Lieque, Hegu, Baihui, Zusanli, Sanyinjiao and Taichong were selected. Manipulation:after routine disinfection on the acupoints, horizontal needling was used at Baihui, while fingernail-pressure needle inserting method was used at Lieque, Hegu, Zusanli, Sanyinjiao and Taichong. The needling depth was 0.5-0.8 cun at Baihui and 1.0-2.0 cun at the remaining acupoints. The neutral supplementation and draining method was used, and the arrival of qi was required. When the needles were removed, the acupoints was pressed to avoid bleeding. Electroacupuncutre was connected at Zusanli,5 Hz in frequency. The treatment was given for 8weeks, five times per week in the first 1 to 2 weeks, three times per week in the 3rd to 4th weeks, and two times per week in the 5th to 8th weeks. The needles were retained for 30 min each time.Shenmen, Lung, Stomach, Endocrine, Pizhixia and Jiaogan were selected for auricular pressing. After routine disinfection on the acupoints, medical seeds were pressed and fixed. It was replaced after 3 to 4 days.In the control group, the types of nicotine patches (7mg/24Hour,14mg/24Hour, 21mg/24Hour) were used, once a day. The duration of treatment was based on the daily smoking.The treatment was given for 8 weeks, and the follow-up visit was performed at the 20th week. The outcome included general information, abstinence rate, FTND, HIS, NMWS, QSU-Brief and number of cigarettes smoked per day, which were recorded at 1st,2nd,4th,8th and 20th week.3. Results3.1 General InformationThere were no significant differences between the two groups in many aspects, such as, age, gender, education level, occupation, smoking age, the age of smoke, nicotine dependence, smoking intensity index, carbon monoxide and cotinine detection, the average daily volume of smoke, smoking as well as smoking cessation difficulty, etc. The subjects of the two groups were from the same sample, and were comparable.3.2 Comparison of smoking cessation rateTreatment group on self-reported withdrawal rate, carbon monoxide detection rate of withdrawal and cotinine measurement withdrawal rate were 40.0%,53.3%, 46.7% at the end of the 8 weeks of treatment, the follow-up were 36.7%,53.3%, 46.7% at the end of the 20th week. Compared with the control group, the withdrawal rate in the treatment group was higher than the control group. There is no statistically significant difference.3.3 Nicotine dependence, withdrawal symptoms, smoking craving, and smoking reduction comparisonNicotine dependence:The FTND score and HIS score of the treatment group and the control group were gradually decreasing during the eight weeks treatment, but the control group damped slightly larger compared to the treatment group. There is no statistically significant difference compared between two groups.Withdrawal symptoms and smoking craving:The MNWS score of the treatment group and the control group was from the beginning of the 1st week treatment to the end of the 20th week, the end of the follow-up was gradually decreasing. The MNWS score of the treatment group was significantly higher than the control group in the 1st to the 4th week. The QSU-Brief in the treatment group and the control group was also decreased, and the treatment group was slightly higher than the control group at the 2nd week, while the rest time was slightly lower than the control group.The amount of smoke reduction:After 8 weeks treatment of the treatment group and the control group,10 or below the amount of smoke statistics showed a gradual upward trend,11-20,21-30,30 or above each level of the amount of smoke showed a downward trend, and the two groups of ascending or descending amplitude are close by, the two groups during treatment at each time point reduction amount of smoke, there was no significant difference.4. ConclusionThis clinical research can draw the following conclusions:1. Acupuncture combined with ear pills therapy was adopted in this study and found no adverse reaction. This therapy is highly security and suitable for clinical operation.2. Acupuncture combined with ear pill treatment responded positively to the voluntary quitters. It can effectively improve the withdrawal rate, ease the withdrawal symptoms and craving for smoking, relieve nicotine dependence and reduce smoking quantity.3. Acupuncture combined with ear pills therapy was significantly better than nicotine patch therapy on improving withdrawal symptoms.4. The recommended future research direction can be turned to evaluate the economic benefits of acupuncture smoking cessation.5. Non intention analysis was conducted in this research. Due to the amount of sample, some of the differences cannot show obviously. The large sample and multi-center clinical randomized controlled trials "National research of Chinese medicine industry-the research in acupuncture smoking cessation " are still being studied.