Auricular Acupressure for Smoking Cessation: A Pilot Randomized Controlled Trial

Background: Many health hazards are related to smoking. Patients who wish to stop smoking often need assistance. Objective: To determine the effectiveness of auricular acupressure for smoking cessation and for the relief of withdrawal symptoms in habitual smokers. Design, Setting, Intervention, and Participants: A prospective, randomized, sham-controlled trial using auricular acupressure was conducted from November 2007 to March 2009 in 70 active smokers in Hong Kong. The active group (n = 38) used Shenmen, Lung, Mouth, and Brain acupoints for 3 weeks. The sham group (n = 32) used non-meridian points. The selected acupoints were stimulated with small hard beads fixed in place with adhesive tape. The enrolled participants were then followed up weekly for 3 weeks and for 3 months after acupressure treatment. Main Outcome Measures: Individual daily cigarette consumption, expiration test for carbon monoxide content, and cigarette withdrawal symptom scores were recorded. Results: At the end of the treatment, cigarette consumption significantly decreased in both groups (35.1% of the active group and 25.8% of the sham group reduced by 50% their daily consumption at 7 days posttreatment). The smoking cessation rate showed no significant difference between the active group and the sham group: 31.3% of the treated participants experienced a reduction of 50% of daily cigarette consumption. Only 17.5% of the participants showed a reduction of carbon monoxide expiration to levels less than 6 ppm (18.2% in the active group vs 16.7% in the sham group; P = .87). Three months after the study, 25 participants were interviewed by phone. Their mean (standard deviation [SD]) resumption of cigarettes compared with pretreatment was 9.17 (7.5) less in the active group compared with 3.5 (7.4) in the sham group (P = .07). There were no significant differences between groups in withdrawal symptoms and no reports of major adverse events in either group. Conclusions: Although the outcomes of this study failed to statistically confirm its efficacy, auricular acupressure was favored by many participants. Acupressure stimulation may not be as effective as needling acupuncture; however, acupressure is easy for the patient to manage. Because of the challenges of smoking cessation, acupressure might still be considered as an adjunctive method with nicotine substitution, pharmacotherapy, or psychotherapy.