Non-traditional acupuncture therapies for smoking cessation: a systematic review of randomized controlled trials

Introduction: Non-traditional acupuncture (NTA), defined as the stimulation of certain parts of the body includes; acupressure, transcutaneous electrical acupoint stimulation (TEAS), laser acupuncture, intradermal needle, and acupoint catgut embedding (ACE). This systematic review evaluated their efficacy and safety for smoking cessation. Methods: Randomized controlled trials (RCTs) comparing NTA with sham NTA or conventional therapy for smoking cessation were included. Ten databases were searched from their inception to March 2021. Data were synthesized using risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI). The primary outcome was abstinence rate defined as abstinence between date of quitting and follow-up. Results: Acupressure was more effective than sham acupressure or conventional therapy in the short-term (RR 1.41, 95% CI [1.04 to1.91]; low certainty; 8 trials, n=637) and for mid-term smoking cessation (RR 1.63, 95% CI [1.27 to 2.09]; low certainty; 8 trials, n=749). TEAS appeared more beneficial for mid-term abstinence (RR 1.58, 95% CI [1.10 to 2.27]; moderate certainty; 3 trials, n=325). Laser acupuncture was superior to sham control for long-term abstinence (RR 2.25, 95% CI [1.23 to 4.11]; moderate certainty; 2 trials, n=160). ACE was comparable to Bupropion for mid-term smoking cessation (RR 0.99, 95% CI [0.70 to 1.40]; low certainty; 2 trials, n=177). No serious adverse events were reported. Conclusions: Low certainty evidence suggests that NTA was effective in short-term, middle-term or long-term smoking cessation. Further long-term follow-up RCTs are warranted to verify these benefits. Registration: INPLASY 202120054.