Study protocol of a pragmatic, randomised controlled pilot trial: clinical effectiveness on smoking cessation of traditional and complementary medicine interventions, including acupuncture and aromatherapy, in combination with nicotine replacement therapy

Soobin Jang, Sunju Park, Bo-Hyoung Jang, Yu Lee Park, Ju Ah Lee, Chung-Sik Cho, Ho-Yeon Go, Yong Cheol Shin, Seong-Gyu Ko, Soobin Jang, Sunju Park, Bo-Hyoung Jang, Yu Lee Park, Ju Ah Lee, Chung-Sik Cho, Ho-Yeon Go, Yong Cheol Shin, Seong-Gyu Ko

Abstract

Introduction: Nicotine dependence is a disease, and tobacco use is related to 6 million deaths annually worldwide. Recently, in many countries, there has been growing interest in the use of traditional and complementary medicine (T&CM) methods, especially acupuncture, as therapeutic interventions for smoking cessation. The aim of this pilot study is to investigate the effectiveness of T&CM interventions on smoking cessation.

Methods and analysis: The STOP (Stop Tobacco Programme using traditional Korean medicine) study is designed to be a pragmatic, open-label, randomised pilot trial. This trial will evaluate whether adding T&CM methods (ie, ear and body acupuncture, aromatherapy) to conventional cessation methods (ie, nicotine replacement therapy (NRT), counselling) increases smoking cessation rates. Forty participants over 19 years old who are capable of communicating in Korean will be recruited. They will be current smokers who meet one of the following criteria: (1) smoke more than 10 cigarettes a day, (2) smoke less than 10 cigarettes a day and previously failed to cease smoking, or (3) smoke fewer than 10 cigarettes a day and have a nicotine dependence score (Fagerstrom Test for Nicotine Dependence) of 4 points or more. The trial will consist of 4 weeks of treatment and a 20 week follow-up period. A statistician will perform the statistical analyses for both the intention-to-treat (all randomly assigned participants) and per-protocol (participants who completed the trial without any protocol deviations) data using SAS 9.1.3.

Ethics and dissemination: This study has been approved by the Institutional Review Board (IRB) of the Dunsan Korean Medicine Hospital of Daejeon University (IRB reference no: DJDSKH-15-BM-11-1, Protocol No. version 4.1.).The protocol will be reapproved by IRB if it requires amendment. The trial will be conducted according to the Declaration of Helsinki, 7th version (2013). This study is designed to minimise the risk to participants, and the investigators will explain the study to the participants in detail. As an ethical clinical trial, the control group will also be given conventional cessation treatments, including NRT and counselling. Participants will be screened and provided with a registration number to protect their personal information. Informed consent will be obtained from the participants prior to enrolling them in the trial. Participants will be allowed to withdraw at anytime without penalty.

Trial registration number: ClinicalTrials.gov (NCT02768025); pre-results.

Keywords: Korean medicine; Smoking; T&CM; acupuncture; study protocol; tobacco control.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Flow chart of T&CM tobacco control programme. NRT, nicotine replacement therapy; T&CM, traditional and complementary medicine.

References

    1. World Health Organization. Third WHO Report on the global tobacco epidemic. Geneva: World Health Organization, 2012.
    1. Siahpush M, McNeill A, Hammond D, et al. . Socioeconomic and country variations in knowledge of health risks of tobacco smoking and toxic constituents of smoke: results from the 2002 international tobacco control (ITC) four country survey. Tob Control 2006;15(Suppl 3):iii65–70. 10.1136/tc.2005.013276
    1. Bier ID, Wilson J, Studt P, et al. . Auricular acupuncture, education, and smoking cessation: a randomized, sham-controlled trial. Am J Public Health 2002;92:1642–7. 10.2105/AJPH.92.10.1642
    1. He D, Berg JE, Høstmark AT. Effects of acupuncture on smoking cessation or reduction for motivated smokers. Prev Med 1997;26:208–14. 10.1006/pmed.1996.0125
    1. Cahill K, Stevens S, Perera R, et al. . Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev 2013;5:CD009329 10.1002/14651858.CD009329.pub2
    1. Heatherton TF, Kozlowski LT, Frecker RC, et al. . The fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict 1991;86:1119–27. 10.1111/j.1360-0443.1991.tb01879.x
    1. Browne RH. On the use of a pilot sample for sample size determination. Stat Med 1995;14:1933–40. 10.1002/sim.4780141709
    1. Hertzog MA. Considerations in determining sample size for pilot studies. Res Nurs Health 2008;31:180–91. 10.1002/nur.20247
    1. Buller DB, Halperin A, Severson HH, et al. . Effect of nicotine replacement therapy on quitting by young adults in a trial comparing cessation services. J Public Health Manag Pract 2014;20:E7–15. 10.1097/PHH.0b013e3182a0b8c7
    1. Tosanguan J, Chaiyakunapruk N. Cost-effectiveness analysis of clinical smoking cessation interventions in Thailand. Addiction 2016;111:340–50. 10.1111/add.13166
    1. Chase EC, McMenamin SB, Halpin HA. Medicaid provider delivery of the 5A's for smoking cessation counseling. Nicotine Tob Res 2007;9:1095–101. 10.1080/14622200701666344
    1. Fiore MC, Jorenby DE, Baker TB, et al. . Tobacco dependence and the nicotine patch. clinical guidelines for effective use. JAMA 1992;268:2687–94.
    1. World Health Organization. International classification of diseases, 10th revision, online versions. 2016. .
    1. U.S. Preventive Services Task Force. The guide to clinical preventive services. Darby, PA: DIANE Publishing, 2008.
    1. Agency for Healthcare Research and Quality. Using pragmatic clinical trials to test the effectiveness of patient-centered medical home models in real-world settings Patient centered medical home research methods series. Rockville, MD: AHRQ, 2013. No. 13-0030-EF.
    1. Fiore MC, Jaén CR, Baker TB, et al. ; Treating tobacco use and dependence: 2008 Update. Rockville, MD: US Department of Health and Human Services, 2008.
    1. Stead LF, Perera R, Bullen C, et al. . Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2012;11:CD000146 10.1002/14651858.CD000146.pub4
    1. Chae Y, Yeom M, Han JH, et al. . Effect of acupuncture on anxiety-like behavior during nicotine withdrawal and relevant mechanisms. Neurosci Lett 2008;430:98–102. 10.1016/j.neulet.2007.10.026
    1. Chae Y, Kang OS, Lee HJ, et al. . Effect of acupuncture on selective attention for smoking-related visual cues in smokers. Neurol Res 2010;32(Suppl 1):27–30. 10.1179/016164109X12537002793805
    1. Chae Y, Park HJ, Kang OS, et al. . Acupuncture attenuates autonomic responses to smoking-related visual cues. Complement Ther Med 2011;19(Suppl 1):S1–7. 10.1016/j.ctim.2010.09.003
    1. Ma E, Chan T, Zhang O, et al. . Effectiveness of acupuncture for smoking cessation in a Chinese population. Asia Pac J Public Health 2015;27:NP2610–22. 10.1177/1010539513503867
    1. Lamontagne Y, Annable L, Gagnon MA. Acupuncture for smokers: lack of long-term therapeutic effect in a controlled study. Can Med Assoc J 1980;122:787–90.
    1. McFadden DD, Chon TY, Croghan IT, et al. . Trial of intensive acupuncture for smoking cessation: a pilot study. Acupunct Med 2015;33:375–80. 10.1136/acupmed-2015-010794
    1. He D, Medbø JI, Høstmark AT. Effect of acupuncture on smoking cessation or reduction: an 8-month and 5-year follow-up study. Prev Med 2001;33:364–72. 10.1006/pmed.2001.0901
    1. The Association of Korean Medicine. Guideline on acupuncture treatment and counselling for smoking cessation 2010.
    1. Wu TP, Chen FP, Liu JY, et al. . A randomized controlled clinical trial of auricular acupuncture in smoking cessation. J Chin Med Assoc 2007;70:331–8. 10.1016/S1726-4901(08)70014-5
    1. White AR, Resch KL, Ernst E. Randomized trial of acupuncture for nicotine withdrawal symptoms. Arch Intern Med 1998;158:2251–5. 10.1001/archinte.158.20.2251
    1. Waite NR, Clough JB, single-blind A. A single-blind, placebo-controlled trial of a simple acupuncture treatment in the cessation of smoking. Br J Gen Pract 1998;48:1487–90.
    1. Louis M, Kowalski SD. Use of aromatherapy with hospice patients to decrease pain, anxiety, and depression and to promote an increased sense of well-being. Am J Hosp Palliat Care 2002;19:381–6. 10.1177/104990910201900607
    1. McCaffrey R, Thomas DJ, Kinzelman AO. The effects of lavender and rosemary essential oils on test-taking anxiety among graduate nursing students. Holist Nurs Pract 2009;23:88–93. 10.1097/HNP.0b013e3181a110aa
    1. Ben-Arye E, Dudai N, Eini A, et al. . Treatment of upper respiratory tract infections in primary care: a randomized study using aromatic herbs. Evid Based Complement Alternat Med 2011;2011:1–7. 10.1155/2011/690346

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