Effect of self-administered auricular acupressure on smoking cessation--a pilot study

Lawrence Leung, Troy Neufeld, Scott Marin, Lawrence Leung, Troy Neufeld, Scott Marin

Abstract

Background: Tobacco smoking is still a worldwide health risk. Current pharmacotherapies have at best, a success rate of no more than 50%. Auricular (ear) acupressure has been purported to be beneficial in achieving smoking cessation in some studies, while in others has been deemed insignificant. We hereby describe the protocol for a three-arm randomised controlled trial to examine the possible benefits of self-administered acupressure for smoking cessation.

Methods: Sixty consenting participants with confirmed habit of tobacco smoking will be recruited and randomized into three arms to receive either auricular acupressure at five true acupoints (NADA protocol), auricular acupressure at five sham points, or no auricular acupressure at all. Participants having auricular acupressure will exert firm pressure to each acupoint bilaterally via the bead in the attached plasters whenever they feel the urge to smoke. The treatment phase will last for six weeks during which all participants will be assessed weekly to review their smoking log, state of abstinence, end-exhalation carbon monoxide levels and possible adverse effects including withdrawal reactions and stress levels. At any time, a successful quit date will be defined with continuous abstinence for the following consecutive 7 days. From then on, participants will be evaluated individually for continuous abstinence rate (CAR), end-exhalation carbon monoxide levels and adverse effects of stress and withdrawal at specified intervals up to 26 weeks. Expectancy of treatment will be assessed with a four-item Borkovec and Nau self-assessment credibility scale during and after intervention.

Discussion: We incorporate validated outcome measures of smoking cessation into our randomised controlled trial design with the objectives to evaluate the feasibility and possible benefits of self-administered auricular acupressure as a non-invasive alternative to pharmacotherapy for smoking cessation.

Trial registration: ClinicalTrials.gov: NCT01389622 (registered Jul 7 2011).

Figures

Figure 1
Figure 1
Auricular points as they are used in acupuncture. The five auricular points chosen according to the National Acupuncture Detoxification Association (NADA) protocol: Autonomic Point (1); Shen Men (2); C. Kidney (3); Liver (4); Lung 2 (5).
Figure 2
Figure 2
Flow chart of proposed pilot study.
Figure 3
Figure 3
Figure 3a, b. Auricular acupressure plasters using Melastoma candidum seeds as beads attached under plasters which are individually packaged.

References

    1. Slama K. Global perspective on tobacco control. Part I. The global state of the tobacco epidemic. Int J Tuberc Lung Dis. 2008;12:3–7.
    1. Gotay CC. Cancer prevention: major initiatives and looking into the future. Expert Rev Pharmacoecon Outcomes Res. 2010;10:143–154. doi: 10.1586/erp.10.9.
    1. Fielding JE, Phenow KJ. Health effects of involuntary smoking. N Engl J Med. 1988;319:1452–1460. doi: 10.1056/NEJM198812013192205.
    1. Al-Sadat N, Misau AY, Zarihah Z, Maznah D, Tin Tin S. Adolescent tobacco use and health in Southeast Asia. Asia Pac J Public Health. 2010;22:175S-180S.
    1. Jha P, Chaloupka FJ, Corrao M, Jacob B. Reducing the burden of smoking world-wide: effectiveness of interventions and their coverage. Drug Alcohol Rev. 2006;25:597–609. doi: 10.1080/09595230600944511.
    1. Laniado-Laborin R. Smoking cessation intervention: an evidence-based approach. Postgrad Med. 2010;122:74–82. doi: 10.3810/pgm.2010.03.2124.
    1. Stead LF, Perera R, Bullen C, Mant D, Lancaster T. Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev. 2008. p. CD000146.
    1. Aguiar M, Todo-Bom F, Felizardo M, Macedo R, Caeiro F, Sotto-Mayor R, Bugalho de Almeida A. Four years' follow up at a smoking cessation clinic. Rev Port Pneumol. 2009;15:179–197.
    1. Bolliger CT, van Biljon X, Axelsson A. A nicotine mouth spray for smoking cessation: a pilot study of preference, safety and efficacy. Respiration. 2007;74:196–201. doi: 10.1159/000097136.
    1. Wennike P, Danielsson T, Landfeldt B, Westin A, Tonnesen P. Smoking reduction promotes smoking cessation: results from a double blind, randomized, placebo-controlled trial of nicotine gum with 2-year follow-up. Addiction. 2003;98:1395–1402. doi: 10.1046/j.1360-0443.2003.00489.x.
    1. Singh P, Kumar R. Assessment of the effectiveness of sustained release Bupropion and intensive physician advice in smoking cessation. Lung India. 2010;27:11–18. doi: 10.4103/0970-2113.59262.
    1. Fagerstrom K, Nakamura M, Cho HJ, Tsai ST, Wang C, Davies S, Ma W, Lee TC, Russ C. Varenicline treatment for smoking cessation in Asian populations: a pooled analysis of placebo-controlled trials conducted in six Asian countries. Curr Med Res Opin. 2010;26:2165–2173. doi: 10.1185/03007995.2010.505130.
    1. Issa JS, Perez GH, Diament J, Zavattieri AG, de Oliveira KU. Effectiveness of sustained-release bupropion in the treatment of smoker patients with cardiovascular disease. Arq Bras Cardiol. 2007;88:434–440. doi: 10.1590/S0066-782X2007000400012.
    1. Purvis TL, Mambourg SE, Balvanz TM, Magallon HE, Pham RH. Safety and effectiveness of varenicline in a veteran population with a high prevalence of mental illness. Ann Pharmacother. 2009;43:862–867. doi: 10.1345/aph.1L661.
    1. Jiang A, Cui M. Analysis of therapeutic effects of acupuncture on abstinence from smoking. J Tradit Chin Med. 1994;14:56–63.
    1. Chen H. Recent studies on auriculoacupuncture and its mechanism. J Tradit Chin Med. 1993;13:129–143.
    1. La Marca R, Nedeljkovic M, Yuan L, Maercker A, Ehlert U. Effects of auricular electrical stimulation on vagal activity in healthy men: Evidence from a three-armed randomized trial. Clin Sci (Lond) 2010;118:537–546. doi: 10.1042/CS20090264.
    1. Grosbglas A. Letter: Auricular acupuncture and smoking. Nouv Presse Med. 1975;4:980.
    1. White AR, Resch KL, Ernst E. Randomized trial of acupuncture for nicotine withdrawal symptoms. Arch Intern Med. 1998;158:2251–2255. doi: 10.1001/archinte.158.20.2251.
    1. Li QS, Liu ZY, Ma HJ, Lu YY, Fang YA, Hou YZ, Cao SH, Zhang ZH. A preliminary study on the mechanism of ear-acupuncture for withdrawal of smoking. J Tradit Chin Med. 1987;7:243–247.
    1. Martin GP, Waite PM. The efficacy of acupuncture as an aid to stopping smoking. N Z Med J. 1981;93:421–423.
    1. Ballal SG, Khawaji YN. Auricular stimulation and acupuncture as an adjuvant to an anti-smoking programme: analysis of the results of a 1-year experience. Tuber Lung Dis. 1992;73:396. doi: 10.1016/0962-8479(92)90048-O.
    1. Waite NR, Clough JB. A single-blind, placebo-controlled trial of a simple acupuncture treatment in the cessation of smoking. Br J Gen Pract. 1998;48:1487–1490.
    1. White AR, Rampes H, Ernst E. Acupuncture for smoking cessation. Cochrane Database Syst Rev. 2000. p. CD000009.
    1. White AR, Rampes H, Ernst E. Acupuncture for smoking cessation. Cochrane Database Syst Rev. 2002. p. CD000009.
    1. Chen HH, Yeh ML, Chao YH. Comparing effects of auricular acupressure with and without an internet-assisted program on smoking cessation and self-efficacy of adolescents. J Altern Complement Med. 2006;12:147–152. doi: 10.1089/acm.2006.12.147.
    1. Bier ID, Wilson J, Studt P, Shakleton M. Auricular acupuncture, education, and smoking cessation: a randomized, sham-controlled trial. Am J Public Health. 2002;92:1642–1647. doi: 10.2105/AJPH.92.10.1642.
    1. Sakka F. Role of auriculotherapy in smoking cessation. Personal experience. Tunis Med. 2002;80:217–219.
    1. Ausfeld-Hafter B, Marti F, Hoffmann S. Smoking cessation with ear acupuncture. Descriptive study on patients after a smoking cessation treatment with ear acupuncture. Forsch Komplementarmed Klass Naturheilkd. 2004;11:8–13. doi: 10.1159/000077190.
    1. White A, Moody R. The effects of auricular acupuncture on smoking cessation may not depend on the point chosen-an exploratory meta-analysis. Acupunct Med. 2006;24:149–156. doi: 10.1136/aim.24.4.149.
    1. Savage Jones H. Auricular complications of acupuncture. J Laryngol Otol. 1985;99:1143–1145.
    1. Gilbert JG. Auricular complication of acupuncture. N Z Med J. 1987;100:141–142.
    1. Lee RJ, McIlwain JC. Subacute bacterial endocarditis following ear acupuncture. Int J Cardiol. 1985;7:62–63. doi: 10.1016/0167-5273(85)90175-5.
    1. Kang HC, Shin KK, Kim KK, Youn BB. The effects of the acupuncture treatment for smoking cessation in high school student smokers. Yonsei Med J. 2005;46:206–212. doi: 10.3349/ymj.2005.46.2.206.
    1. White AR, Moody RC, Campbell JL. Acupressure for smoking cessation-a pilot study. BMC Complement Altern Med. 2007;7:8. doi: 10.1186/1472-6882-7-8.
    1. Song LZ. Acupuncture combined with auricular point sticking and pressing for smoking cessation of 53 cases in Russia. Zhongguo Zhen Jiu. 2008;28:133–134.
    1. Randomisation: type.
    1. Randomisation: Sequence generation.
    1. Randomisation: allocation concealment mechanism.
    1. Tough EA, White AR, Richards SH, Lord B, Campbell JL. Developing and validating a sham acupuncture needle. Acupunct Med. 2009;27:118–122. doi: 10.1136/aim.2009.000737.

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