The Effects of Auricular Acupuncture on Smoking Cessation May Not Depend on the Point Chosen – An Exploratory Meta-Analysis

Abstract

Introduction Auricular acupuncture is given as a treatment for drug dependence. Points are usually chosen on the assumption that the body is represented somatotopically in the ear, although there is no anatomical basis for this. In clinical trials, sham treatment is often given at points that are supposedly 'incorrect' for the condition, in the belief that they are inactive. The aim of this study was to explore whether there is any difference in the effectiveness of auricular acupuncture at 'correct' and 'incorrect' points. Methods Controlled trials of semi-permanent auricular acupuncture or acupressure for smoking cessation were systematically located, and the results combined in exploratory meta-analyses which took into account the study quality.Results Thirteen studies were included. Combining ten studies showed auricular acupuncture at 'correct' points to be more effective than control interventions, odds ratio 2.24 (95% CI 1.61, 3.10), a result which is confirmed in the four high validity studies. Other analyses showed inconsistent results between all studies and higher quality studies. Comparisons of three higher quality studies suggest that 'correct' and 'incorrect' point acupuncture is no different (odds ratio 1.22, CI 0.72, 2.07); and two studies showed that 'incorrect' point acupuncture may be more effective than other interventions (odds ratio 1.96, CI 1.00, 3.86).Conclusion Auricular acupuncture appears to be effective for smoking cessation, but the effect may not depend on point location. This calls into question the somatotopic model underlying auricular acupuncture and suggests a need to re-evaluate sham controlled studies which have used 'incorrect' points. Further experiments are necessary to confirm or refute these observational conclusions.

The Status and Future of Acupuncture Clinical Research

“…In smoking cessation, acupuncture suggested promise in earlier trials. [87][88][89] In a recent meta-analysis, 90 auricular acupuncture was found to be effective for smoking cessation, independently of the points used. However, a recently updated review 61,91 showed no consistent evidence that acupuncture is superior to no treatment.…”

Safety of Acupuncture: Results of a Prospective Observational Study with 229,230 Patients and Introduction of a Medical Information and Consent Form

“…It is administered on the basis of positive evidence for pain-related conditions such as osteoarthritis of the knee [4][5][6] as well as postoperative and chemotherapy-induced nausea and vomiting [7,8]. Despite the lack of positive scientific evidence, it is also used for other conditions such as asthma [9] and smoking cessation [10]. But side effects, even severe ones like pneumothorax, cardiac tamponade, and infections can occur [11][12][13][14][15][16][17][18][19][20][21][22] and a patient should be informed about these.…”

Determining the efficacy of auricular acupuncture for reducing anxiety in patients withdrawing from psychoactive drugs

“…In our study, observations were made over three treatment sessions, and it is not known what changes may have occurred with longer term treatments. Another significant concern has been with the choice of sham points frequently used as controls in acupuncture research (White & Moody, 2006). If the sham points are themselves active points, then the comparison of outcomes between the "treatment" and "sham" groups may be inappropriate.…”