MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

What is ear acupressure?

Proponents claim that ear-acupressure is commonly used by Chinese medicine practitioners… It is like acupuncture but does not use needles. Instead, small round pellets are taped to points on one ear. Ear-acupressure is a non-invasive, painless, low cost therapy and no significant side effects have been reported.

Ok, but does it work?

There is a lot of money being made with the claim that ear acupressure (EAP) is effective, especially for smoking cessation; entrepreneurs sell gadgets for applying the pressure on the ear, and practitioners earn their living through telling their patients that this therapy is helpful. There are hundreds of websites with claims like this one: Auricular therapy (Acupressure therapy of the ear region) has been used successfully for Smoking cessation. Auriculotherapy is thought to be 7 times more powerful than other methods used for smoking cessation; a single auriculotherapy treatment has been shown to reduce smoking from 20 or more cigarettes a day down to 3 to 5 a day.

But what does the evidence show?

This new study investigated the efficacy of EAP as a stand-alone intervention for smoking cessation. Adult smokers were randomised to receive EAP specific for smoking cessation (SSEAP) or a non-specific EAP (NSEAP) intervention, EAP at points not typically used for smoking cessation. Participants received 8 weekly treatments and were requested to press the five pellets taped to one ear at least three times per day. Participants were followed up for three months. The primary outcome measures were a 7-day point-prevalence cessation rate confirmed by exhaled carbon monoxide and relief of nicotine withdrawal symptoms (NWS).

Forty-three adult smokers were randomly assigned to SSEAP (n = 20) or NSEAP (n = 23) groups. The dropout rate was high with 19 participants completing the treatments and 12 remaining at followup. One participant from the SSEAP group had confirmed cessation at week 8 and end of followup (5%), but there was no difference between groups for confirmed cessation or NWS. Adverse events were few and minor.

And is there a systematic review of the totality of the evidence?

Sure, the current Cochrane review arrives at the following conclusion: There is no consistent, bias-free evidence that acupuncture, acupressure, laser therapy or electrostimulation are effective for smoking cessation…

So?

Yes, we may well ask! If most TCM practitioners use EAP or acupuncture for smoking cessation telling their customers that it works (and earning good money when doing so), while the evidence fails to show that this is true, what should we say about such behaviour? I don’t know about you, but I find it thoroughly dishonest.

19 Responses to Ear-acupressure for smoking cessation? False claims by dishonest therapists

  • The trial reports some positives though, daily cigarette consumption was reduced by 35% in the SSEAP group during the “treatment” with an overall reduction in their baseline. Which could make it easier for them to quit smoking in the future. Therefore if the person receiving the EAP eventually quits because of their experience with the practitioner then technically they are not are not being lied to.

    • yes the trial does report that but it was not powered to determine such outcomes; and what you offer are speculations. in any case, the systematic review speaks for itself, don’t you think?

    • I wonder whether these studies are taking into account how determined the subjects are. For example, my father just threw out his cigarettes the day he was diagnosed TB. And never took on smoking again. And that was despite 30 years of smoking. On the other hand wards of university hospitals are full of smoking patients- they are smoking in the restrooms, under the signs that smoking is forbidden. Patients that are not allowed to leave territory of the hospital are begging others to buy them cigarettes….For example, once I overheard a discussion about a smoker who had been brought in with perforated peptic ulcer for 5th time during 3 years.
      So if you enroll subjects who really want to quit, subjects who are constantly told to quit and subjects who think if only there were some miracle cure ….. Or you can enroll only those who want to quit.
      And then there is environment. The only smoker in the family is likely to receive support, unlike the only quitter….

  • Totally agree – it is pure speculation. However the bit that you left out from the cochrane reviews conclusions is the part where it states that further investigation is justified due to EAP (and similar modalities) being so popular.

    I wonder if the same trial were to be run again, but this time include an extra test group that allowed the practitioner to perform their full theatrical repertoire alongside the EAP treatments what the outcome would be?

    • almost every paper concludes that MORE RESEARCH NEEDS DOING… this is a rather irrelevant platitude which merits to be left out, I think. and if the trial were run again….who knows?

  • “telling their customers that it works (and earning good money when doing so)”

    Sounds like that goes for more than just TCM. Western medical practitioners are equally as guilty at promoting things that may or may not work while making money (even better money) in the process. Do you find that to be equally dishonest or is this just a biased review?

    • I would find that just as dishonest; the thing is, I write about alt med on this blog and thus rarely mention defects in conventional medicine.

  • It is appropriate to recall “Hanlon’s Razor” in this context:

    Never attribute to malice that which is adequately explained by stupidity.

    Dishonesty and malice (and greed) are of course major factors in the practice of many TCM-artists and other make-believe healthcare providers. But plain and simple, unadulterated ignorance, stupidity and vanity are good enough to define the characteristics of most of them. We have seen so many examples of this in the discourse here on these pages where they regularly reveal these primordial attributes.

  • I practice auricular acupuncture as part of treatment for addiction I offer it only if the client wants it and it is complimentary. Some clients have found it beneficial when helping with cravings and low mood. I do not charge for this service, in fact, it costs me for the equipment and the yearly assessment and registration.

    We are not all ‘dishonest’ and I do believe that it can be effective or I wouldn’t continue offering it.

  • I do not charge for this service, in fact, it costs me for the equipment and the yearly assessment and registration.

    How noble of you Mrs. Quaye. I hope you will not take it too hard if I tell you that you are spending your money and time on useless antics that are not altogether without risk.

    Luckily you found this blog because after reading the posts here on acupuncture (easy to find using the category list on the right), following the many references given and partaking of some of the learned discussions, you will have learned that acupuncture is a theatrical placebo invented less than a century ago. For this there is ample evidence, which you can find references to in many of the posts here.
    Now you can with confidence spend more time using cognitive therapy or whatever that works much better than ear acupuncture. This particular brand of modern acupuncture was by the way invented “de novo” (not discovered) in the fifties by Paul Nogier, a Frenchman who had no experience, science or theory to build his practice upon, only his imaginative fantasy. Like so many useless therapies, “Auriculotherapy” has never been proven to work.
    If you Google “aruicular acupuncture for dependency” and “acupuncture for dependency” you will find a score of reviews and studies that find no support for its efficacy.
    Of course you will have to weed out the articles written by enthusiasts, many of whom have built their career and pride on this. The easiest clue to know when to dismiss a particular article on acupuncture is when they say in the introduction that acupuncture has been practiced (succesfully) for thousands of years, or something to that effect. This has been proven wrong. Modern thin-needle acupuncture was invented less than a century ago. The metallurgy for making the needles did not evolve until about four hundred years ago anyway.
    What was called “acu-puncture” a century or more ago was old fashioned blood-letting, lancing of boils and evil spirits and diverse pre-scientific cruelty with coarse knives and lances.

    We are not all ‘dishonest’ and I do believe that it can be effective or I wouldn’t continue offering it.

    Of course not. The pope is not technically dishonest even if he believes the world was designed in seven days by an old man in the sky and that chanting latin verses, collecting money from the congregation and asking imaginary spirits for help is virtuous and beneficial.
    What you believe does not relieve you from the responsibility to take care of your disadvantaged and often desperate addicted clients in a safe, efficient and honest manner. Sticking needles into their ear is neither honest nor altogehter safe.
    Perichondritis can be a terrible albeit uncommon complication. Iv-addicts, if that is part of your client base, are often immunocompromised and particularly prone to serious infection.

    If, despite being informed, warned and asked (hereby) to cease and desist in perpetrating this particular parlour trick, you decide to continue to deceive, harm (sticking needles in flesh is a form of bodily injury) and put your clients at risk, then please use full aseptic preparation and handling after informing your clients of possible adverse effects (bleeding and infection) and that the practice was invented from fantasy only about 70 years ago, is not based on evidence, has o physiologically plausible theoretical base and has never been proven to work in proper trials or experiments.

  • Another “Nay-sayer” from traditional western medical practitioners who know little of which they speak! I have been using ear acupuncture ( not acu-pressure ) for over 20 years now and smoking cessation is one I have some experience with.
    Generally, about 75% of my patients are able to stop smoking after a week or two of treatments, but there, is where the problems come in…If they continue to receive tune up treatments periodically, they tend to do better.

    One or two visits do not work well and those patients usually return to smoking soon.

    I tell them that the treatments help them with the anxiety of withdrawal, but do not make them want to quit. There must be some self control on their part.

    So, what about after the month or two that we will want to see them for? Over 50% are still smoke free after 6 months

  • I perform ear acupuncture ( not pressure ) on people who request it to help them stop smoking. I explain to them that it often ( not always ) helps reduce the anxiety of withdrawal . I find that if they come in for 4 or 5 visits, most people will be a non-smoker. About half of those are smoking again within 6 months. Still, not a bad deal for what I charge. If they have a monthly tune up for a year, more than 75% are smoke free.

  • I do electro Impulse therapy and we don’t claim the therapy itself make them quit, it assists them to calm their minds. Relaxation or lack of anxiety is a major attribute to quit smoking.
    By coping much better with the physical side, they can easily manage the habitual side (we give also a lot of tips and guidance)

    Various people have different addiction (dependency) to substances, so just taking 20 subjects against 20 subjects in a blind trial is quite a wild guess and unfair comparison…………. bad statistics!

    What makes auricular therapy work? By enabling the smoker to manage going Cold Turkey after first session, have another follow up after 3-5 days after which the ex smoker is comfortable non smoker.

    It is amazing to hear how much easier they manage after auricular therapy compared to quitting before…. 1-2 days of difficulty until the anxiety wanes and they are doing so good….. and yes, the medicine makes them feel terrible and they can’t stand that!

    We manage 90% plus success rate over 6.5 years in MY PERSONAL therapy centre, hundreds of ex smokers are now more than 3, 4, 5, 6, years smoke free and sending us smokers daily who ask them how they managed from 40 a day to ZIP! Why would so many customers send us referrals if it doesn’t work? (It’s how you apply it!!!)

    I don’t care what any doctor says, watch the score board!, what’s your success rate?

    Been doing it more than 6 and half years, no matter how much they s20-60 aday, 40+ years, NO problem.

    You can put that in your pipe and smoke it!

    Most medicine are also not proven…………. clinical tests are subject to “how” it’s done to get desired outcome…

    How many times I’ve been to the doctor and walking out with lots of medicine, he says, if not better in 3 days please come again……….. Pffff…. isn’t that unethical!
    Guess what, it takes same time without medicine than with medicine…. one just makes you feel a bit better when recuperating.

  • You apparently have no idea what your talking about – you’re stating assumptions and negative claims that aren’t true. I’ve read testimonies from actual people who have done the treatment and they told of this working through acupressure alone, completely quitting within weeks. I’m guessing yu’re just against any holistic & natural processses/ modalities you’re article is damaging and a disservice to those researching for facts on a acupressure. I charge for the service because it works & it is working for many other conditions as well.

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