Everyone knows, I think, that smoking is bad for our health. Why then do so many of us still smoke? Because smoking is addictive – and addictions are, by definition, far from easy to get rid of. Many smokers try acupuncture, and acupuncturists are making a ‘pretty penny’ on the assumption that their treatment is an effective way to stop the habit. But what does the best evidence tell us?
A new randomized, double-blind, placebo-controlled clinical trial with 125 smokers was conducted to determine whether ear acupuncture with electrical stimulation (auriculotherapy) once a week for 5 consecutive weeks is more effective than sham treatment.
The results showed that there was no difference in the rate of smoking cessation between the two groups. After 6 weeks, the auriculotherapy group achieved a rate of 20.9% abstinence which was not significantly different from the 17.9% in the sham group.
The authors of this study concluded that “the results … do not support the use of auriculotherapy to assist with smoking cessation. It is possible that a longer treatment duration, more frequent sessions, or other modifications of the intervention protocol used in this study may result in a different outcome. However, based on the results of this study, there is no evidence that auriculotherapy is superior to placebo when offered once a week for 5 weeks, as described in previous uncontrolled studies.”
Of course, they are correct to state that, theoretically, a different treatment regimen might have generated different outcomes. But how likely is that in reality?
To answer this question, we might consult the Cochrane review on the subject (which incidentally is close to my heart: I initiated it many years ago and was its senior author until it was plagiarised by my former co-worker and my name was replaced by that of his new boss [never a dull day in alternative medicine research!]).
The latest version of this article concludes that “there is no consistent, bias-free evidence that acupuncture, acupressure, laser therapy or electrostimulation are effective for smoking cessation, but lack of evidence and methodological problems mean that no firm conclusions can be drawn. Further, well designed research into acupuncture, acupressure and laser stimulation is justified since these are popular interventions and safe when correctly applied, though these interventions alone are likely to be less effective than evidence-based interventions”
This is a very, very (yes, I meant very, very) odd conclusion, I think. If I had still been an author of this plagiarised paper, I would have suggested something a little more straightforward: 33 studies of various types of acupuncture for smoking cessation are currently available (if we include the new trial, the number is 34). The totality of this evidence fails to show that acupuncture is effective. Therefore acupuncture should NOT be considered a valid option for this indication.
12 Responses to Acupuncture for smoking cessation?
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i was stunned by this sentence.
Supposing the bias in the studies were rather “pro” to the performed therapy they should have had at the least some positive outcome of evidence.
Since there was none of such,a firm conclusion “must” to be drawn (not “cannot” be drawn) in the way Prof Ernst did.
The citation leads in its consequence to the worthelesness of any “negative” result in evaluating a study.
Edzard said:
Wow! Were you able to do anything about it?
yes, i did complain to my “line-manager” on the occasion of my next annual assessment.
Is there more you can say about this – this sounds like a huge issue that needs exposing.
i could write a book about this – what do you want to know?
Maybe you should write a book and expose the whole thing!
Was the complaint taken seriously? Did your ‘line manager’ agree it was plagiarism? Did the person who did it admit it? What action was taken?
i am!
very briefly, this is what happened:
the complaint was noted, there was no disputing the fact that it was plagiarism [the evidence was too clear], the line-manager said he would look into it – which he didn’t. i had to remind him repeatedly [eventually i asked whether PMS stood for ‘Plagerism Made Simple’] and finally i got a reply that my former co-worker and his new boss had been interviewed, the former said he would not do it again and the latter insisted that he had had no idea about all this. my line-manager then felt that the matter was closed. i never had as much as an appology and was told that, with my extensive publication list, it did not really matter whether i had one more or less. i fear my med school even submitted the fraudulent article to the RAE because, when i asked to see our submission, i was not given it to check.
Goodness. Surely the least – and morally right – action they should have taken would have been to have had the paper corrected or at the very least have an addendum published and to have the RAE submission corrected?
nothing od this sort happened; all of this, of course, occurred fairly soon after Prince charles had complained about me to my peers, i had a 13 months investigation upon me and [even though the investigation found me innocent] i became persona non grata at exeter uni.
but even though, an appology would have been nice – still none to this very day!