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BackgroundNon-traditional acupuncture (NTA) therapies widely used for smoking cessation include acupressure, transcutaneous electrical acupoint stimulation (TEAS), laser acupuncture, intradermal needle, and acupoint catgut embedding (ACE). Our aim was to evaluate their therapeutic effects and safety for smoking cessation. MethodsRandomized controlled trials (RCTs) comparing NTA therapies with sham NTA or conventional therapy for smoking cessation were included. Ten databases were searched from their inception to February 2021. Two review authors independently screened studies, extracted data, and assessed the risk of bias. Meta-analysis was conducted with RevMan 5.4 software. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to assess the quality of evidence. The primary outcome was abstinence rate at short-term (1-3months), mid-term (3-6months), and long-term (≥6months). ResultsTwenty-five RCTs involving 2600 smokers were identified. Acupressure was found more effective than sham acupressure or conventional therapy in improving short-term (RR 1.41, 95% CI [1.04 to1.91]; low certainty; 8 trials, n=637) and mid-term abstinence rate (RR 1.63, 95% CI [1.27 to 2.09]; low certainty; 8 trials, n=749). Intradermal needle was not superior to sham control or counseling for short-term (RR 1.62, 95% CI [0.85 to 3.08]; low certainty; 5 trials, n=346) and mid-term abstinence rate (RR 1.49, 95% CI [0.68 to 3.27]; low certainty; 3 trials, n=187).TEAS failed to show a better effect than sham TEAS or counseling for short-term abstinence rate (RR 1.27, 95% CI [0.96 to 1.67];moderate certainty;5 trials, n=485), TEAS appeared more beneficial for mid-term abstinence (RR 1.58, 95% CI [1.10 to 2.27]; moderate certainty; 3 trials, n=325). Laser acupuncture was superior to sham control for long-term abstinence rate (RR 2.25, 95% CI [1.23 to 4.11]; moderate certainty; 2 trials, n=160). ACE was comparable to Bupropion for mid-term abstinence rate (RR 0.99, 95% CI [0.70 to 1.40]; low certainty; 2 trials, n=177). No serious adverse events were reported in the included trials. Conclusions Low to moderate certainty evidence suggests that acupressure, TEAS, laser acupuncture and ACE maybe effective in achieving short-term, middle-term or long-term smoking cessation. Further large, long-term follow-up RCTs are warranted to verify their benefits and safety.Systematic review registration: INPLASY 202120054. |
