Is auricular acupuncture effective in assisting smokers to quit, as compared to sham auricular acupuncture?
Date of publication of the systematic review: June 2012
Design
Systematic review of 6 randomized controlled trials (RCTs).
Participants
823 smoking adults (mean age range: 37.5 to 53.7 years, male % range: 49.6% to 84.8%) with a mean number of cigarettes per day ranging from 24 to 27.2.
Intervention
Auricular acupuncture for smoking cessation was defined as the stimulation of specific acupoints on the ear using needles or laser. Certified acupuncturists were appointed to provide the intervention. Among the included trials, the number of auricular acupuncture sessions ranged from 1 to 20 and the time of treatment ranged from 56 to 600 minutes.
Comparator
Comparison: Auricular acupuncture versus sham auricular acupuncture.
Major Outcomes
Outcome 1: Smoking abstinence at > 6 months.
Smoking abstinence was defined as continuous abstinence during the time between the end of the treatment and the point of follow-up.
Settings
All included trials were conducted in outpatient settings.
Comparison    Auricular acupuncture versus sham auricular acupuncture
Main Results
Compared to sham auricular acupuncture, auricular acupuncture showed significant improvement on smoking abstinence rate among adult smokers (pooled relative risk increment (pooled RRI): 2.53, 95% CI: 0.03 to 11.07).
Comparison: Auricular acupuncture versus sham auricular acupuncture among adult smokers
Outcomes (units) No. of studies (Total number of participants) No. of events/ No. of participants Heterogeneity test (I2) Pooled RRI (95% CI) Overall quality of evidence*
Intervention Comparator
1 (NA) 6 (825) 137/ 415 45/ 410 85% 2.53 (0.03 to 11.07) Moderate
Keys: RRI = relative risk increment; CI = confidence interval.
Comparison    Auricular acupuncture versus sham auricular acupuncture
Main Results
Compared to sham auricular acupuncture, auricular acupuncture showed significant improvement on smoking abstinence rate among adult smokers (pooled relative risk increment (pooled RRI): 2.53, 95% CI: 0.03 to 11.07).
Comparison: Auricular acupuncture versus sham auricular acupuncture among adult smokers
Outcomes (units) 1 (NA)
No. of studies (Total number of participants) 6 (825)
No. of events/ No. of participants Intervention 137/ 415
Comparator 45/ 410
Pooled RRI (95% CI) 2.53 (0.03 to 11.07)
Overall quality of evidence* Moderate
Keys: RRI = relative risk increment; CI = confidence interval.
Conclusion
Benefits
Compared to sham auricular acupuncture, auricular acupuncture showed significant benefit for adult smokers on promoting smoking abstinence. The overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse effects regarding the use of auricular acupuncture or sham auricular acupuncture were reported in the included trials.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pubmed/22502956
The synopsis is based on the following article:
Tahiri M, Mottillo S, Joseph L, Pilote L, Eisenberg MJ. Alternative smoking cessation aids: a meta-analysis of randomized controlled trials. Am J Med. 2012 Jun;125(6):576-84.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.