American Journal of Medicine, internal medicine, medicine, health, healthy lifestyles, cancer, heart disease, drugs

Smoking Cessation Alternatives

Alternative Smoking Cessation Aids: A Meta-analysis of Randomized Controlled Trials


Unconventional smoking cessation aids, such as acupuncture and hypnotherapy, can increase smoking cessation substantially. For patients who prefer not to use nicotine replacement therapy or smoking cessation drugs, practitioners should consider offering acupuncture or hypnotherapy as an alternatives.


Acupuncture, hypnotherapy, and aversive smoking are the most frequently studied alternative smoking cessation aids. These aids are often used as alternatives to pharmacotherapies for smoking cessation; however, their efficacy is unclear.

We carried out a random effect meta-analysis of randomized controlled trials to determine the efficacy of alternative smoking cessation aids. We systematically searched the Cochrane Library, EMBASE, Medline, and PsycINFO databases through December 2010. We only included trials that reported cessation outcomes as point prevalence or continuous abstinence at 6 or 12 months.

Fourteen trials were identified; 6 investigated acupuncture (823 patients); 4 investigated hypnotherapy (273 patients); and 4 investigated aversive smoking (99 patients). The estimated mean treatment effects were acupuncture (odds ratio [OR], 3.53; 95% confidence interval [CI], 1.03-12.07), hypnotherapy (OR, 4.55; 95% CI, 0.98-21.01), and aversive smoking (OR, 4.26; 95% CI, 1.26-14.38).

Our results suggest that acupuncture and hypnotherapy may help smokers quit. Aversive smoking also may help smokers quit; however, there are no recent trials investigating this intervention. More evidence is needed to determine whether alternative interventions are as efficacious as pharmacotherapies.

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— Mehdi Tahiri, MD, Salvatore Mottillo, MD, Lawrence Joseph, PhD, Louise Pilote, MD, MPH, PhD, Mark J. Eisenberg, MD, MPH

This article originally appeared in the June 2012 issue of the The American Journal of Medicine.

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