Comparison between Acupuncture and Nicotine Replacement Therapies for Smoking Cessation Based on Randomized Controlled Trials: A Systematic Review and Bayesian Network Meta-Analysis

Runjing Dai; Yongchun Cao; Hailiang Zhang; Na Zhao; Dong Ren; Xiaomei Jiang; Guisen Zheng; Shisan Bao; Xingke Yan; Jingchun Fan

doi:10.1155/2021/9997516

Comparison between Acupuncture and Nicotine Replacement Therapies for Smoking Cessation Based on Randomized Controlled Trials: A Systematic Review and Bayesian Network Meta-Analysis

Evid Based Complement Alternat Med. 2021 Jun 16:2021:9997516. doi: 10.1155/2021/9997516. eCollection 2021.

Authors

Runjing Dai^#¹, Yongchun Cao^#², Hailiang Zhang¹, Na Zhao¹, Dong Ren³, Xiaomei Jiang³, Guisen Zheng¹, Shisan Bao¹, Xingke Yan⁴, Jingchun Fan¹

Affiliations

¹ School of Public Health, Center for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu 730000, China.
² Human Resources Management Department, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu 730050, China.
³ Psychosomatic and Sleep Medicine, Gansu Gem Flower Hospital, Lanzhou, Gansu 730060, China.
⁴ College of Acupuncture-Moxibustion and Tuina, Gansu University of Chinese Medicine, Lanzhou, Gsnsu 730000, China.

^# Contributed equally.

Abstract

Objectives: To evaluate the efficacy and/or safety of acupuncture therapy (AT) in quitting smoking.

Methods: Randomized controlled trials (RCTs) were searched in PubMed, Cochrane Library, Embase, Web of Science, and Chinese Biomedical Database (CBM). We used Cochrane Collaborative Quality Assessment to assess the risk of bias. Bayesian network meta-analysis was utilized to evaluate the efficacy and safety of different interventions. Data analyses were conducted using WinBUGS 1.4.3, Stata 14, and RevMan 5.3.5 software.

Results: A total of 2706 patients from 23 studies were included, involving 6 treatment arms. Network meta-analysis demonstrated that there was no significant difference in short-term abstinence rates or changes in Fagerstrom test for nicotine dependence (FTND) scores and daily smoking among these groups (AT, sham acupuncture therapy (SAT), auricular acupressure (AA), sham auricular acupressure (SAA), acupuncture plus auricular acupressure (APAA), and nicotine replacement therapy (NRT)). However, there was a significant difference between SAA and AA with risk ratio (RR) of 2.49 (95% CI 1.14, 5.97) in long-term abstinence rate. The probabilistic ranking results showed that APAA and AA were superior to other interventions in the comparison of abstinence rates. There was no obvious inconsistency between the direct comparison and indirect comparison, using the consistency test.

Conclusion: AA was superior to SAA in smoke quitting, but there was no difference among other interventions in long-term truncation rates. There was no difference in short-term abstinence rates among these selected groups. We need large sample RCTs to clarify the advantages of interventions such as APAA and AA. In addition, reporting of adverse events that may occur during treatment also should be enhanced to complement evidence-based medicine. The trial is registered with PROSPERO CRD42020164712.