Laser Acupuncture for Adolescent Smokers—A Randomized Double-Blind Controlled Trial

American Journal of Chinese Medicine, Summer-Fall, 2000 by Cai Yiming, Zhao Changxin, Wong Song Ung, Zhang Lei, Lim Seuk Kean

Table 3. Subgroup Analyses of the Comparative Efficacy of Acupuncture Treatment and Sham Control

                  Motivation for Smoking Cessation

Motivation      Group      No. of     Complete
Levels                    Patients   Cessation    P-Value

Not at all/   Treatment      74      14 (18.9%)    0.86
Ambivalent    Control        73      14 (19.2%)

Quite         Treatment      38       6 (15.8%)    0.85
determined    Control        41       6 (14.7%)

Very          Treatment      16       8 (50.0%)    0.86
determined    Control        26      10 (38.5%)

                 Motivation for
                 Smoking Cessation

               Reduction
               [is greater
               than or
Motivation     equal to]
Levels            50%         P-Value

Not at all/    59 (79.7%)      0.92
Ambivalent     55 (75.3%)

Quite          32 (84.2%)      0.90
determined     35 (85.4%)

Very           14 (87.5%)      0.83
determined     23 (88.5%)

                     Duration of Smoking (months)

                          No. of     Complete
Months          Group     Patients   Cessation    P-Value

3 to 12       Treatment      32      7 (21.9%)     0.87
               Control       36      10 (27.8%)

13 to 36      Treatment      63      17 (27.0%)    0.85
               Control       59      16 (27.2%)

> 36          Treatment      33      4 (12.1%)     0.97
               Control       45      4 (8.9%)

                Duration of
              Smoking (months)

               Reduction
               [is greater
                than or
               equal to]
Months            50%        P-Value

3 to 12        27 (84.4%)     0.97
               28 (77.8%)

13 to 36       52 (82.5%)
               50 (84.7%)     0.97

> 36           26 (78.8%)     0.89
               35 (77.8%)

                       Number of Cigarettes Smoked
                            Per Day (sticks)

                          No. of     Complete
Sticks          Group     Patients   Cessation       P-Value

5 to 10       Treatment     102       23 (22.6%)      0.93
              Control       111       27 (24.3%)

11 to 15      Treatment      14        3 (21.4%)      0.64
              Control        15        1 (6.7%)

> 15          Treatment      12        2 (16.7%)      0.69
              Control        14        2 (14.3%)

               Number of Cigarettes
              Smoked Per Day (sticks)

               Reduction
               [is greater
                than or
               equal to]
Sticks            50%        P-Value

5 to 10        81 (79.4%)     0.99
               86 (77.5%)

11 to 15       12 (85.7%)     0.99
               15 (100%)

> 15           12 (100%)      0.99
               12 (85.7%)

Factors relating to subjects' personal experience and behavior were analyzed, namely, reactions to treatment, motivation to stop smoking, family members being smokers, close friends being smokers and whether subjects were asked to come for treatment. The results are shown in Tables 2 and 3. No significant difference is observed in the two groups. This confirms that randomization was successful.

Both treatment and control group reported unfavorable reactions (headache, giddy, nausea, vomiting or change of odor in cigarette smoking) in around 20% of subjects during the treatment period. There was no difference between the two groups.

Table 3 shows the relationship between the outcome and smoking history, motivational level and number of cigarettes smoked per day. There was no significant difference in the outcomes between the treatment and control groups (p [is greater than] 0.05).

Discussion and Conclusion

We report a double blind, placebo-controlled study of the effect of laser acupuncture on adolescent smokers who attended the Smoking Cessation Clinic at the Institute of Health, Singapore. The effectiveness of laser acupuncture treatment was compared with control (sham acupuncture) and no difference was demonstrated. However, both groups showed a substantial number of subjects who stopped and a larger percentage who reduced their smoking. Several factors, which might have influenced the outcome of the study, were analyzed and established as controlled for in the randomization process.

The sample size was predetermined by the expected outcome of the treatment and control group, as indicated by other studies. This was to ensure that a definitive and valid conclusion could be reached overcoming a problem of many previous studies emerging from small sample sizes.

Our results show that the effectiveness for both groups was around 80 percent, similar to most previous studies. In a review of 64 publications by Jiang the overall efficacy was 84% as measured immediately post-treatment (Jiang, 1994). A main difference is that most of those studies, however, have shortcomings in the designs such as the lack of a placebo control, small sample size, and the outcome measurement being non-blind.

In the study by Tan, mentioned earlier, he reported laser acupuncture to be highly effective for adult smokers (Tan, 1990). He used a control group of 30 subjects who received sham acupuncture on auricular points for one minute, and established a positive response rate of 26.6%. This is in sharp contrast to our study outcome of 80.7%. However, it has to be pointed out that his study differs from ours in that his subjects were adults. It also was not randomized or controlled. Furthermore, the methodology of his study such as randomization and evaluation was not detailed.

It has to be pointed out that the proportion of subjects reporting unfavorable reactions to treatment were the same at around 20% in our study in each group (Table 2). This is a level expected of any placebo treatment, and this implied that in both groups the effect is predominantly psychological.