The effectiveness and safety of auricular acupoint-related therapy for nicotine dependence: A systematic review and meta-analysis.

INTRODUCTION

This study aims to systematically evaluate the efficacy and safety of auricular acupuncture-related therapies (AARTs) in managing nicotine dependence (ND).

METHODS

We searched eight databases from their inception through December 2024 and screened randomized controlled trials (RCTs) evaluating AART for ND. The primary outcome was the ND cessation rate. We assessed study quality using the ROB-2 tool and applied the GRADE approach to determine the certainty or quality of of evidence.

RESULTS

Nine RCTs involving 1032 patients were analyzed. Meta-analysis results indicate that AART significantly reduces the Minnesota Nicotine Withdrawal Scale score (MNWS) in ND patients compared to nicotine replacement therapy (NRT) (mean difference, MD=1.47; 95% CI: 0.06-2.88, p<0.05). However, no significant differences were observed in ND point cessation rate, Fagerström test for nicotine dependence score (FTND), Hamilton Anxiety Scale score (HAMA), daily smoking volume, or exhaled CO levels between AART and NRT. Notably, AART was associated with a lower incidence of adverse events compared to NRT (relative risk, RR=0.15; 95% CI: 0.04-0.56, p<0.01). There were also no significant differences in the ND point cessation rate between auricular-plaster therapy (APT), body acupuncture (BA), and the combination of APT and BA.

CONCLUSIONS

AART is effective in improving ND, showing greater efficacy in reducing MNWS and enhanced safety compared to NRT. Given the limited number of studies, the optimal AART regimen remains undetermined. Further research is needed to confirm and refine these findings.