Acupuncture to quit smoking?

Acupuncture is very helpful for helping people quit smoking. Some of the more common protocols used are found on the Acupuncture for Smoking Cessation section. The article "ang67" recommends is also good reading as it discusses the relatively difficult nature of smoking addiction and treatment. It is often much easier to help people with hard drug addictions like heroin, or cocaine, than it is smoking due to the many triggers involved. In a person who is ready to quit, however, acupuncture and some minor lifestyle and dietary changes is very helpful.

hallo Mr Chad,

I am an acupuncturist in Indonesia, I have a problem in treating my patient. She have an HNP, after having treatment for 5 times with acupuncture, the patient say me that she have pain in every place I puncture my needle. What happened to her and what should I do to her.

Thanks for your reply

Does acupuncture really help to stop smoking? Some of the biggest studyes that have been done for this have proved that acupuncture was not usefull to stop smoking. Other studys sugest that acupuncture may have a secundary roll to perform in smoking cessation.

In Portugal I see publicity sayng that acupuncture is sucessful in 90% or 96% of the cases, or that you stop smoking with 2 treatments. Honestly I seriously doubt of the efficacy in acupuncture on smoking cessation.

One thing is certain, you still need lot´s more scientific studies to show that it has a relevant roll.

I feel like you are missing my critical point. My point is that there will -always- be a difference between professional results and clinical trials. In other words, the clinical evidence as it is currently obtained (i.e. double-blind, fixed protocol clinical trials) will -never- show the same results that -can- be obtained by a skilled practitioner in his/her clinic. If you are looking for verification of the medicine, you should study and train with true masters in the field that get repeatable results - not by reading clinical trials. This is because clinical trials use standard protocols which in very rare cases perform anywhere near as well as correctly applied Chinese Medicine based on a full intake and proper diagnostic considerations in TCM terms. You should read some of the work by Ted Kaptchuk on the to get an idea of the difficulties in studying acupuncture with the western double-blind clinical trial model. You could also read a recent article I wrote on how to best read clinical research related to cam.

So, in short, if there is a clinic near you that is claiming a 96% success rate you should be talking to them directly, seeing what they do, and hanging out with them and watching if the patients are actually improving. 96% seems high, particularly within 2 sessions, but there are practitioners out there who get tremendous results and just as many that don't - it's part of the nature of the medicine.

If you are asking that if you applied the same protocol to every person would you believe that you would get a 96% success rate - then, my answer is probably not. If you treated everyone correctly, provided other information and avenues for diet/lifestyle change, etc. and gave it some time (i.e. not 2 sessions) then you could very well get results in the 90% and above.

In the first place I would like to apologize for the time I took to answer but I´ve been with a lot of work.

I continue to disagree with you. Let´s suposse that there´s always a diference bettween scientific studies and clinical practice. Why did you ask me scientific data on teh first place? Why did you use the NADA protocolos as an example? Your argument is like this: it´s scientifically proven. But when another acupuncturists show you proff that it´s not proven you say: "well there´s always a diference between scientific research and clinical data". This is brilliant. Why do we even need scientific studyes? If they show it works, great. If not, that´s great also because there is always diference bettween scientific studies and clinical data. This is not a serious argument.

Then you say that double blind protocolos will never show the same results as clinical data. I don´t now why. Honestly. You assume that all clinical trials use standard protocolos (like NADA protocolo that you have defended) but there are people concerning in creating studies with personalized protocolos. Abd I should remember you that even with the standard protoclos acupuncture as been eficacious on pain treatment for example.

You advise me that I should study with true masters. How can I find a true master? It´s simple: just search for the guy that say´s has the beste results. Because that´s teh only way you have to find true masters. Can you even take seriously this argument? True masters should be capable of performing a great scientific test with repeatable results.

If you have noted your arguments have contradicted themselves since the begining. Personalized protocolos versus NADA protocoos, scientific data versus diference with clinical data. I would also like to thank you for the links to the research problem in acupuncture but I already Know them and others. That is a problem that I have been researching for some years now.

To finish. You have written: "but there are practitioners out there who get tremendous results and just as many that don't - it's part of the nature of the medicine".

In the first plave there is any way to find if the results that are being selled are true. And I know a lot of people that lie in this profession so I have to take that for it´s real value: that´s none. Second of all it´s not part os the nature of medicine having doctor´s with great results and others with none. That the nature of a system that don´t control the learning of the professionals or the marketing that they do to their treatments.

This is what I think: the profs that exist are not consisting, there is important scientific data that contradict´s studies that suport that kink of claims, there is scientific data that show error´s in studies that suport that claim and you´re arguments are contradictory and do not support themselves. However I would like to thank you for this small change of ideias because you have gave me rwasons to write a new article for my blog. lololol

Also would like to congractulate you for the creation of yin yang house.

Is it your honest opinion that western drugs approved in the market do not have conflicting studies? If so, I suggest that you do a lot more research before you enter this debate and understand the role money has to play in that process as well. Taking prozac, as an example, which obviously does -something-, there were a number of studies (most hidden by the company and leaked out later) that showed the drug did absolutely nothing. For a drug (in the US) to pass only some of the studies have to show effect and others showing the opposite effect or no effect can and will be disregarded. The role that money plays in this process is well understood. Along that same note, there is quite a difference between masking symptoms and fully treating conditions. It is clear that acupuncture is often held up to a ridiciously high standard with regards to results in clinical studies compared to what passes for many western medications.

You seem to be hung on people saying they can get results in a treatment or two with chronic conditions, I agree with you that that is more marketing than reality. But saying you cannot treat conditions like fibromyalgia, or even smoking, that are commonly treated by any number of practitioners is just plain incorrect. Does it take more than two treatments, yes, but does that mean it is not treatable - absolutely not. And many practitioners, myself included, have all experienced conditions that are treated extremely quickly - even within one or two treatments. The body has a limitless potential to heal and sometimes these things happen. I wouldn't base a study on the phenomena or market it myself, because that's not really the point, but it happens. And while I do not claim it as a success story for acupuncture, I do claim it as a success story for the healing potential of the body. Just to stick with studies - here is one that found effect from one treatment on myofascial pain (see study).

And, yes, based on how you are trying to argue these points, it is fairly clear that you have a unbalanced emphasis on studies than on clinical realities. But that is fine. Start doing more research and show that acupuncture does or doesn't work for various conditions - the field needs more critical researchers like yourself. Get together a competent group of practitioners and start publishing your studies. If they show smoking isn't treatable, that's great. If not, that's fine as well.

The truth is that even excellent researchers are still exploring the best ways to study acupuncture. The failures in the studies are sometimes acupuncture - but they are often study design, quality of practitioners enrolled (in the US using more MD's poorly trained in acupuncture than fully trained acupuncturists), etc. And it is what they are looking for. Take for example a study to see if smoking can be cured in 2 sessions. So you do it and you try and it comes out with poor results - you feel that this means acupuncture cannot be treated with smoking. A good read of the study, however, only says that in this study with this population of people 2 treatments were not enough. So you re-evaluate the study, and you try it in 6 sessions, and on and on. It is important to note that most studies involving acupuncture are done because there is enough clinical evidence to warrant people taking the funds to even look into the hows and whys of what they are experiencing clinically.

An example of this approach was a study looking at the long term effects from acupuncture on knee pain (see study). The study was conducted because there was effects noticed in clinical settings. This study looked at whether these effects were sustained. So they got 30 people together randomized them and performed the study. The study didn't find a significant change in patients 12 months out (although it did in the short run). So the conclusion was not that acupuncture doesn't work (wasn't even what they were looking for) but that this warrants a larger study. A critical read would be 30 people is not enough to base a decision and looking at longer term studies involving acupuncture need different criteria than shorter ones.

Research is a complex world of funding opportunities, and performing studies step by step. Positive or negative you would never read a study (or logically even a couple studies) and base a lot on it. They don't do that for medicines, and you shouldn't do it for acupuncture. What we do know is a lot happens clinically when the setting is right, there is relationship with your patients, there are more treatments (usually), and on and on. These aspects are very difficult to account for in acupuncture studies (and in western studies as well). There was a western study a while back that took a few medications (cannot remember which ones) and a few doctors. People found the medications they used more effective when they said that they liked their doctor. For the people with the grumpy doctor, that they didn't like, the medications didn't work as well. Does that mean the medications don't work? No, of course not.... Does that mean that there is more going on in the interchange, yes. And studies like that are not out to prove anything, just to illustrate the point so better studies (that account for different phenomena) can be created in the future.

With regards to Fibromyalgia and acupuncture:

Improvement in Fibroymyalgia symptoms with Acupuncture (see study).

Treatment of Fibromyalgia with Formula Acupuncture (see study).

Read closely the objective of the second study - "to investigate whether typical acupuncture methods such as needle placement, needle stimulation, and treatment frequency were important factors in fibromyalgia symptom improvement"

Note, the study isn't even looking at whether acupuncture is helpful for fibromyalgia (that is a given based on clinical evidence and previous studies) - it is looking at issues such as needle placement, technique, and treatment frequency. Accordingly, it is not useful to base an opinion on whether or not fibro is treatable with acupuncture with this study in particular. It is simply setting a precidence in studies to evaluate whether or not this criteria needs to be accounted for in future studies regarding acupuncture and fibromyalgia as well as in future acupuncture studies generally.

To avoid getting too far off track, however, do you treat smoking in your clinic? If so, what protocols and points do you use? And what is your overall response rate? And since you brought it into the equation, the same questions go for fibromyalgia? Do you treat it? If so, what have you done? And what is your overall response rate? If you don't treat either, then how are you going to effectively judge between what you read in studies and what you see in your clinic? If you are concerned about the practice locally that is making these claims, why don't you invite them into the discussion to see what they do (literally send them an email and have them respond within this forum), or as I suggested previously go either as a professional or undercover as a "patient", and see what they do. Then we can discuss that. Perhaps they do have some interesting and effective protocols. And, if they do, these might be worthy of incorporating into studies in the future. I strongly feel that it is practitioners that drive change and advancement in the field - not studies. In other words, we can agree to disagree but if you want to discuss something, this is the place to discuss acupuncture not conjecture.... so what have you tried with these conditions and why do you think it hasn't worked?

What does it mean to you to "cure" a condition? I certainly don't use the word myself, but we regularly treat fibromyalgia and people get to a point where they are symptom free and stay that way, call it what you will. This is repeated time and time again by myself, my colleagues, and all of my teachers from various styles. Is every case successful, no, do we treat it in 2 treatments, no, but again this does not mean it is not treatable. You are, again, basing your claims on a few studies when thousands of practitioners (practicing many modalities I might add) worldwide regularly treat the condition.

The whole point of my writing was to illustrate the purpose of studies. You do one looking at fibro over 6 weeks, then over 12, and on and on until you find the best treatment options. We do the same thing in our clinic. We try one way, then another, and another, and over time and building on my teachers vast experience we come up with something unique. Later we may study aspects of it, which in fact we have and will continue to do so.

Drug companies have millions of dollars to do research, so they test internally on and on and then do whatever amount of studies that need to be done to get the drug passed. There simply isn't the money nor the collective interest to do these kinds of studies for acupuncture. Accordingly, clinical experience weighs far more than research - because we have more of it.

The entire field is based on the collective experience of generations of teachers. Personally, I trust that far more than a study. I know there are aspects of acupuncture that are not reproducible by all practitioners - I've touched on that previously and won't get into it again. For the studies to be useful (and this is already happening) there need to be of three types. (1) Using animals to understand some of the deeper biochemical changes brought about by acupuncture, (2) double-blind clinical trials, and (3) clinical observational studies of people who do get results letting them practice within their own theory (no set protocols, different interactions with various patient types, etc.). When you take the three together you may find some gems that can advance the field.

Chinese Medicine is not Western Medicine - it's just not that simple and it cannot be studied in the same way. Variability in needling technique, personalities, treatment space, point choice, diagnostic ability, etc. are all too great to be studied the same way. Accordingly, you will see (and appropriately so) different results from different people. Will you see charlatans and the like as well, yes, and you will see many practitioners who regurgitate the same boring point protocols over and over, with the same techniques, and get the same inferior results. On the other hand you will see the renegades and the thinkers in the field who extend our thinking and get phenomenal repeatable results. The more time you spend with those people, the better off you will be.

When you say, "Second of all no acupuncture practitioner will go into public discussion about is methods."

I'm in a public discussion about what we do, which is why I'm asking what you do - so we can discuss acupuncture and not a bunch of trivial subjects. We have books, seminars, discussions, etc. all over this site and others describing in complete detail, our system, why it is different, what kind of results we get, etc. Other practitioners do the same thing. Most are thrilled when you ask to come observe them for awhile and are more than happy to discuss things with you in detail. If they are not, they very likely do not have anything worthy to discuss.

So, again, what do you do? and why do you feel it hasn't worked?

To add a slight bit more to my point, even studying "acupuncture" is a convoluted statement to some degree. What is "acupuncture" when you are studying it? What does it mean when you say you have clinical success with "acupuncture"? It's a general term, in most minds, including practitioners. Comparing a fixed point protocol study to what happens in an "acupuncturists" office is comparing apples to oranges in most cases. Most people go to their acupuncturist and they get acupuncture, cupping, tuina, energywork, herbal medicine, lifestyle counseling, dietary help, etc. So when a practitioner treats a condition was it "acupuncture" - or acupuncture and herbs, or acupuncture, tuina, and herbs. You get my point. Either way, this is one of many reasons it is difficult to study in the way that western medications are studied. This is also why many very intelligent people are looking at the best ways to study Chinese Medicine as a whole and acupuncture as a simple modality within that role.

So our disagreement really comes down to one basic thing. When you say, for example, acupuncture does not treat fibromyalgia. What you are saying is that because a fixed point protocol study done only to look at needling doesn't show the data then the evidence isn't there to warrant acupuncture as a modality to treat that condition. I'm saying that's not the entire truth. What I am saying is that the clinical evidence is there and clinical treatments involve non fixed protocols, and the host of other things that naturally come with a visit to your "acupuncturist". Accordingly, you would expect better results in the full setting...

I would like to know what you think the difference between treat and cure is. As I very, very clearly stated before I don't use the word myself, but when I say treat, I mean treat until the person has the absence of symptoms and then you don't need to treat them anymore. Some would call that cure, I call that treating. Perhaps treating to resolution would be better. It's certainly our goal and it happens regularly with fibromyalgia and smoking for that matter.

You seem to think that treating means managing? No? If not, what is the final outcome of your treatments? Do you treat people indefinitely? And if not, what do you call it when they no longer need treatment (i.e. they are "cured")? Or does that not happen?

I'm certainly not in this profession to treat people indefinitely - that would be a waste of my time and a waste of my patients time, money, and energy. We treat for a full resolution of symptoms so people no longer need treatment. Sometimes this takes longer, sometimes shorter but it is always the goal.

You seem to have a problem with people who get results, yet every single time I ask you what you do for "x" condition you cannot talk. You are able to degrade my intellect, and say I'm turning your arguments around, and say things like "studies say" and not show any links to any of the studies you are speaking of - but when I ask you what you do so we can talk about acupuncture you say nothing? Why is that?