Low Level Laser For The Stimulation Of Acupoints For Smoking Cessation: A Double-Blind, Placebo-Controlled Randomised Trial And Semi-Structured Interviews. Kerr, C.M., Lowe, P.B. & Spielholz, N.I. (2008). Journal of Chinese Medicine 86: 46-51.
The results from this double blind placebo controlled trial did support the hypothesis that low level laser acupoint stimulation was significantly more effective than the placebo in bringing about a cessation in smoking behaviour and that the effectiveness continued up to six months. These can be summarised as follows:
First, both three and four low-intensity laser treatments, applied to specific ear and body acupoints as described, resulted in significantly higher proportions of individuals who ceased smoking for up to six months than did those exposed to placebo laser therapy.
Second, four laser treatments were associated with significantly higher proportions of individuals who ceased smoking for up to six months than did three laser treatments.
Third, the relative risk for stopping smoking for at least six months after these treatments were 3.4 for Group A versus Group C, 9.8 for Group B versus Group C, and 2.9 for Group B versus Group A. Thus, both laser therapy groups were associated with higher likelihoods of smoking cessation for up to at least six months than placebo, and four laser treatments were associated with an almost three-fold increase in smoking cessation compared to three laser treatments.
Subjective data from some subjects in this study suggested that laser acupoint stimulation took away their cravings. The craving experienced by all addicts is what mostly drives them to seek further doses of the drug. Without cravings there is no need to take the drug, hence more subjects in Groups A and B ceased smoking; they no longer desired a cigarette. Other participants in the study claimed that it was the feeling of calmness and reduced anxiety that made it possible for them to stop smoking. Smoking is a stimulant causing the body to produce more epinephrine and norepinephrine both of which accelerate cellular energy utilisation and mobilise energy reserves (Martini and Bartholomew 2003). The sensation to the smoker is that of increased awareness and faster heart rate and breathing. Laser therapy appears to raise the level of endorphin, a natural opioid (Han 1982, Strauss 1987, Karavis 1997), to the point where a sense of warmth and well being was experienced. Different physiological responses occur in all persons so it is possible that this subgroup may have produced more endorphins than others and so had an enhanced feeling of well being which would have promoted sleep and rest and contributed to the sense of well being that they remarked upon. This pleasant state encouraged abstinence from tobacco. (a. feeling of calmness and reduced anxiety not listed in table 5; b. isnt comment on endorphins just speculation in this study?)
Some of the group claimed to feel irritable and unable to concentrate although they experienced no cravings. Irritability is a recognised symptom of withdrawal and it is possible that these persons were not building up their own endorphin levels as quickly as others from within the groups. These persons would most probably have benefited from further laser treatment. If this could not be achieved then it seems highly that they would revert to smoking and this could go some way to explaining why many subjects within both treatment groups were not successful; they had simply not had enough laser treatment.
Statistical analysis between the treatment groups showed a significant difference between those who had had either of the laser treatments and the control. This lent further support to the theory for a physiological rebalancing of endorphins within the body induced by the stimulation of the acupoints. However it seems that the speed at which this rebalancing is achieved is different in each person and some may require more treatments while others need fewer. The significant difference in smoking cessation between Groups A and B would appear to support this.
A small number of subjects (8%) referred to the unpleasant taste of cigarettes when starting to smoke again after several weeks of non smoking. There was also reference to headaches (3%) but these were not well described and it was difficult make judgments about whether they were of importance to this study or just coincidence. Some persons referred to eating more than usual (11%) but none of the group had increased in weight during the six months when they were most closely monitored. This was verified by regular weighings undertaken at the beginning of the study and at intervals of three and six months.
The results that emerged from the data indicated that acupoint stimulation using lasers does indeed modify the physical symptoms of withdrawal and make it possible for motivated persons to succeed in overcoming habitual smoking of tobacco, and this was further supported by the subjective comments made by the participants themselves, especially during the treatment phases and at the follow ups at three and six months. It seems that therapy involving acupoint stimulation is best given as a course of several treatments on at least four and possibly more occasions. Further studies would be needed to determine the optimum number. With regards to the RCT we feel that further studies such as this one are required to strengthen our findings and our reservations are based mostly upon the quality of the participants. Although large in number it was that of a self-selecting sample and this casts doubt on how generalisable the outcomes of the study may be to the general population.
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