Acupuncture for smoking cessation

An overview of systematic reviews

Bibliographic Data

ID22070710
AuthorsShun Fan (National Clinical Research), Jixuan Wang (National Clinical Research, corresponding author), Xiaoyu Wang (0000-0002-6800-1275, National Clinical Research), Haining Zhang (0000-0002-4367-4369, National Clinical Research), Huanan Li (0000-0002-8834-4320, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine), Jianwu Wang (0000-0002-9933-1170, National Clinical Research), Wei Zhang (0000-0002-5458-9581, National Clinical Research, corresponding author), Jingui Wang (0000-0001-9947-9821, National Clinical Research, corresponding author)
Year2026
Volume13
Pages1677231-1677231
Publication date2026-01-15
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1677231
PMID41626375
OpenAlexW7124285472
LanguageEN
References cited35

Background An increasing number of randomized controlled trials (RCTs) investigated various forms of acupuncture for smoking cessation; however, their findings remain inconsistent, and substantial controversy persists regarding both its efficacy and safety. Objectives This overview aimed to synthesize the outcome evidence presented in existing systematic reviews (SRs) on acupuncture for smoking cessation, appraise the methodological quality of the included SRs, and re-evaluate the primary outcomes. Methods A comprehensive literature search was conducted in eight databases from inception to December 31, 2024, with no language restrictions. Two independent reviewers screened the eligible studies. The methodological quality of the included SRs was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The Risk of Bias in Systematic Reviews (ROBIS) tool was used to evaluate potential bias. Reporting quality was assessed with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. The certainty of evidence from the SRs was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. After removing duplicate randomized controlled trials, we re-conducted meta-analysis for the primary outcomes using R software version 4.4.2 and TSA Viewer version 0.9.5.10, and performed trial sequential analysis (TSA) to examine the reliability and robustness of the findings. Results This overview included 10 SRs, covering 74 RCTs. Using AMSTAR 2, ROBIS, and PRISMA 2020 for evaluation, we found that the methodological quality, risk of bias, and reporting quality of the 10 SRs were unsatisfactory. The quality of evidence evaluated by GRADE was mostly rated as low or critically low; however, acupuncture appeared to contribute to improved abstinence rates. In the updated meta-analysis, acupuncture showed superiority over sham acupuncture for short-term abstinence (RR = 1.37, 95% CI: 1.08, 1.73, p = 0.0092) and outperformed waiting list controls ( p = 0.0204). However, no significant benefits were observed for long-term abstinence compared to sham, nor was acupuncture superior to nicotine replacement therapy or behavioral therapy. Furthermore, TSA indicated that the required information size was not reached, suggesting a risk of false-positive findings for the short-term benefit. Conclusion Although the evidence for acupuncture in smoking cessation remains insufficient, acupuncture appears to improve short-term abstinence rates. However, substantial heterogeneity and methodological limitations were identified. TSA suggested a potential risk of false-positive findings, highlighting the need for further high-quality research. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42023473514 , identifier CRD42023473514

Acupuncture · Alternative medicine · Identifier · MEDLINE · Systematic review · Acupuncture Treatment Research Studies · Meta-analysis and systematic reviews · Smoking Behavior and Cessation