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Does laser therapy or acupuncture help smokers quit?

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I’m frequently asked about the effectiveness of acupuncture for stopping smoking, and more recently these questions have been about “laser therapy”. “Laser therapy” uses “cold lasers” instead of needles in an acupuncture-like treatment.

Unfortunately the existing evidence does not support the effectiveness of either of these treatments. The conclusion of the most recent Cochrane review was that:
“There is no consistent evidence that acupuncture, acupressure, laser therapy or electrostimulation are effective for smoking cessation”.
If you want to read the details of that review, click on
http://www.cochrane.org/reviews/en/ab000009.html

If you would like to view a Fox news item on this topic click on:
http://www.freedomlasertherapy.com/video/foxnews.htm

Over 10 years ago, when I was running a tobacco treatment clinic at St George’s Hospital Medical School in London, UK, we did a mini evaluation of a local laser therapy clinic. The clinic claimed very high quit rates, but that didn’t turn out to be the case. Basically I’d advise people wanting to quit smoking not to waste their time and money on laser therapy, but rather to make use of treatments that have been demonstrated to increase your chances of quitting smoking (counseling from a trained professional, NRT, Zyban or Chantix).

My report is reproduced below:

Brief Evaluation of the Laser Therapy Stop Smoking Centre (205 St John's Hill, Battersea).

INTRODUCTION

The charity QUIT, which aims to help and encourage smoking cessation provides a Quitline service. As part of this service smokers can phone the Quitline and be informed of smoking cessation treatment services in their local area. However, QUIT quite correctly do not feel it appropriate to direct customers to centres which make excessive and unsubstantiated claims as to their treatment's efficacy. This issue arose when the Battersea Laser Therapy Centre asked to be included on the QUIT register. QUIT was asked to use its good offices to persuade the Department of Health that Laser Therapy should be available in every NHS and Trust Hospital. The Battersea Clinic's Chief Executive, Mr Barry Murphy claimed that their treatment is about 90% successful and that this had been substantiated by a Department of Trade and Industry consultant. In addition he claimed that the treatment is quick, painless and that there are no withdrawal symptoms. Mr Peter McCabe, Director of QUIT, asked me to look into the treatment and decide whether or not these claims are likely to be accurate.

On discussing this with Mr Murphy he was very willing to be of help and suggested that I send along ten smokers with a serious desire to quit, and that I monitor their success. He also confirmed that the treatment is 90% successful, and that by this he meant that 90% of smokers who attend the clinic stop smoking completely and don't have another puff of tobacco for at least the following year. He admitted that they do not have any hard evidence to back up this claim. Although I was aware that ten subjects is not enough to prove anything, there is ample evidence in the scientific and medical literature suggesting that smoking cessation treatments rarely achieve one year success rates above 30% and therefore if even 6 or 7 of the subjects I sent to the clinic succeeded then that might warrant further investigation.

AIM

To evaluate the likelihood that the Battersea Laser Therapy Clinic achieves 90% one-year smoking cessation success rates.

METHOD

10 volunteer smokers with a strong desire to quit and a willingness to attend the Laser Therapy clinic for treatment were recruited by advertisement at St George's Hospital, Tooting. All the subjects were first of all interviewed by Jonathan Foulds in order to check that they were appropriate to refer to the Laser Therapy Clinic (ie highly motivated healthy smokers who would be willing to attend follow-up appointments).

SUBJECTS

A main subject characteristics are presented in the table. All the subjects stated that their desire to stop smoking was "quite strong" or "very strong", and every one of them had tried before. None of them had any serious concurrent medical problems. As indicated by the range of cigarettes per day and expired carbon monoxide, the sample included both light and quite heavy smokers. Generally, they were a fairly typical group of smokers' clinic clients.

Main Subject Characteristics

Number male/ female: 4/6
Mean Age (range): 34 (18-60)
Mean number of cigarettes per day (range): 20 (7-35)
Mean expired carbon monoxide (range): 16 (5-26)
Mean number of years of smoking (range): 17 (3-40)
Strength of desire to quit (0-4, 4=very strong): 3.6 (3-4)
Mean number of previous attempts to quit (range): 5 (1-20)

PROCEDURE

Once the subjects agreed to participate, an appointment was made for them to attend the Laser Therapy Clinic. It was arranged that in addition to attending the clinic they would be contacted by Jonathan Foulds one week after their "quit date" and then again in 2-3 months time in order to monitor progress. Subjects who claimed to be abstinent were asked to validate this by providing a measure of expired carbon-monoxide with a concentration of less than 10 parts per million.

RESULTS

Participation: All of the subjects attended the clinic at least once (range = 1-4 visits).

Smoking Cessation: At one week follow-up 3 of the 10 subjects had stopped smoking and not had a puff during the previous week. All had appropriately low expired carbon monoxide levels (6, 6 and 4 ppm). Of the other seven subjects one managed four days without a cigarette, three managed two days and three only managed to abstain for one day.
At 2-3 month follow-up only two subjects continued to abstain. All of the other subjects were smoking on a daily basis. Interestingly, the two who managed to abstain were by far the lightest smokers in the group. They had been smoking only 7 and 10 cigarettes per day over the past few years, and had expired carbon-monoxide levels of only 5 and 6 ppm at the pre-quit assessment interview.

Withdrawal Symptoms: Several of the subjects reported that they had experienced nicotine withdrawal symptoms and craving during the first week. For example, one subject said "I had a lot of craving, I was in a foul mood, felt miserable and restless. I had poor sleep and dreamt about smoking." Another commented, "They claimed I'd have no craving or irritability. I was disappointed because I was craving for a cigarette as soon as I left the clinic and felt very irritable... no different to previous times".

General Comments by Subjects: The subjects were generally appreciative of the clinic staff's positive attitude and the encouragement they received from the clinic. They did not find the laser treatment uncomfortable and a number commented on how relaxed they felt during the procedure. Three reported headaches after the first session and wondered whether this might have been caused by the laser. Some felt that the clinic made excessive claims about the treatment, eg one commented, "They claimed to be able to help loose weight, stop taking drugs, stress management, depression etc and gave the impression that the laser would take care of it....it can't be true".

DISCUSSION

The success rates found in this small group (30% at one week and 20% at around 10 weeks) are roughly what one would expect to find in a group of smokers who make a serious attempt to stop smoking on their own without any formal help. The fact that only the two lighter smokers stopped smoking suggests that the treatment lacks any ingredient which treats nicotine dependence. This sample is really far too small to come to any conclusions about the clinic's success rates. However, there is no indication or sign that it contains any unusually therapeutic ingredient and it is clear that the claim of 90% success is completely inaccurate. Similarly, the claim that the treatment eradicates craving and withdrawal symptoms would seem to be inaccurate.

One could argue that anything which encourages people to try to stop smoking is not such a bad thing. However, where this involves conning people into parting with large sums of money (eg £100) on the basis of false claims of high success rates this is clearly not in the public interest. Such individuals may consequently fail to obtain effective help to stop smoking, and deserve the right to make decisions about their treatment on the basis of accurate information.

A review of the effectiveness of acupuncture for smoking cessation (Schwartz, 1988) found only one study which attempted to biochemically validate claimed successes. This study found a success rate of 8% at 13 months. The review also commented, "There is no evidence from this review that acupuncture may relieve withdrawal symptoms. It has not been demonstrated that acupuncture is able to promote smoking cessation". Nothing from this small evaluation suggests that laser therapy is able to promote smoking cessation either.

CONCLUSION

This brief evaluation found no evidence to substantiate the claim that Laser Therapy is 90% effective in helping smokers to quit, or in relieving withdrawal symptoms and craving. In fact the short term success rate was only 20%, and a number of subjects experienced strong craving and withdrawal symptoms.

The Laser Therapy Centre and those who are associated with it should immediately cease to make excessive and unsubstantiated claims about the effectiveness of the treatment and should withdraw any material which makes such claims.



Jonathan Foulds
Chartered Clinical Psychologist
Lecturer in Tobacco Addiction, St George's Hospital Medical School
December 1996
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About the Author


MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.

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