Table 4.

Original investigations of acupuncture therapy effects in nicotine-dependent subjects

Publication year; first author		Objectives	Subjects	Stimulated acupoints (acupuncture type, acupoints, frequency)	Assessments	Outcomes
2004	Chae [21]	To investigate the acupuncture effects on the functional alterations of the mesolimbic dopaminergic systems	35 Male Sprague–Dawley rats	Acupuncture at Zusanli (ST36), Shenmen (HT7), or Taiyuan (LU9) for 4 days	Nicotine-induced FLI in the striatum and the nucleus accumbens	acupuncture had a therapeutic effect on nicotine addiction
2005	Park [65]	To examine whether the DRD2 TaqI A polymorphism is associated with the response to acupuncture	231 Healthy Korean male smokers	AA at lung, throat, Shenmen (HT7), and endocrine points for 96 s, 3 times for a week	Cigarette consumption, the desire to smoke, and Genomic DNA extracted from blood samples	Acupuncture was effective to influence the DRD2 TaqI A polymorphism
2008	Chae [20]	To investigate the effect of acupuncture on anxiety-like behavior and corticotrophin-releasing factor (CRF) and neuropeptide Y (NPY) mRNA expression in the amygdala during nicotine withdrawal	38 Male Sprague–Dawley rats, n = 18 acupuncture	Acupuncture at Zusanli (ST36), Shenmen (HT7), 30 s for 3 days	The anxiogenic response by using an elevated plus maze. CRF and NPY mRNA levels by using reverse transcription polymerase chain reaction (RT-PCR) analysis	acupuncture attenuated anxiety-like behavior following nicotine withdrawal
2008	Bonnette [15]	To explore the effects of ATENS in combination with addiction education, behavioral training and coaching	6 Smokers	Acupuncture at 5 NADA protocol or 1-3 points, 5 times a week for 8 weeks	In-depth interviews for withdrawal symptoms, anxiety and stress levels	auriculotherapy relieved withdrawal symptoms and reduced anxiety and stress levels during the detoxification
2009	Yeh [83]	To evaluate the effects of a 6-week acupoint stimulation program for quitting	59 Smokers	Acuouncture at Shenmen (HT7), lung, stomach, mouth and endocrine and Tim mee for 20 min, once a week for 6 weeks	Demographic factors, serum cotinine, carbon monoxide exhalation, daily tobacco consumption, and quit smoking rate of participants before and after the 6-week intervention	Acupuncture showed no statistically significant effect on quitting smoking
2010	Thanavaro [72]	To explore the efficacy of ATET as an adjunctive treatment to intensive individual counseling on smoking cessation	29 Subjects	Auricular transcutaneous electrostimulation therapy at 10 areas on the pinna	The “Fagerstrom Test for Nicotine Dependence,” the “What Are Your Triggers Test” and the “Why Do I Smoke Quiz.”	individual counseling may produce smoking cessation rates comparable to counseling with pharmacotherapy
2010	Chae [18]	To investigate the effect of acupuncture on the selective attention to smoking-related visual cues	29 Smokers	Acupuncture, Shenmen (HT7), (NA)	The attentional bias and cigarette withdrawal scale	Acupuncture ameliorated the smoking withdrawal symptoms as well as the selective attention to smoking-related visual cues
2011	Chae [19]	To investigate effects of acupuncture on ameliorating cigarette withdrawal symptoms	29 Smokers, n = 15 acupuncture	Acupuncture at Shenmen (HT7) or Shousanli (LI10), 20 min for 3 days	The cigarette withdrawal scale (CWS), comparing the low-frequency/high-frequency (HF/LF) ratio in the HRV of the RA and SA groups	acupuncture attenuated withdrawal symptoms and smoking cues-induced autonomic responses
2013	Kang [38]	To investigate acupuncture effects on ameliorating cravings induced by smoking-related visual cues	25 Male smokers	Acupuncture at Shenmen (HT7) for 1 min	fMRI and craving scores to smoking-related visual cues were assessed before and after RA or sham treatment	acupuncture alleviated cue-induced cravings through the regulation of activity in brain regions involved in attention, motivation, and reward

Acupoints in NADA protocol are located at (sympathetic: in the deltoid fossa at the junction of the infra-antihelix crus and the medial order of the helix, lung: in the center of the cavum concha, liver: located in the posterior to upper portion of the helix crus, kidney: in the cleft between the upper plateau, and the helix)