Comparative Evaluation of the Effect of Pharmacotherapy, Low-Level Laser Therapy, and Behavioral Counseling on Tobacco Cessation: A Parallel Randomized Clinical Trial

Document Type : Original Article

Authors

Unit of Public Health Dentistry, Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India

10.34172/ahj.1673

Abstract

Background: Nicotine lozenges help reduce nicotine gradually. They are a discreet NRT alternative. This study compared nicotine dependence, cotinine levels, quit rates, and physical effects before and after one month of NRT lozenges, laser therapy, and counselling.
Methods: This randomised controlled trial tested nicotine lozenges, laser therapy, and counselling. This trial included 75 participants (25 per group) over one month. Seventy-five participants were divided into three groups of 25. The “Jus-Check™ Rapid Nicotine Test” was used. Laser therapy targeted both ears weekly for four weeks, with counselling provided weekly. Primary outcomes included nicotine dependence, cotinine levels (saliva/urine), and quit rates; whereas, secondary outcomes included physical effects before and after intervention.
Findings: The results showed a significant decrease in nicotine dependence and cotinine (P < 0.001) in all groups. However, differences between groups and quit rates were not statistically significant.
Conclusion: Nicotine lozenges are as effective as laser therapy and counselling for quitting smokeless tobacco. This approach reduces dependence, lowers cotinine, increases quit rates, and improves physical effects.

Highlights

Mahesh Ravindra Khairnar(Google Scholar)(Pubmed)

Keywords

References

  1. Tiwari RK, Sharma V, Pandey RK, Shukla SS. Nicotine addiction: neurobiology and mechanism. J Pharmacopuncture. 2020;23(1):1-7. doi: 10.3831/kpi.2020.23.001
  2. Parsons LH, Hurd YL. Endocannabinoid signalling in reward and addiction. Nat Rev Neurosci. 2015;16(10):579-94. doi: 10.1038/nrn4004
  3. Tata Institute of Social Sciences (TISS), Ministry of Health and Family Welfare, Government of India. Global Adult Tobacco Survey India, 2016-17 (GATS 2 India). Available from: https://ntcp.mohfw.gov.in/assets/document/surveys-reports-publications/Global-Adult-Tobacco-Survey-Second-Round- India-2016-2017.pdf.
  4. Agaku IT, King BA. Validation of self-reported smokeless tobacco use by measurement of serum cotinine concentration among US adults. Am J Epidemiol. 2014;180(7):749-54. doi: 10.1093/aje/kwu182
  5. Post A, Gilljam H, Rosendahl I, Meurling L, Bremberg S, Galanti MR. Validity of self-reports in a cohort of Swedish adolescent smokers and smokeless tobacco (snus) users. Tob Control. 2005;14(2):114-7. doi: 10.1136/tc.2004.008789
  6. Collins SE, Witkiewitz K, Kirouac M, Marlatt GA. Preventing relapse following smoking cessation. Curr Cardiovasc Risk Rep. 2010;4(6):421-8. doi: 10.1007/s12170-010-0124-6
  7. Borup G, Mikkelsen KL, Tønnesen P, Christrup LL. Exploratory survey study of long-term users of nicotine replacement therapy in Danish consumers. Harm Reduct J. 2015;12:2. doi: 10.1186/1477-7517-12-2
  8. Chon TY, Lee MC. Acupuncture. Mayo Clin Proc. 2013;88(10):1141-6. doi: 10.1016/j.mayocp.2013.06.009
  9. Li DP, Kong LH, Qin R. Meta-analysis of clinical efficacy of acupuncture in treating simple obesity. J Hubei Univ Tradit Chin Med. 2014;16(4):100-2.
  10. Ebbert JO, Severson HH, Croghan IT, Danaher BG, Schroeder DR. A randomized clinical trial of nicotine lozenge for smokeless tobacco use. Nicotine Tob Res. 2009;11(12):1415- 23. doi: 10.1093/ntr/ntp154
  11. Goniewicz ML, Zymełka A, Czogała J, Koszowski B. [Problems of abuse of and dependence on Nicotine Replacement Therapy (NRT)]. Przegl Lek. 2006;63(10):1119-22. [Polish].
  12. Panos NG, Tesoro EP, Kim KS, Mucksavage JJ. Outcomes associated with transdermal nicotine replacement therapy in a neurosurgery intensive care unit. Am J Health Syst Pharm. 2010;67(16):1357-61. doi: 10.2146/ajhp090402
  13. National Cancer Institute. Clinical Trial Randomization Tool. Available from: https://ctrandomization.cancer.gov/.
  14. Stuyt EB, Voyles CA. The National Acupuncture Detoxification Association protocol, auricular acupuncture to support patients with substance abuse and behavioral health disorders: current perspectives. Subst Abuse Rehabil. 2016;7:169-80. doi: 10.2147/sar.S99161
  15. Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO. The Fagerström test for nicotine dependence: a revision of the Fagerström tolerance questionnaire. Br J Addict. 1991;86(9):1119-27. doi: 10.1111/j.1360-0443.1991. tb01879.x
  16. Yavagal PC, L N. Efficacy of laser auricular acupuncture for smoking cessation: a randomised controlled trial. Sultan Qaboos Univ Med J. 2021;21(2):e275-81. doi: 10.18295/ squmj.2021.21.02.017
  17. Velangi CS, Yavagal PC, Nagesh L. Role of auricular laser acupuncture and psychological counseling in reducing nicotine dependence due to smoking: a randomized controlled trial. Indian J Public Health. 2021;65(3):243-9. doi: 10.4103/ijph.IJPH_810_20
  18. Hand S, Edwards S, Campbell IA, Cannings R. Controlled trial of three weeks nicotine replacement treatment in hospital patients also given advice and support. Thorax. 2002;57(8):715-8. doi: 10.1136/thorax.57.8.715
  19. Dar R, Stronguin F, Etter JF. Assigned versus perceived placebo effects in nicotine replacement therapy for smoking reduction in Swiss smokers. J Consult Clin Psychol. 2005;73(2):350-3. doi: 10.1037/0022-006x.73.2.350
  20. Pai A, Prasad S. Attempting tobacco cessation--an oral physician’s perspective. Asian Pac J Cancer Prev. 2012;13(10):4973-7. doi: 10.7314/apjcp.2012.13.10.4973
  21. Raja M, Saha S, Mohd S, Narang R, Reddy LV, Kumari M. Cognitive behavioural therapy versus basic health education for tobacco cessation among tobacco users: a randomized clinical trial. J Clin Diagn Res. 2014;8(4):ZC47-9. doi: 10.7860/jcdr/2014/8015.4279
  22. Kerr CM, Lowe PB, Spielholz NI. Low-level laser for the stimulation of acupoints for smoking cessation: a double-blind, placebo-controlled randomised trial and semi-structured interviews. J Chin Med. 2008(86):46-51.
  23. Lim RC. Painless laser acupuncture for smoking cessation. Med Acupunct. 2018;30(3):159-62. doi: 10.1089/acu.2018.1295
Addiction & Health
Volume 18
Pages 1-9

Files

Share

How to cite

Statistics