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Effects of Intensive Electroacupuncture on Nicotine Withdrawal and Withdrawal-Related Sleep Symptoms in Patients with Nicotine Dependence: A Three-Arm Randomized Controlled Trial

Year: 2026

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: Background: Whether intensive electroacupuncture (EA) during early nicotine withdrawal improves symptom trajectories remains unclear. Objective: To compare intensive EA with low-density EA and varenicline for withdrawal symptoms and explore withdrawal-related sleep symptoms. Methods: In this single-center, three-arm, open-label randomized trial, 114 participants were allocated equally to intensive EA, low-density EA, or varenicline for 4 weeks. EA was administered daily or every other day during week 1, respectively, and three times weekly during weeks 2-4. Outcomes were assessed at baseline, weeks 1-4, and 1 and 3 months after treatment. The main outcome for the present analysis was the week-1 change in Minnesota Nicotine Withdrawal Scale (MNWS) total score. Withdrawal-related sleep symptoms were assessed exploratorily using a score derived from two MNWS sleep-related items. Analyses used analysis of covariance and generalized estimating equations, with exploratory analyses of time-averaged symptom burden and post-treatment changes. Results: Per-protocol analyses included 110 participants. At week 1, intensive EA was associated with lower adjusted MNWS scores than varenicline (mean difference, -5.75; 95% CI, -6.95 to -4.55) and low-density EA (-5.88; 95% CI, -7.08 to -4.67). Exploratory analyses suggested improvements in craving and withdrawal-related sleep symptoms. The proportions with exhaled carbon monoxide ≤4 ppm at 3 months after treatment were 29.7%, 18.9%, and 13.9% in the intensive EA, varenicline, and low-density EA groups, respectively (overall p=0.234). Conclusion: Intensive EA may alleviate withdrawal symptoms during early smoking cessation. Exploratory sleep findings require confirmation. The study did not establish a benefit for smoking abstinence, and longer follow-up is needed.

Source: Therapeutics and Clinical Risk Management

DOI: 10.2147/tcrm.s639287