Electroacupuncture as a Non-Pharmacological Intervention for Nicotine Dependence: Evidence from a Randomized Clinical Trial

Nicotine dependence, a chronic addictive disorder characterized by high relapse rates, represents a significant global public health challenge. This study employed a randomized, single-blind, parallel-group controlled design to systematically evaluate the efficacy and safety of electroacupuncture compared with varenicline in the treatment of nicotine dependence. The results demonstrated that electroacupuncture achieved significantly superior outcomes across multiple key outcome measures relative to varenicline: the electroacupuncture group exhibited a greater mean daily reduction in Fagerström Test for Nicotine Dependence (FTND) scores (-1.11 points/day vs -0.33 points/day, P < 0.001) and a higher rate of sustained improvement at the 3-month follow-up (84.4% vs 69.5%). With respect to the Heaviness of Smoking Index (HSI), the electroacupuncture group showed a more rapid and sustained decline (sustained rate: 81.7% vs 63.9%, P = 0.002). Moreover, electroacupuncture demonstrated significant advantages in alleviating nicotine withdrawal symptoms (sustained rate: 75.3% vs 52.8%, P = 0.026) and reducing daily cigarette consumption (79.0% vs 56.2%, P < 0.001). The potential mechanism may involve modulation of the mesolimbic dopamine system. These findings support electroacupuncture as a safe, effective, and sustainable non-pharmacological intervention for smoking cessation, particularly suitable for individuals with high nicotine dependence who are sensitive to adverse drug reactions or exhibit poor medication adherence, and suggest its potential role as a complementary or alternative strategy in clinical smoking cessation programs. Future research should further validate its long-term efficacy and investigate the neurobiological mechanisms underlying its effects on relapse prevention.