Complementary and Alternative Therapies in Tobacco Cessation: A Systematic Review

Background and aims: Tobacco use is a widespread preventable cause leading to death resulting from noncommunicable diseases.As there are limited choices for assisting tobacco users in quitting, complementary and alternative therapies (CATs) have also been tried to facilitate the quitting process.This study aimed to evaluate the efficacy of these CATs in tobacco cessation.Materials and methods: The systematic review was registered in PROSPERO, and the literature search was conducted in four electronic repositories: PubMed, Web of Science, Scopus, and the Cochrane Library.Randomized clinical trials (RCTs) evaluating the success of the various CATs in facilitating tobacco cessation were included in the study.The Cochrane Risk of Bias tool (ROB2) was used to determine the risk of bias in the full-text articles considered for qualitative evaluation.Results: Utilizing the assigned keywords, the search strategy was applied, and a total of 748 articles were obtained.The outcome data and the quality of the studies were assessed independently by two reviewers.RCTs conducted using the different CATs for tobacco cessation were included, and after full-text screening, the risk of bias was assessed for 26 articles.The various CATs that have been tried for tobacco cessation are acupressure, acupuncture, enjoyable and motivating activities, yoga, meditation, hypnotherapy (HT), guided imagery, transcranial direct current stimulation (tDCS), aromatherapy, virtual reality (VR), and the approach bias modification (ApBM) procedure.Acupuncture and ear acupressure therapies demonstrated a low risk of bias but showed no significant difference compared with sham therapy.The effectiveness of the other CATs cannot be fully established, as few studies showed some concerns, and a few had a high risk of bias. Conclusion:CATs can be used as adjunctive approaches in tobacco cessation, particularly for addressing psychological triggers and withdrawal symptoms.Further validation through meticulous and large-scale clinical trials is needed.Integrating CATs into standard cessation protocols can offer a holistic pathway to improve quit rates and reduce tobacco-related harm.