World No Tobacco Day falls on Thursday when many smokers will try to abstain for just one very long day. For those who want to really kick the habit, acupuncture may help. Zhang Qian takes a deep breath and tells how.

Roughly 320 million Chinese adults are regular smokers, and an estimated 1 million smoking-related deaths occur each year. Reduction in the numbers is negligible and more young people and women are picking up cigarettes.

Research in 2010 showed that 356 million people smoke regularly or occasionally, including young people.

Most people acknowledge that smoking is dangerous to their health, causing cancer and heart disease and contributing to stroke, and many people say they want to quit. But the addiction is powerful and many people are fearful of uncomfortable withdrawal symptoms and pessimistic because of the high failure rate of those who try to kick the habit and fail. Many fail repeatedly.

There's a long list of painful withdrawal symptoms: intense cravings, headaches, dizziness, coughing, agitation, anxiety, insomnia, fatigue, depression, irritability and lack of focus, among others. And there's psychological addition that makes it difficult to stop smoking for long. Pressure from work, family and daily life increase the urge to smoke.

On Thursday, the 25th World No Tobacco Day, smokers are urged to try to abstain for one day and seriously consider giving up tobacco for good.

Apart from widely used nicotine-replacement therapies, traditional Chinese medicine therapies have been proved effective in reducing cravings and easing withdrawal symptoms, making it easier to fight the addiction. Experts warn there is no silver bullet, but say acupuncture and some herbal treatments can help.

Will power alone usually isn't enough. The temporary brain stimulation from nicotine and the physical discomfort when nicotine levels in the blood drop are the major causes of withdrawal or abstinence syndrome.

TCM approach

Western doctors frequently prescribe nicotine replacement therapy that gradually reduces the delivery of nicotine. This still provides some brain stimulation while preventing the damage caused by tar and other components of cigarette smoke. Drugs to reduce cravings, nervousness and anxiety may also be prescribed.

By contrast, the TCM approach involves acupuncture with needles and pressing acupuncture points in the ear (auricular acupoint pressure) - which are linked with the brain and reduce cravings and withdrawal symptoms.

TCM is still new in the anti-smoking medical treatment but it has made advances in smoking cessation without the use of drugs, according to Dr Tang Jie, chief physician of the Respiratory Department of Yueyang Hospital attached to Shanghai University of TCM. It has also been used in other kinds of addiction to ease cravings and withdrawal discomfort.

Interference through energy channels is the way acupuncture works in treating drug and smoking addition.

"Modern research shows that acupuncture on certain points can provide brain stimulation similar to nicotine, thus preventing and relieving the symptoms caused by lack of nicotine. And this can help in quitting smoking," according to Dr Yang Jinsheng of the China Academy of TCM .

Body and ear acupuncture

"Though the will power to quit is still important, the much-reduced withdrawal syndrome will make quitting much easier and increase the patient's confidence in his or her ability to quit," Dr Tang of Yueyang Hospital says.

Traditional acupuncture body points like lie que, bai hui, nei guan and he gu also reduce craving and relieve discomfort. It is recommended to have professional acupuncture therapy two to three times a week. For longer therapeutic effects, it's recommended to stimulate acupuncture points on the ear by means of tiny seeds or pellets attached with plaster just above those points. Then patients rub those spots on their ears, the more the better.

Since ear is a "reflective region" for almost all the organs and energy channels in the body, stimulating its acupuncture points has effects similar to acupuncture elsewhere on the body. TCM compares the shape of the ear to an inverted fetus or "upside down little man" and the lobe of the ear corresponds to specific places in the head and brain.

"Press and rub the points hard until they feel sore and do it whenever your hands are free," Dr Tang recommends. Generally, the seeds can stay in place for five to seven days in winter, while only three days in summer heat, because of sweating and loosening of the plaster. If seeds are missing, patients should see a doctor for replacement.

Special clinics to help smokers quit have been opened in some TCM hospitals in Shanghai, including Yueyang Hospital. An over-all evaluation of the patient will be made before therapy is prescribed. That includes checking the lungs, cardiovascular condition and general condition as well as the level of addiction.

For heavy smokers who have failed to quit, acupuncture and ear acupoint pressing is often prescribed. For those with severe withdrawal symptoms, herbal medication is usually prescribed in addition.

"It usually takes three to six months for a complete course of treatment and psychological support from family and friends is always necessary," Dr Tang says. "Only by ending physical and psychological reliance on cigarettes can a patient say 'no' to tobacco for good."

He gu

Location: On the dorusm of the hand; between the 1st and 2nd metacarpal bones; on the radial side of the midpoint of the 2nd metacarpal bone.

Benefits: help relieve headache, sore throat and constipation. It also helps smokers taste bitter when smoking, so as to break the reliance.

Lie que

Location: about 5cm above the wrist crease, superior to the styloid process of the radius.

Benefits: help restrict smoking addiction, relieve coughing, difficult breath, phlegm and other discomfort related with smoking.

Tim-Mee

Location: on the wrist near the base of the thumb

Benefits: help restrict crave for cigarette

Zu san li



Location: 9cm below the sunken point in the knee, one finger width lateral from the anterior border of the tibia.

Benefits: help benefit the digestive system, solve phlegm and relieve coughing. It also helps relieve discomfort caused by smoking, such as difficult breath, coughing and sore throat.