Case Report

Treatment for Smoking Addiction without the Use of Any Medication

Huang Wei Ling*

Medical Acupuncture and Pain Management Clinic, Franca, Sao Paulo, Brazil

*Corresponding author: Huang Wei Ling, Medical Acupuncture and Pain Management Clinic, Rua Homero Pacheco Alves, Franca, Sao Paulo, Brazil. Tel: (+55 16) 3721-2437; E-mail:

Citation: Huang WL (2019) Treatment for Smoking Addiction without the Use of Any Medication. J Pul Med Respi Ther 2019: 18-27

Received Date: 21 November, 2018; Accepted Date: 29 January, 2019; Published Date: 18 February, 2019


Introduction: Smoking addiction is a widespread problem around the world. The main source of addiction is nicotine (found in tobacco products), which is a colorless, water-soluble substance that acts on the nervous system by sending messages to receptors in the brain to release dopamine.

Presently, the most common medical treatment for smoking addiction is done with the use of antidepressant medications.

Purpose: The purpose of this study is to demonstrate that the treatment of smoking addiction can be done without the use of any drugs, because when high-concentrated drugs are used for this aim they can be harmful to the patients’ health.

Methods: The method used is documented in two case studies. The first patient was a 40-year-old male who was addicted to cigarettes for 32 years and tried acupuncture treatment to stop his smoking habit. The second case was a 21-year-old male, who had testicular cancer and had undergone treatment to stop smoking with antidepressants.

Findings: Both patients were able to stop smoking with reduced abstinence-symptoms and no relapses, using only acupuncture and Chinese dietary therapy.

Conclusion: We can conclude that it is possible to treat smoking addiction without the use of any kind of medication. As demonstrated by these two case studies, acupuncture and Chinese dietary therapy can remove the smoking addition. In this study, if the use of high-concentrated drugs was maintained, it could result in a decline in the health of both patients.

Keywords: Acupuncture; Antidepressants Medication; Arndt-Schultz’s Law; Diet; Energy; Smoking Addiction; Traditional Chinese Medicine


Smoking addiction is a widespread problem around the world [1-3]. The habit of smoking is associated with a range of diseases such as pulmonary and throat cancer. Smoking increases the risk for:

  • Coronary heart disease by 2 to 4 times,
  • Stroke by 2 to 4 times,
  • Men developing lung cancer by 25 times, and
  • Women developing lung cancer by 25.7 times [1].

Many people seek treatment to this problem by the use of antidepressants for treatment, such as Buproprion and Nortriptyline [4]. However, the number of patient relapses is 50% in the first year and the antidepressant medications being used have a range of negative side effects [5]. Traditional Chinese Medicine (TCM) proposes an alternative treatment with little to no side effects [6-7].


The purpose of this study is to demonstrate that the treatment of smoking addiction can be done without the use of any drugs. Another goal is to emphasize the avoidance of all high-concentrated drugs, such as antidepressants, (the most frequently used medication for the treatment of smoking addiction). According to the Arndt-Schultz law, these drugs may be considered harmful to the patients’ health, decreasing the patients’ vitality and causing other health complications that worsen the patients’ quality of life.


The methods used are described in two case studies of patients who were chronic smokers (referenced herein), and other documented reviews of current treatments for smoking addiction in the Western and Oriental cultures.

In Case Report 1 patient was 40-years-old, had never done any previous treatment for his smoking addiction, and was able to stop smoking in 21 days without the use of any drugs.

The Case Report 2 patient was 21-years-old, started smoking when he was 15, and had been smoking for around five years. He tried to stop when he was 17 by the use of the antidepressant Buproprion. He used Buproprion for four years. The medication was helpful in the first year of intake in which case the patient was able to stop smoking for 12 months. Nevertheless, the patient relapsed and resumed his smoking habit while continuing to use the antidepressant Buproprion. With acupuncture sessions twice a week, auricular acupuncture and Chinese dietary counselling, the patient stopped smoking in the second week of treatment, with no relapses until now, four months later. He was also able to stop the intake of Buproprion during the acupuncture treatment.

Case Report 1

Male, M.F.S, 40-year-old, obese, teacher in the business area. The patient started smoking young, quickly became addicted and had been a smoker for 32 years. The addiction was compromising his financial and body health. However, it was extremely hard for him to stop.

According to the patient, the habit of smoking was very pleasurable. In the beginning, the cigarettes appeared to be a good way of gaining energy, controlling his anxiety, and provided him a feeling of calm. He rapidly became dependent and he was aware of his dependency.

He sought out the services of Traditional Chinese Medicine, where he was diagnosed with Qi, Yin and Yang deficiency associated with Heat retention. Through auricular acupuncture sessions, associated with apex ear bloodletting and Chinese dietary nutrition advice, the patient was treated and was able to stop smoking.

He was oriented to avoid cold water, dairy products, raw foods, foods of sweet flavor, coffee, soda, matte tea, fried food, chocolate, honey, white flour, coconut, eggs and alcoholic beverages.

He went to auricular acupuncture with mustard seeds sessions, twice a week, and stopped smoking 21 days after his first session. According to him, the treatment was exceptional and extremely effective. He did not suffer from any cigarette-abstinence symptoms nor has he had any relapses.

Case Report 2

The second patient, male, 21-year-old, start smoking as a teenager, when he was 15. He was a smoker for two years, and started a treatment with the use of an antidepressant called Bup (Buproprion) in order to quit the addiction.

With the use of antidepressants, the patient was able to stop smoking in the first year (approximately for a 12-month period). In the meantime, the patient developed a cancer in the left testicle that was surgically removed, and a medium sized tumor in the thorax region. This tumor has since diminished and is presently dormant.

Due to the emotional pressure of the disease, the end of a relationship and an abrupt change of city; he started smoking again. His mother recommended the acupuncture treatment, in order to solve his smoking addiction, when he was 21-years-old, and the patient decided to go.

The TCM’ diagnosis was Yin, Yang, Qi and Blood deficiency, associated with Heat retention. Currently, the patient does acupuncture sessions twice a week and stopped smoking in the second week of treatment without any relapse.

As a background, the patient presented numerous allergies all over the body, which he has had since birth. He was an overweight child and has had breathing problems, jaundice, redness in the skin, and acne over the years.

After the acupuncture treatment, the patient also presented a significant improvement in his skin condition.

Auricular Acupuncture Points Used in Case 1 and 2

The acupuncture points used in both cases are represented in figure 1. For treating smoking addiction, auricular acupuncture points are used were:

Shen Men to treat anxiety, Kidney to treat Yin and Yang disharmonies, Liver, Lung, and Spleen to treat the Blood Deficiency; and Large Intestine to facilitate the detoxification and elimination of feces, and Hunger point to treat the increase of appetite related to the smoking withdrawals.

The auricular acupuncture treatment is done with small square pieces of adhesive tape with two mustard seeds each and they are fixed to the ear at the chosen points [8-11]. 


Figure 1: Auricular Acupuncture points


The treatment is usually performed twice a week in the first ten sessions, and then maintained once a week for 10 more sessions. The patients are instructed to press the auricular points with the index finger three times per day for one minute each time. The patients are instructed to remove the seeds on the same day of the next session, to allow the ear to rest before the next application. The patients are also advised to clean the ear with alcohol, before the next procedure.

The treatment is determined according to the patient’s anamnesis in the Western Medicine diagnosis, and to the patient’s energy disturbances according to Traditional Chinese Medicine [8-11]. 

Auricular acupuncture and acupuncture with needles were used in the second patient (The first patient used only auricular acupuncture). The focus in this treatment is not only to cure the symptoms, but also to treat the patient as a whole, in his energy level, treating Yin, Yang, Qi, Blood and Heat retention.  

The systemic acupuncture points used in the treatment were bilateral LR3, ST36, GB34, CV4, CV6, CV12, ST25, CV17, BL23 and Bitong. The needle used for the systemic acupuncture procedure was made of stainless steel, 25 x 40 mm. Specifically, for the Bitong point figure 2, the needling time was 15 minutes. The other points were only needled during his exhalation, and taken out during inhalation. This procedure was performed to not weaken the patients’ energy, as the patient was already with his energy weakened (deficiency of Yin, Yang, Qi, Blood and Heat retention).

The Bitong point is used specifically for the treatment of smoking addiction, because it worsens the cigarette taste, diminishing the pleasure in smoking. 


Figure 2: Bitong Point



The treatment proposed (use of auricular acupuncture, systemic acupuncture, Chinese dietary nutritional therapy and moxibustion) was effective for both case studies described by assisting in the quit smoking process without any abstinence-symptoms and with no relapses.

In the Case Report 1, the treatment proposed was also able to help him to lose weight, diminish anxiety, improve sleep and decrease pain in the body.

In the Case Report 2, the treatment proposed was also able to help him to diminish anxiety, improve the skin condition, sweat less, eat less, gain wait and to feel more vivid.

These results were achieved because the treatment balanced the four energies, Yin, Yang, Qi and Blood, and released the Heat Retention. Acupuncture was also important to regulate the energy flow, diminishing anxiety and the necessity of smoking.

The treatment also did a gradual withdrawal of the anti-depressant drug, taken by the patient of the Case Report The second patient reported the following symptoms and sensations in the first days of cigarette withdraw:

  1. Energy Peaks and Fatigue During the First Days;
  2. Shortness of Breath;
  3. Stuffy Nose;
  4. Tickle in The Throat;
  5. Deeper Sleep;
  6. Hunger Reduction, But More Appetite;
  7. More Sensibility to The Sunlight;
  8. More Resistance to The Sun Heat;
  9. Less Perspiration;
  10. More Concentration, With Dispersion Peaks;
  11. More Need for Candy
  12. Less Urinary Urgency. 

According to the patient’s report, these symptoms disappeared in a few days, after the first withdraw phase.


With the purpose of understanding the importance of the subject, the diseases associated to with smoking addiction will be described, together with the benefits of quitting smoking. The Western medicine view of addiction will also be described, followed by the current common treatments for the smoking addiction, such as Nicotine Patches, Electronic Cigarettes and Antidepressants.

In addition, Traditional Chinese Medicine perspective will be described, as well as the way they comprehend the addiction and how they treat it. The main principles of TCM will also be described, with the main purpose of comprehending the reasoning basing TCM.

Diseases Associated to Smoking

Smoking increases the risk of developing cancer in different areas of the body, such as bladder, blood (acute myeloid leukemia), cervix, colon and rectum (colorectal), esophagus, kidney and urethra, larynx, liver, oropharynx (includes parts of the throat, tongue, soft palate, and the tonsils), pancreas, stomach and trachea [1].

The list of hazards related to smoking is huge. The habit is also associated with fertility problems, making it harder for women to get pregnant. When the mother smokes during pregnancy, a range of other different risks also appear, such as preterm delivery, stillbirth, low birth weight, sudden infant death syndrome, ectopic pregnancy and facial clefts in infants [1]. For men, smoking can diminish the male sperm count [12].

Smoking is also associated with bone health. It also affects the health of teeth and the mouth. It can also increase the risk of acquiring cataracts, among other different pathologies in the eyes, such as age-related macular degeneration [1].

The risk of developing diabetes type 2 also increases by 30-40% [1].

Benefits of Quitting Smoking

Quitting smoking has many advantages, and even a person who smoked for many years can stop and still collect the benefits of quitting [13].

Within a month of quitting, the cycle of addiction will be broken and the nicotine receptors in the brain return to normal. The blood circulation, which was also suffering from the smoking habit, will return to normal within 2 to 12 weeks after stopping, making it easier to exercise, and lowering the risk of heart attacks [13].

Smoking damages the nerves in the nose and mouth, disturbing the senses of taste and smell. After 48 hours without smoking, these nerves will start going back to normal, and the senses of taste and smell will improve. Together with improved breathing and physical activity, there is also an increase in the energy [13].

As circulation improves and the oxygen levels increase, the body’s immune system is given a boost. The yellowish color in the teeth will also come back to normal [13]. Sex life will also be improved with more energy and better breathing; nicotine affects directly the sexual performance [13].  

Smoking might be associated with psychological aspects of addiction, making it harder to stop, as the patient is physiologically dependent of the substance.  This psychological dependence, can take years to overcome. 

The traditional treatment is completely associated with emotional and individuals’ triggers. Some doctors may recommend nicotine patches in the beginning, in order to reduce the urges in the withdrawn, and the use of anti-depressants is common, based on the idea of psychological dependency. 

Western Perspective of Addiction

Western medicine has been studying the addiction concepts, and trying to fight addiction for a long time. Rehabilitation professionals address the general drug addiction problems by use of various methods to restore a person who is addicted to something. Cigarette smoking is in the same place.  However, despite the negative advertising, taxing and information about tobacco smoking, people keep smoking. In Brazil, more than 10% of the Brazilians between 20-24 years, smoke every day. The numbers are even for older people: more than 15% of people between 50-59 smoke [3].

Nicotine patches: Some doctors recommend the use of nicotine patches in the beginning of the detox   process, in order to reduce the abstinences caused by the lack of cigarettes [14].  As the cigarettes have a range of toxic substances, the use of patches containing only nicotine is healthier than the cigarettes itself. The nicotine patches also have a positive effect when considering the loss of the habit of smoking, which also performs an important part in the smoking cessation.

Electronic cigarettes: The use of electronic cigarettes is very common in some countries, such as the United States.  A study published in 2017 by the Cancer Research UK found that those who switched regular cigarettes to electronic ones reduced the levels of carcinogens in their body. Nicotine intake, however, has no reduction.  However, the use of these devices is a palliative that does not reduce the quantity of nicotine in the brain, not curing the addiction.  As the person will be still receiving nicotine, the patient will continue to be dependent, only changing the device [14].

Antidepressants to stop smoking: The nicotine dependence can make the patient struggle during the withdrawal. The signs of significant dependence are, in general, smoking more than one pack of cigarettes per day; Smoking less than five minutes after waking up; smoking while sick; waking up at night to smoke [2,4,15]. Antidepressants are commonly known for being helpful during smoking cessation. Nicotine withdrawal can be responsible for depressive symptoms and antidepressants may be helpful. There are also antidepressants with a specific effect on neural pathways and receptors, underlying the addiction and urges [2,4,15].

Many antidepressants drugs are commonly used as a smoking cessation aid, such as bupropion; doxepin; fluoxetine; imipramine; lazabemide; moclobemide; nortriptyline; paroxetine; S-Adenosyl-L-Methionine (SAMe); selegiline; sertraline; St. John's wort; tryptophan; venlafaxine; and zimeledine. Some of these drugs, like varenicle, are prescribed for 12 weeks, after the patient quits, which may be followed by 12 more weeks of treatment in order to diminishing relapse chances. As in the other two antidepressants, varenicle side effects include nausea, vomiting, headache, trouble sleeping, unusual dreams, sleepwalking, constipation, gases, changes in taste, skin rashes, seizures and mood or behavior changes, such as depression, hallucinations, delusion, aggression, hostility, agitation, anxiety, panic or suicidal thoughts [15].

There is insufficient evidence that adding Buproprion to nicotine replacement therapy (NRT) provides any additional long-term benefit [15].

Nicotine acts in the nervous system, where it connects with receptors and triggers, releasing dopamine, which creates the pleasure of smoking. The mechanisms in which the antidepressants as Bupropion act in the organism are not well understood, but as with all the antidepressants, the idea is to send a different chemical message. When the pleasure of smoking is taken out, it becomes easier to stop the addiction [4].

Nortriptyline also have serious side effects. Some patients reported suicidal feelings or drastic mood changes. The most common side effects are dry mouth, lightheadedness, shaky hands, blurred vision, and urinary retention. You might experience withdrawal symptoms like nausea, headache, and weakness if you suddenly stop taking nortriptyline [2,4,15].

The potential of addiction in the antidepressants is also something to consider when deciding the treatment for smoking addiction.

The use of other drugs, not necessarily antidepressants is also common for smoking cessation in the rest of the world. Clonidine is one example of an alternative. It is an FDA approved medication to treat high blood pressure. The intake of a pill twice a day or the use of a skin patch may be helpful during smoking cessation [16]. Seeking an alternative treatment, the number of people which have used acupuncture and Traditional Chinese herbs to stop smoking easily is increasing over the last decade [16].

Physiological Aspects

The patient is the only one who can quit the smoking problem. The addiction is linked to a range of mental processes, which are difficult to stop.  Electronic cigarettes, nicotine patches and antidepressants are not always successful.  Many patients seek a different form of treatment, which will make the withdrawal easier and avoid relapses.

According to Olaya García-Rodríguez, in the article Probability and predictors of relapse to smoking: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the risk of relapse and start smoking again is above 50% in the first year, and will only reduce to 10% after 30 years of abstinence. The author also states that the risk of relapse will never fully disappears [5].

Arndt-Schultz’s Law

The Arndt-Schulz’s law, originally formulated in 1888, represented in Figure 3, helps to better understand the effects of different drug concentrations on an individual. The rule states that for all substances, small doses stimulate, moderate doses inhibit and overdoses kill. According to this law, highly diluted drugs improve organic processes.

While high concentrations harm health. This hypothesis curiously coincides with homeopathic theory. Currently, Maturana and Varela, two Chilean researchers, have proven this and much more regarding the sizes of doses in the role of stimulating or inhibiting the vitalities of living beings” [8-11].


Figure 3: Arndt-Schultz’s Law.


The use of antidepressants to treat smoking addiction could create addiction to the antidepressants, creating a risk of substituting one addiction for another. High concentrated medications, in this case, antidepressants, cause reduction of the vital energy, according to Arndt-Schultz law, inducing loss of memory and concentration, loss of libido, loss of energy, also causing reduction of the Kidney energy when intake for more than 30 days [8-11].

In the first case, if the patient uses high concentrations of medications in order to treat smoking addiction; he would bring other complications to his body as a whole resulting in diminished vital energy caused by the medicines. As the patient was obese, the reduction of his vital energy could worsen his condition and open the possibility of having other diseases. As the patients’ vital energy is weakened, other diseases may appear.

In the second case, the patient was oriented to gradually reduce the use of the anti-depressants, until the complete withdrawl. We used only acupuncture to treat his smoking addiction to maintain the energy and emotional balance, and avoid the energy imbalance caused by high-concentration medication use. As the patient had a historic of malign diseases, the use of this kind of medication would diminish even more his vital energy, increasing the possibility of recurrence of the tumors or the appearance of new tumors or cancers in other parts of the body.

According to the Zihui Tang study of 2017, entitled A Study of Traditional Chinese Medicine Body Constitution Associated with Overweight, Obesity, and Underweight, obesity, overweight and underweight can be associated with Qi and Yang deficiency [17].

According to the Arndt-Schultz law, the intake of high-concentrated drugs provokes an inhibitory effect in energy, leading to more energy deficiencies, such as Qi and Yang deficiency, in this way worsening the condition of case 1 and case 2 patients.

Deficiency of different energies, such as Yin, Yang, Qi and Blood can also cause cancer, according to the Cancer Research UK, in a study of 2018 [18]. The use of high-concentrated medications, such as antidepressants for the treatment of smoking addiction, would cause decrease of the vital energy, resulting in worsening of the patients’ energy condition. In the specific case of the second patient, who already had one previous testicular cancer, energy deficiencies could increase the chances of acquiring a new cancer or a having a relapse of the old cancer. 

Traditional Chinese Medicine and Western Medicine Points of View

The substantial differences between the Western and Traditional Chinese Medicine can be more clearly seen and understood through the metaphor of the tree. It is important to understand this difference in order to comprehend the effectiveness of Traditional Chinese Medicine treatment in cases with unknown cause, for example, the speech disorders [8-11].

Traditional Chinese Medicine comprehends the functioning of the human being, through a holistic view, influenced by external factors such as wind, cold, heat, dryness, humidity and diet, and internal factors such as the emotions [8-11].

The tree that bases the metaphor is a common tree with a trunk and several branches. Each branch represents a medical specialty and each leaf that comes out of each branch represents the symptoms and diseases of each specialty. This visible part is the object of study and practice in the Western medical profession because of the curriculum offered in the medical schools around the world.

The leaves represent the symptoms and diseases of the pathologies and the branches represent the medical specialty. Those are the visible part of the pathologies, and the current medical colleges aim to understand, analyze and cure those pathologies. In the specific case of smoking addiction, Western Medicine treatments are at the leaf level, and Traditional Chinese Medicine treats it at the root level, treating the energy imbalances [8-11]. However, when considering other traditions and approaches of medicine, such as Traditional Chinese Medicine, we can analyze other parts of the tree as well. The entire tree (including the roots) are the focus of Traditional Chinese Medicine. According to Traditional Chinese Medicine, the root corresponds to the Theory of Five Elements and the Theory of Yin and Yang. Those are the theories and principles basing Traditional Chinese Medicine. The entire scheme proposed, can be better understood with the support of figure 4.

Figure 4: Schematic Drawing of the views of Western Medicine and Traditional Chinese Medicine.


Traditional Chinese Medicine

Tobacco and Traditional Chinese Medicine

Historically, as soon as tobacco entered into China it became a major cause of preventable diseases and premature death. TCM scientifically proved to reduce cravings for cigarettes, and the World Health Organization recommends the use of Acupuncture as a therapeutic way of quitting tobacco addiction [6].

According to Traditional Chinese Medicine, tobacco dries the Fluids and the Jing. While Western culture will focus the effects of tobacco in the lungs, Chinese Medicine will consider the side effects in a holistic way. Tobacco might deplete Kidney-Jing, explaining the toxicity of tobacco in pregnancy [6].

The act of smoking will also build a range of toxins in the body, including phlegm and catarrhal, having grave consequences in a long-term period [6]. The withdrawn symptoms are similar to the ones reported by the second patient, nausea, palpitations, mood swings and restlessness may occur [6].

Yin and Yang 

In the follow-on treatment carried out on the two clinical cases patients presented, acupuncture techniques that belong to Traditional Chinese Medicine in order to balance the energies Yin, Yang, Qi and Blood was used, which are the basis of everything for health maintenance and/or formation of diseases [19].  

Traditional Chinese Medicine understands the Yin and Yang as the energy forces that rule the whole universe. They are present inside the body and in nature. Some examples include sky and earth, day and night, water and fire, active and passive, male and female and so on [19].

Harmony is sought between Yin and Yang (Figure 5), and any imbalance must be avoided. Yin refers to formed substances, such as organs, tissues, cells and body fluids, which are visible and measurable things. Yang is the action potential, Qi, and heat in the body [19]. The Yin and Yang surged from the observation of nature. The concepts apply to all kinds of cycles. The energy is always dynamic and is always changing. When the Yin is in its utmost, Yang will start to grow and the opposite is also true. This is well represented in the Yin and Yang symbol. The creation of the theory is attributed to Zou Yan, although the origin of the symbol (Figure 5) might be attributed to Korean and Japanese groups. The opposite small circles inside each part of the symbol represent the cycle idea; one is always growing inside the other [19,20]. 


Figure 5: Yin and Yang.


Yin, Yang, Qi and Blood

To evaluate blood levels, we need to ask whether a patient has daily bowel movements; otherwise, this indicates Blood Deficiency. Qi Deficiency is revealed if the patient admits to sweating abnormally during the day. A patient is also asked if he or she usually feels hot or cold, indicating a Yin or Yang Deficiency, or even both. For Heat Retention, we ask if a patient has a dry mouth, halitosis, bleeding gums, abdominal pains, itching, acne, etc. [8-11]. 

To determine their energy disturbances, patients were asked several questions, in their first appointment, to evaluate their Blood, Qi, Yin and Yang, and Heat Retention (Figure 6). This allows treatment not only for the symptom, but also for the root of the problem relating to energy disharmonies [8-11]. 

This approach was presented by the author at the 2015 Society for Acupuncture Research Conference in Boston. The research on this approach showed that, by treating these disharmonies, it is possible to treat all the diseases in a diversity of specialties simultaneously although a doctor might not know that a patient has a particular problem [8-11]. 


Figure 6: Yin, Yang, Qi and Blood relationship.


Addiction in Traditional Chinese Medicine

Traditional Chinese Medicine has been showing positive results in the treatment of different types of drug addiction for a long time. The first record of the use of Acupuncture and Chinese Nutritional Therapy in the treatments of drug addiction dates back to more than 160 years ago [6].

In the last decade, the use of TCM in this kind of treatment has been growing rapidly [14,17].

According to Shi J, in his article entitled “Traditional Chinese medicine in treatment of opiate addiction.”, when looking for information about different ways in which TCM was previously used to treat drug abuse, he found a database with 340 works of professional literature including 85 patient files on TCM for drug addiction. In the database, 90% of the publications originated from mainland China [21].

In China, since 2000, the use of TCM methods to cure drug addiction is legalized by the Chinese State Food and Drug Administration. TCM has been used in order to treat opioid addictions, and all different types of drugs. It could not be different for smoking [6,14,17].                The approach used by TCM is successful in the treatment of different kinds of addiction because it approaches the body as a unity, in a holistic view [8-11].

The addiction is, in this case, a reflex of an imbalance in the body energy that may be associated with emotional or physical problems. This point of view differentiates from Western perspective, which associates addiction to the substance in use [4].

In the book 'Chasing the Scream: The First and Last Days of the War on Drugs”, the author states there is a relation with the social environment in which the addicted is inserted, therefore, proposing there is a connection between the emotional and external factors and the addiction [21] TCM states the same thing.   


According to TCM, disease is associated with perturbations on the flow of the Qi energy.  The goal of the acupuncture is to restore the balance, correcting the perturbations in the flow, using points close to the skin. Acupuncture is based on the belief that an energy force (Chi or Qi) flows around the body through channels, regulating and improving the function of the organs.  Acupuncture often leads to the release of endorphins into the body.  It is an important part of the Traditional Chinese Medicine and from the Chinese health culture for more than 2,500 years. The effectiveness of acupuncture can be proven by to the many different diseases that has been shown to be treated with this method. Specially on diminishing pain, there are no allopathic medicines, which compare to the level of success, when observing a long-term intake of the drug or practice of the acupuncture therapy [22].

There are different approaches and ways in which the acupuncture is practiced, on the patient described in the case studies; the treatment was using auricular acupuncture with mustard seeds. The points used by acupuncture affect energy flow to the mouth, lungs and respiratory system as well as to parts of the brain that generate cravings for tobacco. Between treatments, small pellets were often taped to the acupuncture points on the ear.  When cigarette craving occurs, gently pressing the pellets stimulates the acu-points promoting calm and eliminating the craving [7].

Acupuncture also helps, physically, to detoxify the body from the nicotine, which will also be helpful to make the withdrawl easier, and diminish the risk of relapse [5].

In literature about the subject, the use of acupuncture is so effective because, according to Chinese Medicine, the habit of smoking can be associated with different energy stuck in the body and in the mind, usually, due to tension, anxiety or anger. When smoking, the warm air penetrates the lungs, the head and the heart, bringing the feeling of relaxation. However, this is not a good way of releasing the stuck Qi. Acupuncture is effective because it can regulate the Qi flow in the same way, making it easier for the patient to not relapse [23].

The practice may also be used to regulate the nervous system in order to break nicotine addiction.  Treatment is focused on reducing cravings, irritability and restlessness.

The studies showed smokers that received acupuncture treatment reduced their desire to smoke more than with allopathic treatments. The patients also reported to perceive a worsening taste to the cigarettes, when compared to before the treatment [23].

Chinese Dietary Nutrition   

Chinese Dietary Nutrition therapy is considered a medical branch in Traditional Chinese Medicine, and many pathologies are treated only with diet changes. According to the theory of Chinese Dietary Nutrition, all foods have different energies, and depending on the patients’ energy imbalance, various foods might be important to eat or to avoid [24,25].

According to TCM, what is consumed by the body has the main goal of nourishing the energy meridians, helping to balance Yin and Yang energies, promoting the production of Blood and consequently maintaining the Qi energy function [24,25].

This energy-nourishment process happens through the taste of food. According to TCM, an ideal diet includes all the five tastes. Each taste will nourish one of the Five Elements, in the Five Element Theory. The Wood Element, which is represented by the Liver organ, is nourished by the sour taste. The Fire Element, represented by the Heart is nourished by the bitter taste. The Earth Element, represented by the Spleen is nourished by the sweet taste [24,25].

The Metal Element, represented by the Lungs is nourished by the Spicy taste, and finally, the Water Element, represented by the Kidney organ, is nourished by the salty taste [24,25].

Figure 7: Five Elements and Tastes.


As Hypocrites stated: “Make your food your medicine and your medicine your food”. This sentence emphasizes the importance of a correct diet to maintain the health of the body, and to treat diseases. As there are foods causing energy imbalances, there are also diets that can rebalance and restore the health of the body.

In the specific case studies described, both patients were oriented to avoid foods that would worse nutrient absorption, caused by deficiency of the Spleen-Pancreas meridian [24,25].

Foods that can cause deficiency in the energy of the Spleen-Pancreas are dairy products, raw foods, cold beverages and foods with sweet flavor [24,25].

When the nutrients absorption is compromised, it may cause a deficiency in the Blood production, leading to a deficiency of Blood. Blood deficiency may be the cause of depression symptoms, fatigue, constipation, hair loss, among other varied symptoms. This deficiency, in turn, may cause internal Heat formation [24,25].

The internal Heat formation is responsible for symptoms such as anxiety, panic syndrome, irritability, etc. The anxiety may lead to an increased desire of smoking cigarettes [24,25].

The patients were also oriented to avoid coffee, soda and matte tea, with the main goal of avoiding the imbalance of the Kidney energy, responsible for the formation of Yin and Yang energies. If, for example, there is a Kidney deficiency because of a wrong diet, the Yin and/or Yang energy of the Kidney will diminish, and this decrease in the Kidney’s energy may lead to internal Heat formation, responsible for anxiety symptoms. The anxiety symptoms consequently can lead to desire of smoking [24,25].

The last group of food not recommended for the patients’ diet were frying, eggs, coconut, honey, melted cheese and alcoholic beverages. These are hot-energy foods, which can lead to internal Heat build-up directly, also leading to anxiety symptoms [24,25].


We can conclude that it is possible to treat smoking addiction without using any kind of medication, according to these two case studies, using acupuncture and dietary counseling.

For this aim, the treatment considers the patient in a holist view, treating all the imbalances of Yin, Yang, Qi, Blood and Heat retention, to control and treat all physical and emotional diseases that the patient has (depression, anxiety, and other mood change symptoms). The use of acupuncture favors Qi flow, releasing the stuck Qi, which is the reason for the smoking, according to TCM. 

We emphasize the necessity of avoiding the use of drugs in this study, since drugs in high-concentrations can cause a deficiency of vital energy and in this way, cause a weakening of the patient, and may lead, in the future, to the appearance of other physical or emotional diseases.


*Special thanks for Ronald Howard Fong for proofreading the article grammatically and structurally. 


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