Comparative Evaluation of the Effect of Laser Therapy and Behavioral Counseling in Tobacco Cessation: A Randomized Controlled Trial

Abstract

Background: Laser auricular acupuncture is a form of therapy that is non-invasive, aseptic, and painless, thus advantageous over the traditional form of acupuncture for tobacco cessation. The objective of the study is to evaluate and compare nicotine dependence, urinary cotinine level, physical effects, and quit rate among tobacco chewers before and one month after laser therapy and behavioral counseling, and to evaluate and compare extrinsic stains one month post-intervention. Methods: The present study was a randomized controlled trial, with laser therapy and behavioral counseling as the test and control interventions, respectively. The laser was focused on both ears once a week for four weeks. Counseling sessions were held once a week for four weeks. Nicotine dependence, urinary cotinine level, physical effects, as measured using the Visual Analog Scale, and quit rate were recorded before and after the intervention. Results: The results showed significant reductions in nicotine dependence in both laser and counseling groups post-intervention (P < 0.001). Urinary cotinine levels increased significantly in the counseling group post-intervention (P = 0.010). Inter-group comparison revealed significant differences in pre-and post-intervention cotinine levels (P < 0.05). Adjusted analysis confirmed significant post-intervention differences between the groups (P = 0.048). Conclusion: This study demonstrates that combining laser auricular acupuncture therapy with behavioral counseling yields superior outcomes for smokeless tobacco cessation compared to behavioral counseling alone. The combined approach results in greater reductions in nicotine dependence, lower urinary cotinine levels, slightly higher quit rates, and significant improvements in various physical effects associated with tobacco use. © 2025 The Author(s); Published by Kerman University of Medical Sciences.