This study described smoking cessation programmes that use TKM interventions in South Korea, and the study results provide basic information for planning future smoking cessation programmes to contribute increasing smoking cessation rates and finally promoting health. In conventional western medicine, there are smoking cessation treatment guidelines for primary care physicians that were developed by the Korean Academy of Family Medicine . The guidelines recommend following doctors’ advice, individual or group behavioural counselling, self-help interventions, attending smoking cessation clinics, and medicinal treatments, such as bupropion, nortriptyline, and NRT.
In China, a non-smoking clinic was established in 2007 at the Acupuncture and Moxibustion Hospital, Academy of Chinese Medical Sciences, and the patients were treated with acupuncture, massages, and herbal patches . Traditional Chinese medicine (TCM) is relatively well used in cessation treatment; however, there are no national cessation programmes using TCM that are led by the government.
The PHC-SCP, also known as the TKM smoking cessation class, was included in five health promotion programmes. The budget for all 5 of the Health Promotion Programmes using Tradition Korean Medicine (HaPP-TKM) was USD 300,000 per public health centre; however, it is unclear how much was used for the PHC-SCP (Table 1). Additionally, the details of the PHC-SCP are slightly different for each public health centre. However, the PHC-SCP is integrated with western medicine programmes, and this is a strong advantage that the other programmes do not provide.
The implementation of the MOGEF-SCP is relatively easy due to the cooperation of schools, which provide good conditions for not only performing treatments but also providing education. Acupuncture is more appropriate than NRT for teenagers because NRT is not recommended for them . Non-smoking pill is used in some TKM clinics optionally, according to the judgment of TKM doctors. Meanwhile, a herbal nicotine patch was developed and has been sold as general medicine in China .
The NHIS-SCP enhanced the accessibility to tobacco control therapy by providing medical care in clinics to anyone. Accordingly, the number of participants has overwhelmingly increased, and the budget for full support of medical costs was limited. However, this programme is still in its stages and TKM interventions, such as acupuncture and herbal medicines, are not yet covered by insurance. In Japan, cessation treatments have been covered by health insurance since 2006; however, traditional medicine is not included in the cessation treatment programmes .
The treatments are provided according to the guidelines for TKM cessation treatment in South Korea. According to Park’s study , ear acupuncture was the most frequently used TKM intervention for cessation treatment. The developed guidelines are the ‘Guideline on Acupuncture Treatment and Counselling for Smoking Cessation’ , developed by the Association of Korean Medicine (AKOM), and the ‘Guideline on Smoking Cessation Treatment for Health Care Providers’ , developed by the Ministry of Health and Welfare (MW) and the National Health Insurance Service (NHIS).
Currently, the main TKM intervention used in the smoking cessation programmes is acupuncture . There are many clinical trials using ear- or body- acupuncture as an intervention in several countries . As a result of the ear acupuncture treatments provided through the MOGEF-SCP, 102 of 472 (22.5%) high school students who had more than 5 ear acupuncture treatments succeeded in complete smoking cessation, and 360 (75.6%) showed smoking cessation or significant smoking reduction . Herbal medicines were used to help relieve withdrawal symptoms, including anxiety, increased appetite, and phlegm.
As the study of the national lead T&CM in smoking cessation programmes was few, our study results provide details about the interventions used in TKM smoking cessation programmes in South Korea (Table 2). This is also differentiation of this study because T&CM is not included in national lead cessation programme in other countries. On the basis of our study, information can be utilised when planning smoking cessation treatments with T&CM in other strategies or countries. Furthermore, the study results suggest future research plans for tobacco control studies.
However, there are limitations of TKM smoking cessation programmes. First of all, cessation rate of each programme was not reported. It is the biggest weakness of this study that comparing endpoints of three programmes cannot be done. Second, TKM is still not highly used in smoking cessation treatment. This should be followed by government support. TKM interventions are not supported in the NHIS-SCP and the medical cost is relatively expensive compared with that of conventional western medicines. Third, the evaluation of TKM programmes is insufficient. Quantitative assessments, such as urine tests and pulmonary function tests, and qualitative assessment should be utilised to properly evaluate the programmes. In last, since the lack of reporting form and system, some information such as the number of participating institutions, and budgets were unable to report. The reporting system should be established to keep sustainable programmes. Fourth, a standard guideline for TKM smoking cessation treatment based on well-designed trial results is needed to support its efficacy and safety. Finally, various TKM interventions, such as herbal medicines and moxibustion, should be developed to increase smoking success rate.