الفهرس 
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Abstract
The aim of the previous study was to evaluate the effectiveness of cupping therapy and aversion therapy as adjuvant methods in smoking cessation program.
This was a prospective, randomized study that was conducted on a sample of 60 smokers during the period from August 2021 to January 2022 and were recruited from Ain Shams University Hospitals (inpatient and outpatient clinics) divided into three groups:
group I: consisted of 20 participants who were subjected to (standard method for smoking cessation) known also by the five ‘A’s consisting of (Ask, advice, assess, assist, arrange).
GroupII: consisted of 20 participants who were subjected to same smoking cessation as group I in addition to aversion therapy method as an adjuvant, conducted by providing the smoker with a pack of onion powdered cigarettes made by mixing tobacco with dried onion powder by equal amount. Smokers were allowed to smoke up to 3 cigarettes per day.
group III: consisted of 20 participants who were subjected to same smoking cessation as group I in addition to bloodletting cupping therapy as an adjuvant. where each smoker received monthly cupping session for three consecutive months. Bloodletting cupping was done by placing plastic cups for a few minutes on the surface of the healthy skin after making superficial scars with a special lancet in it to draw out the corrupt blood outside the body.
Follow up visits were arranged monthly to measure different outcomes among smokers in different groups either complete success, partial success or failure, also to assess and follow up any symptoms they would have as a result of stopping smoking (nicotine withdrawal symptoms) or any symptoms they’d have after cupping therapy sessions, and refill of the powdered cigarette pack in aversion therapy according to the smoking desire.
The study showed that there was no statistically significant difference (p value >0.05) between the success rate in the three different groups. The success rate of quitting was the same among smokers in group I and group III (complete success 10% and partial success 10%), while the success rate of quitting among smokers in group II was (complete success 0% and partial success 15%).
There were significant statistical correlations (P<0.05) found between the outcome and the age, occupation, duration and pack/year smoking, while there was insignificant statistical difference (P<0.05) between the outcome and marital status, comorbidities and previous quitting attempts.
There was no significant difference between three groups in the frequency of withdrawal symptoms during follow up visits, while there was significant statistic reduction in frequency of dizziness, headache and fatigue between follow up visits in the three groups, weight gain increased during follow up visits.
from the previous study, it was concluded that:
1- The willpower of smokers is the first and main step in success in smoking cessation
2- The conventional program for smoking cessation (the 5 A’s) is the most effective method in smoking cessation.
3- Aversion therapy and bloodletting cupping therapy maybe used as safe, non invasive cheap adjuvant therapies to aid in smoking cessation though results about their ability to produce significant change in success rate of smoking cessation is still conflicting.
Recommendations
1. Effective smoking cessation program should include individual counseling, group counseling and telephone counseling.
2. Still more researches are required to establish the beneficial role of bloodletting cupping therapy and aversion therapy as adjuvant therapies in smoking cessation program.
3. Expanding the media campaigns of smoking cessation, and clarification the risks of smoking and ways to quit smoking
4. A specialized a smoking cessation clinic in every hospital should be present to provide counseling about smoking cessation using the 5 A’s method and to follow up for withdrawal symptoms and relapse prevention.