Successful Smoking Cessation after Foot Reflexology

Abstract

Foot reflexology is a traditional Chinese medicine that is used for facilitating smoking cessation. Foot reflexology for smoking cessation is easy to learn and do, as well as being safe and cost-effective. However, it is not commonly used in cessation clinics in health care centers, compared with other methods, because there are few studies that verify its effectiveness. More studies about the effect of foot reflexology on smoking cessation are needed. Therefore, the purpose of this experimental evaluation research (single-group trial) was to study the effect of foot reflexology on the smoking cessation behavior of daily smokers and predictors of successful smoking cessation with foot reflexology.

The study was conducted in Ratchaburi Province, Thailand. The province was divided into two zones, and the researchers randomized one district from each zone. One subdistrict health promoting hospital (SHPH) was randomized, with a sample size of 120 smokers from each SHPH, so that the total number of subjects was 240. The study volunteers were given brief advice with 2As (Ask and Advice) regarding smoking cessation, followed by foot reflexology for around 20 minutes for 10 consecutive days. Data were collected using interviews and a record form at a pre- and post-massage date from day 2 to day 10. The study volunteers were followed up at 30, 90 and 180 days to measure continuous abstinence rate (CAR). Data were analyzed by descriptive and analytical statistics including Chi-square, one-way ANOVA, and binary logistic regression.

The results of foot reflexology showed that CAR increased steadily over 10 days of massage, from 4.1% at day 2 to 29.2% at day 10 and gradually decreased to 28.8%, 25.6%, and 26.7% at one, three, and six months. The study of factors associated with smoking cessation was achieved by using bi-variate analysis. There were four factors that were statistically significant. The first one was age of smokers; CAR of the smokers aged 60 years and over was 41.5%, which was higher than the smokers aged <24 years (27.8%) and 25-59 years (20.4%) (p = 0.004). The second one was the daily number of cigarettes smoked; the CAR of smokers who smoked 1-9 cigarettes/d was 48.6%, which was higher than those who smoked 10-19 cigarettes/d (26.0%) and >20 cigarettes/d (21.1%) (p<0.001). The third one was nicotine dependence level; the CAR of the smokers who had a low and moderate level of nicotine dependence were 32.6% and 32.4%, in contrast with 19.4% in those who had a high level of nicotine dependence (p = 0.009). The fourth one was intention to quit smoking; the CAR of smokers who intended to quit smoking within 7 days and 30 days were 31.4% and 33.3% compared with 13.3% in those who intended to quit within 6 months or more and 13.2% in those who did not intend to quit (p = 0.032). These 4 factors were able to explain the variability of CAR (26.9%).  

The results of this research confirm that foot reflexology is an effective way to facilitate smoking cessation. Therefore, the Ministry of Public Health should promote the use of foot reflexology in public health facilities. Training for traditional Thai medicine personel, at all levels, should be organized in order to provide knowledge and skills in foot reflexology for smoking cessation, and expand its application.