Tobacco Cessation Protocol Doris Hubbs, MD, FACP April 27, 2013

 Traditional diagnosis: Inspection Auscultation and Olfaction Inquiring Palpation

 Traditional diagnosis: Inspection of face, body, and especially the tongue: S: tongue size and shape C: tongue color and coating U: tongue underside M: tongue markings and moisture

 Principal meridians (and internal organs) are reflected on specific tongue areas kidney Liver-stomach-spleen Heart-lung

 Color Light red or pink: normal Red: abnormal heat Pale: yang deficiency or blood deficiency Purple tongue: stasis Tongue Color can be affected by food or natural pigmentation

PALE TONGUELIGHT RED TONGUE

Need good lighting, preferably natural light For adequate inspection of color

LIGHT RED TONGUERED TONGUE

DARK RED TONGUEPINK TONGUE

THICK TONGUE NORMAL FULL SIZE TONGUE SLIGHTLY SWOLLEN EDGES

SWOLLEN EDGES THIN TONGUE?

UNEVEN COAT NORMAL THIN, WHITE MOIST COAT

YELLOWISH, THICK, DRY COAT WHITE COAT “WITHOUT ROOT”

NOTE TEETH MARKS AND RED TIP LOOK FOR VENOUS CONGESTION

Ear (auricular) Hand Scalp (Tongue)

 Observe abnormal ear markings, discolorations, abnormal skin  Palpate for tenderness at specific points  Use electrodermal point finder to locate regions with low skin resistance (high skin conductance)

 Acupressure with seeds or pellets  Acupuncture needles: Short needles, 15 mm ASP needles (stay in for 1-2 days) Electroacupuncture Laser stimulation

 National Acupuncture Detoxification Association Protocol  Works for withdrawal of opiates & other  Shen Men  Autonomic Point  Lung 1 or 2 (use the more reactive)  Liver  Kidney

 Cingulate gyrus  Thalamus  Omega 2  Point zero prime  Shen men

 The tongue can be valuable for diagnosis  The radial pulse can be important for diagnosis but is more difficult to master  Auriculotherapy is one type of microsystem acupuncture that is relatively easy to use  Other microsystems of acupuncture include (Korean) hand acupuncture and Japanese and Chinese scalp acupuncture

 More than one protocol available for decreasing withdrawal symptoms  Body acupuncture and ear acupuncture  Does NOT keep the person from smoking or buying cigarettes  Only helps with the w/d symptoms: craving, irritability, nervousness, etc.

 Quit cigarettes the night before (day 0)  Day 1: give full treatment protocol  Day 2 or 3: repeat full tx protocol  Open door for ear protocol for 1 st wk  Day 8: give full tx protocol  Week 3: repeat full tx protocol  Week 5 or 6: repeat full tx protocol

GV 8, GV 18, (AND GV 20) SP 3 ON EACH FOOT WITH 4 HZ ELECTRICITY

AURICULOTHERAPY FOR ANXIETY NADA PROTOCOL

 Cochrane review of acupuncture for cigarette cessation: no evidence of benefit Acupuncture may improve withdrawal symptoms, but patients need to be committed to stopping cigarettes in order to be successful.

 Cigarette protocols and auriculotherapy can be helpful for withdrawal symptoms, including craving, irritability, and anxiety  Patients need to be committed to stop smoking in order to have long term success