Global Views A brief illustration of the official national standards for the safe use of cupping therapy (Hijama) in Saudi Arabia Tamer Aboushanab a,⇑ , Saud AlSanad b,c a National Center for Complementary and Alternative Medicine, Riyadh 11662, Saudi Arabia b National Center for Complementary Medicine Ministry of Health, Riyadh 11662, Saudi Arabia c College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh 11662, Saudi Arabia article info Article history: Received 26 February 2018 Accepted 11 June 2018 Available online xxxx Keywords: Cupping Hijama Standards Safety Equipment abstract Cupping therapy (Hijama in Arabic) is a popular traditional treatment especially in Asia, the Middle East and Central Europe. Traditionally, cupping therapy has been one of the most used practices in Saudi Arabia. Standardization of the practice of cupping therapy is a very important step to eliminate or reduce any adverse events related to cupping. This article gives a brief illustration and highlights the important points of the first accredited Saudi Arabian standards for the safe use of cupping equipment and its applications. Please cite this article as: Aboushanab T, AlSanad S. A brief illustration of the official national standards for the safe use of cupping therapy (Hijama) in Saudi Arabia. J Integr Med. 2018; xx(x): xxx–xxx Ó 2018 Shanghai Changhai Hospital. Published by ELSEVIER B.V. All rights reserved. 1. Introduction Cupping therapy (Hijama in Arabic) is a popular traditional healing therapy especially in Asia, the Middle East and Central Eur- ope [1]. Cupping therapy was an early technique used in traditional medical systems such as traditional Chinese medicine, and Unani medicine [1]. Cupping therapy has been a very popular healing practice in Islamic countries since it was recommended by Prophet Mohammed after the rise of Islam [2]. Traditionally, cupping ther- apy has been one of the most used therapeutic practices in Saudi Arabia [3]. Therefore, its regulation in Saudi Arabia has been under- taken by the National Center for Complementary and Alternative Medicine (NCCAM), under the Ministry of Health. Standardization of the practice of cupping therapy is a very important step to eliminate or reduce any adverse events related to cupping. Standardization of cupping therapy may also facilitate the integration of cupping into modern medicine [4]. 2. The official standards for the safe use of cupping therapy As a part of the continuous efforts for ensuring the safety of the practice of cupping therapy, the Saudi NCCAM collaborated with the Saudi Food and Drug Authority (SFDA) to develop the first Saudi Arabian standard specification for the safe use of cupping equipment. This standard has been accredited by SFDA. The title of the standards is ‘‘Safe Use and Handling of Cupping Devices and Their applications” and the identification code is SFDA.MD 001:2017 [5]. The scope of this standard is to set the minimum acceptable requirements for the safe use of the cupping therapy devices and safe practice of their therapeutic uses. The main sections of the standard are: the scope, normative references, terms and defini- tions, specifications, labeling requirements, methods of sampling and analysis, and test reporting [6]. Examples of the general requirements for the safe use of cupping devices and their applica- tions are: manufacturers are responsible for safe design and man- ufacture of cupping therapy devices from appropriate materials; only licensed SFDA cupping devices can be used; only licensed NCCAM practitioners are allowed to practice wet cupping (blood- letting cupping); cupping therapy equipment should be disposable (single use) except for home users’ cupping devices that are used to perform dry cupping; disinfection of the cupping set (cups and suc- tion pump) should be done by licensed practitioners before each cupping session; infection control measures should be strictly fol- lowed; national guidelines for waste disposal should be followed; a consultation with medical specialist is recommended before per- forming any type of cupping therapy [6]. Other specifications establish standards for the use of safe materials in manufacture, the quality of manufactured cupping products and quality of cup https://doi.org/10.1016/j.joim.2018.07.006 2095-4964/Ó 2018 Shanghai Changhai Hospital. Published by ELSEVIER B.V. All rights reserved. ⇑ Corresponding author. E-mail address: t.shaban@nccam.gov.sa (T. Aboushanab). Journal of Integrative Medicine xxx (2018) xxx–xxx Contents lists available at ScienceDirect Journal of Integrative Medicine journal homepage: www.jcimjournal.com/jim www.journals.elsevier.com/journal-of-integrative-medicine Please cite this article in press as: Aboushanab T, AlSanad S. A brief illustration of the official national standards for the safe use of cupping therapy (Hijama) in Saudi Arabia. J Integr Med. (2018), https://doi.org/10.1016/j.joim.2018.07.006