1 Bapuji Dental College and Hospital, Davanagere, Karnataka, India; 2 Dayanand Sagar College of Dental Sciences, Bangalore, Karnataka, India *Corresponding Author’s e-mail: pujacyavagal@gmail.com : Objectives: Te aim of the current study was to compare urinary cotinine levels, nicotine dependence and physical efects related to smoking in smokers before and after laser auricular acupuncture, psychological counselling and a combination of laser treatment with counselling. Methods: Tis study was carried out from February to July 2019 in India. A total of 60 smokers were randomly allocated to three interventional groups. Urinary cotinine levels, nicotine dependence and physical efects due to smoking were evaluated using NicAlert strips (Nymox Pharmaceutical Corp., Quebec, Canada) the Fagerström questionnaire and a visual analogue scale, respectively, at baseline and one month post-intervention. Pearson’s chi-square, Kruskal Wallis analysis of variance and Wilcoxon sign rank tests were used for statistical analyses. Results: Tere was a signifcant reduction in urinary cotinine levels and nicotine dependence and signifcant improvement in behaviour and physical efects related to smoking in all groups post-intervention (P <0.05). Reduction in nicotine dependence was signifcantly higher in the laser group (4.4 ± 1.66) compared to other groups (P <0.01). Reduction in urinary cotinine levels was highest in the laser with counselling group (0.85 ± 0.3) compared to the other groups. Tere was a signifcant reduction in irritability, headache, craving for smoking, tiredness and anxiety as well as a substantial increase in calmness, unpleasant taste of smoking, the ability to concentrate and appetite in the laser auricular acupuncture group compared to the other groups (P <0.01) Conclusion: Laser auricular acupuncture alone and in combination with psychological counselling can reduce nicotine dependence among smokers. Keywords: Auricular Acupuncture; Laser; Nicotine; Tobacco Dependence; India. Efficacy of Laser Auricular Acupuncture for Smoking Cessation A randomised controlled trial *Puja C. Yavagal 1 and Nagesh L. 2 Sultan Qaboos University Med J, May 2021, Vol. 21, Iss. 2, pp. e275–281, Epub. 21 Jun 21 Submitted 28 May 20 Revision Req. 10 Aug 20; Revision Recd. 25 Aug 20 Accepted 9 Sep 20 Tis work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License. https://doi.org/10.18295/squmj.2021.21.02.017 CLINICAL & BASIC RESEARCH A K - Auricular laser acupuncture alone and in combination with psychological counselling reduces nicotine dependence among smokers. A P C - Low-level laser therapy can be used to stimulate auricular acupoints to reduce nicotine dependence related to smoking. It can also be used as an adjunct therapy along with psychological counselling. - Laser acupuncture is a non-invasive, aseptic and painless therapy which can reduce the withdrawal symptoms associated with smoking cessation. A ddiction to smoking is a complex condition which can disturb a person’s life, leading to health problems, deterioration of vital organs, systemic complications and often premature death. 1 Te World Health Organization (WHO) classifes tobacco dependence in the category of ‘Diseases, Symptoms or Conditions’. To address this disease, smoking cessation strategies play a pivotal role in saving current smokers from smoking-related mortality and morbidity. Te success of such strategies, however, is limited. In a review article based on 633 studies of the most available interventions for smoking cessation, Viswesvaran and Schmidt concluded that the average observed success rate across all methods was just 19% with a 6.4% success rate for placebo controls. 2 Conventional techniques for smoking cessation have demonstrated a relatively low success rate, quick relapse and unpleasant withdrawal symptoms. Of individuals using conventional approaches to quitting smoking, 20% reported that such treatments had failed in helping them quit smoking. 3 Many smokers, therefore, search for help in complementary and alternative medicine (CAM). In a study by Sood et al., 27% of subjects indicated using CAM as an aid for tobacco cessation, and 67% reported interest in the future use of CAM for smoking cessation. 3 Studies have shown therapeutic efects of acupuncture, considered a CAM, for tobacco dependence, but further proof of this intervention’s efcacy is needed. 4 Stimulating auricular acupoints afects the limbic system of the brain, and specifcally the reward centre. Tis modulation of the reward system is mediated through auricular branches of the trigeminal, the vagus nerve and the superior cervical plexus leading to greater restfulness and sleep management at the supraoptic chiasma. When smokers experience withdrawal systems during smoking cessation, stimulating auricular acupoints leads to modulation of reward pathways and the