Many people express surprise that Acupuncturists are not allowed to mention most of the work that they do in their advertising.
In fact just using the word ‘treatment’ can lead to problems if it is used in a context that implies a guaranteed result.
This is due, in part, to previous rulings by the Advertising Standards Authority (ASA) and the Committee of Advertising Practice (CAP). Their position is that they wish to uphold the highest standards in advertising and as such they oversee all that goes on in print and broadcast media, including the internet.
We support this wholeheartedly.
Most Acupuncturists, for example, will happily provide “treatment” for someone wishing to give up smoking, or lose weight, and in a number of instances, they can be successful in helping that individual to quit.
Of course, for every success story, there will be failures, much as there is with conventional or ‘Western’ medicine. For example, not everyone who uses patches to stop smoking achieves their aim.
To be able to make claims in advertising that Acupuncture actually works there needs to be empirical clinical evidence to support those claims.
This cannot be simply a patient who was treated and then got better, as there is no control which says that they may have got better without any intervention at all.
Today’s environment requires double blind clinical trials against substitutes and placebos to really stand a chance of being accepted, and even then, to be accepted there would have to be a statistically valid improvement in the results from acupuncture over other treatments for it to be accepted as effective.
All of which means that despite the thousands of years of use, and millions of people who have used acupuncture, unless you can prove it works through clinical trials you cannot say it in your advertising.
There are a number of bodies who are trying to redress this balance including the British Acupuncture Council but the progress is slow.
Until there is sufficient clinical research and agreement from the regulatory bodies then acupuncturists will simply have to content themselves with telling you how nice their premises are, and how long they have been practising.
To illustrate the current degree of regulation we are reproducing the full guidance from the ASA/CAP website but to save you time we’re posting it here.
This is the snapshot of the ASA/CAP page as taken in January 2019
What is acupuncture?
Acupuncture is the insertion of needles into the skin and underlying tissues in key ‘points’ for therapeutic or preventative purposes. The theory behind the therapy is that certain “trigger points” – probably nerve fibres or receptors – are stimulated with needles which are thought to induce rhythmic discharges that cause a release of endogenous opioids and oxytocin.
What treatment claims are likely to be a problem?
The ASA is likely to expect all claims of efficacy to be supported by robust evidence in the form of clinically controlled trials.
In 2013 the ASA investigated a complaint about two leaflets which made efficacy claims for Traditional Chinese Acupuncture and Group Acupuncture. It stated “Some of the conditions we treat include: – Women’s health, including disturbances of the menstrual cycle, gynaecological disorders – Men’s health, including prostatitis, urinary disorders, fertility – Emotional issues, stress, anxiety, depression, addictions – Headaches, migraines, tinnitus, dizziness, vertigo – Sleep disturbances – Immune system imbalances, allergies, Herpes zoster (Shingles) – Gastro-intestinal conditions – Musculoskeletal problems including joint pain, back pain – Upper respiratory disorders e.g. sinusitis, asthma – Hypertension (High blood pressure)”. Although the evidence demonstrated that acupuncture could be effective in the relief of pain associated with some instances, the ASA considered that in relation to the reference to some conditions, the claims in the ad went further than the evidence supported and therefore concluded that the ad was misleading (University College London Hospitals t/a The Royal London Hospital for Integrated Medicine, 12 June 2013).
In 2017, the ASA considered evidence in relation to a number of claims including those which stated that acupuncture could help with fertility support, musculoskeletal problems, headaches, migraines, insomnia and anxiety. Although the advertiser submitted a large amount of evidence, the ASA considered that it was not sufficiently robust to the support those treatment claims (Eileen Mannion Acupuncture, 18 October 2017).
Marketers occasionally claim that acupuncture can help delay or prevent ageing. To date, neither CAP nor the ASA has seen evidence that acupuncture can slow down, reverse or relieve the superficial signs of ageing or heal scarring. Marketers should not make claims relating to the improvement of the appearance of skin conditions.
Neither CAP nor the ASA has been provided with evidence to demonstrate that hand-held acupuncture and acupressure devices are effective in treating conditions commonly treated with traditional acupuncture. Marketers are reminded to hold robust evidence for any treatment claims (SCD Ltd, 17 April 2013; Alliance International Ltd, 28 January 2009).
What treatment claims are likely to be acceptable?
The ASA has been provided with clinical evidence and has ruled that the following claims are likely to be acceptable (University College London Hospitals, 12 June 2013).
- Short-term improvement in the symptoms of overactive bladder syndrome (through electro-acupuncture at the SP6 point)
- Short-term relief of tension type headaches
- Short-term relief of migraine headache
- Short-term relief of chronic low back pain
- Short-term relief of neck pain or chronic neck pain
- Short-term relief from temporomandibular (TMD/TMJ) pain
- Temporary adjunctive treatment for osteoarthritis knee pain
However, the ASA has equally upheld complaints about ads that refer to the above conditions but where it was not made clear that any relief achieved was temporary or “short-term” (Eileen Mannion Acupuncture, 18 October 2017).
The ASA is likely to accept advertising claims about the sensory effects of acupuncture including claims about well-being or references to “feeling revitalised”, “more positive” or “relaxed”.
Can practitioners of acupuncture claim to treat conditions that should be treated under the supervision of a qualified health professional?
CAP understands that no compulsory regulation exists for acupuncture practitioners and the ASA is yet to consider whether, for those practitioners who are registered with an appropriately accredited body, they are likely to be considered to be suitably qualified for the purposes of the Code (Rule 12.2)
Where practitioners are registered with a body that has appropriate accreditation in place, such as that provided by the Professional Standards Authority Voluntary Register Scheme, it seems likely that the ASA will consider such credentials to be appropriate evidence of suitable qualification.
CAP otherwise advises that marketers should not claim to treat (or discourage essential medical treatment for) any conditions for which medical supervision should be sought (REDACTED and Virtual Tapestry Ltd, 22 May 2013).
Updated 21 November 2017
The following text was originally taken from the ASA/CAP website in March 2017
What is acupuncture?
Acupuncture is the insertion of needles into the skin and underlying tissues in key ‘points’ for therapeutic or preventative purposes. The theory behind the therapy is that certain “trigger points” – probably nerve fibres or receptors – are stimulated with needles which are thought to induce rhythmic discharges that cause a release of endogenous opioids and oxytocin.
What treatment claims are likely to be a problem?
The ASA is likely to expect all claims of efficacy to be supported by robust evidence in the form of clinically controlled trials.
In 2013 the ASA investigated a complaint about two leaflets which made efficacy claims for Traditional Chinese Acupuncture and Group Acupuncture. It stated “Some of the conditions we treat include: – Women’s health, including disturbances of the menstrual cycle, gynaecological disorders – Men’s health, including prostatitis, urinary disorders, fertility – Emotional issues, stress, anxiety, depression, addictions – Headaches, migraines, tinnitus, dizziness, vertigo – Sleep disturbances – Immune system imbalances, allergies, Herpes zoster (Shingles) – Gastro-intestinal conditions – Musculoskeletal problems including joint pain, back pain – Upper respiratory disorders e.g. sinusitis, asthma – Hypertension (High blood pressure)”. Although the evidence demonstrated that acupuncture could be effective in the relief of pain associated with some instances, the ASA considered that in relation to the reference to some conditions, the claims in the ad went further than the evidence supported and therefore concluded that the ad was misleading (University College London Hospitals t/a The Royal London Hospital for Integrated Medicine, 12 June 2013).
In 2017, the ASA considered evidence in relation to a number of claims including those which stated that acupuncture could help with fertility support, musculoskeletal problems, headaches, migraines, insomnia and anxiety. Although the advertiser submitted a large amount of evidence, the ASA considered that it was not sufficiently robust to the support those treatment claims (Eileen Mannion Acupuncture, 18 October 2017).
Marketers occasionally claim that acupuncture can help delay or prevent ageing. To date, neither CAP nor the ASA has seen evidence that acupuncture can slow down, reverse or relieve the superficial signs of ageing or heal scarring. Marketers should not make claims relating to the improvement of the appearance of skin conditions.
Neither CAP nor the ASA has been provided with evidence to demonstrate that hand-held acupuncture and acupressure devices are effective in treating conditions commonly treated with traditional acupuncture. Marketers are reminded to hold robust evidence for any treatment claims (SCD Ltd), 17 April 2013; Alliance International Ltd, 28 January 2009).
What treatment claims are likely to be acceptable?
The ASA has been provided with clinical evidence and has ruled that the following claims are likely to be acceptable (University College London Hospitals, 12 June 2013).
- Short-term improvement in the symptoms of overactive bladder syndrome (through electro-acupuncture at the SP6 point)
- Short-term relief of tension type headaches
- Short-term relief of migraine headache
- Short-term relief of chronic low back pain
- Short-term relief of neck pain or chronic neck pain
- Short-term relief from temporomandibular (TMD/TMJ) pain
- Temporary adjunctive treatment for osteoarthritis knee pain
However, the ASA has equally upheld complaints about ads that refer to the above conditions but where it was not made clear that any relief achieved was temporary or “short-term” (Eileen Mannion Acupuncture, 18 October 2017).
The ASA is likely to accept advertising claims about the sensory effects of acupuncture including claims about well-being or references to “feeling revitalised”, “more positive” or “relaxed”.
Can practitioners of acupuncture claim to treat conditions that should be treated under the supervision of a qualified health professional?
CAP understands that no compulsory regulation exists for acupuncture practitioners and the ASA is yet to consider whether, for those practitioners who are registered with an appropriately accredited body, they are likely to be considered to be suitably qualified for the purposes of the Code (Rule 12.2)
Where practitioners are registered with a body that has appropriate accreditation in place, such as that provided by the Professional Standards Authority Voluntary Register Scheme, it seems likely that the ASA will consider such credentials to be appropriate evidence of suitable qualification.
CAP otherwise advises that marketers should not claim to treat (or discourage essential medical treatment for) any conditions for which medical supervision should be sought (REDACTED and Virtual Tapestry Ltd, 22 May 2013).
Updated 21 November 2017
The following is the original text previously on the website, subsequently superseded by the above text.
Therapies: Acupuncture
Note: This advice is given by the CAP Executive about non-broadcast advertising. It does not constitute legal advice. It does not bind CAP, CAP advisory panels or the Advertising Standards Authority.
This section should be read in conjunction with the entry on ‘Therapies, General’.
Acupuncture is the insertion of needles into the skin and underlying tissues in key ‘points’ for therapeutic or preventative purposes. The stimulation of certain “trigger points” – probably nerve fibres or receptors – with needles, electrical impulses or lasers is thought to induce rhythmic discharges that cause a release of endogenous opioids and oxytocin. Other theories have been put forward to explain acupuncture’s apparent success at relieving menopausal hot flushes and sweats and reducing skin-flap necrosis in reconstructive surgery.
CAP understands that no statutory regulation exists for acupuncture practitioners and they should not claim to be able to treat serious or prolonged conditions (Rule 12.2). Marketers of acupuncture are advised to encourage consumers to take independent medical advice (Rule 12.3).
CAP is unlikely to accept claims that acupuncture can treat tinnitus or can control appetite. Although commonly claimed, we have not seen evidence that acupuncture can either help quit smoking or aid weight loss (Chinese Medicine Centre, 14 January 2004). And CAP has not seen evidence that acupuncture can “de-tox” the body, improve blood circulation, increase metabolism or boost energy.
Marketers occasionally claim that acupuncture can help delay or prevent ageing. To date, neither CAP nor the ASA has seen evidence that acupuncture can slow down, reverse or even relieve the superficial signs of ageing. CAP, therefore, advises marketers not to make claims relating to the improvement of the appearance of skin conditions (scarring as well as the signs of ageing).
Acupuncture practitioners may, however, claim they can help treat dental pain, nausea and vomiting, provide short-term relief of tension-type headache, migraine headache relief, temporary or short term relief of low back pain and provide temporary adjunctive treatment for osteoarthritis knee pain (the latter must include the stated caveats). Practitioners may be asked to supply evidence for the efficacy of their treatment in the event of an ASA challenge (Herbmedic, 22 October 2003 (complaint 4)).
At the time of writing, scientific studies seemed inconclusive for some conditions and marketers are advised not to advertise acupuncture for them unless they have robust evidence to support efficacy. Those conditions include addictions, asthma, headaches, feeling blue, certain types of facial pain, trouble sleeping, lateral elbow pain, shoulder pain, and neck pain. It might be possible, however, to speak about the purely sensory effects of acupuncture and make claims about well-being and well-feeling or to use phrases such as “feel revitalised”, “more positive” or “relaxed”.
Evidence is almost certainly going to have to include placebo-controlled trials on humans and back in 1998 the Lancet suggested that a placebo acupuncture needle (which pricks the skin without penetrating it) might be suitable for use in such trials.
Neither CAP nor the ASA accepts that hand-held acupuncture and acupressure devices work (Dove Alliance UK Ltd, December 1999
Note: This advice is given by the CAP Executive about non-broadcast advertising. It does not constitute legal advice. It does not bind CAP, CAP advisory panels or the Advertising Standards Authority.
