Effects of Manual Acupuncture on Malondialdehyde Levels and State Anxiety Inventory Scores in Active Smokers: A Randomized Controlled Clinical Trial

This study aims to evaluate the effects of a single session of manual acupuncture on oxidative stress and state anxiety in active smokers. Oxidative stress will be assessed using plasma malondialdehyde (MDA), while state anxiety will be evaluated using the State Anxiety Inventory (SAI). Participants will be randomly assigned to receive either manual acupuncture or sham acupuncture. MDA concentration and SAI scores will be assessed at baseline and 90 minutes after completion of the intervention. The study will also explore the correlation between changes in plasma MDA concentration and changes in SAI scores to assess the relationship between oxidative stress and state anxiety following the intervention.

Inclusion Criteria: * Male or female participants aged 21-40 years. * Active cigarette smokers, defined as smoking ≥20 cigarettes per day for \>5 years, and meeting the Centers for Disease Control and Prevention (CDC) definition of a current smoker: an adult who has smoked at least 100 cigarettes in their lifetime and currently smokes cigarettes. * No previous history of manual acupuncture treatment. * Body mass index (BMI) of 18.5-29.9 kg/m². * Willing and able to comply with all study procedures and to provide written informed consent. * Able to communicate adequately and independently complete the study questionnaires. Exclusion Criteria: * Use of tobacco or nicotine products other than conventional cigarettes, including e-cigarettes, vaping products, hand-rolled cigarettes, nicotine patches, or nicotine gum. * Current fever or body temperature \>37.5°C at screening. * Previous diagnosis of a chronic disease, including autoimmune disease, cancer, liver disease, kidney disease, pulmonary disease, or cardiovascular disease. * History of metabolic syndrome, defined as the presence of ≥3 components, including central obesity, dyslipidemia, hypertension, and diabetes mellitus. * Skin lesions at or near the acupuncture needle insertion sites, including tumors, wounds, keloids, or infections. * History of a hematologic disorder, including platelet count \