Abstract Background Tobacco addiction affects both the mind and the body. Most people find that a mix of medicine, a strategy to change personal habits, and emotional support is the most effective way to quit. The aim of the work was to compare between the effectiveness of cupping therapy and aversion therapy as adjuvant methods in smoking cessation program. Patients and methods A prospective randomized study was done on 60 smokers recruited from Ain Shams University Hospitals who were divided into three groups. Group I : included 20 participants subjected to counseling only (the five A’S); Group II : included 20 participants subjected to counseling and aversion therapy using onion-powdered cigarettes by mixing tobacco with dried onion powder by an equal amount; Group III: included 20 participants subjected to counseling and a monthly bloodletting cupping session for 3 consecutive months, follow up visits were conducted every 2 weeks for 3 months to assess outcome and withdrawal symptoms. Results There was no statistically significant difference (p value >0.05) between the success rate in the three different groups. The success rate of quitting was the same among smokers in group I and group III ( complete success 10% and partial success 10%), while the success rate of quitting among smokers in group II was ( complete success 0% and partial success 15%). There were significant statistical correlations (P < 0.05) found between the outcome and the age, occupation, duration and pack/year smoking, while there was insignificant statistical difference (P < 0.05) between the outcome and marital status, comorbidities and previous quitting attempts. There was no significant difference between three groups in the frequency of withdrawal symptoms during follow up visits, while there was significant statistic reduction in frequency of dizziness, headache and fatigue between follow up visits in the three groups, weight gain increased during follow up visits. Conclusion Using adjuvant methods like aversion and bloodletting cupping therapy in smoking cessation programs doesn’t seem to produce significant change in success rate of quitting smoking.