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. 2018 Oct;148(4):396-410.
doi: 10.4103/ijmr.IJMR_1983_17.

Smokeless tobacco cessation interventions: A systematic review

Suzanne Tanya Nethan  1 , Dhirendra Narain Sinha  2 , Kumar Chandan  3 , Ravi Mehrotra  3
Affiliations

Smokeless tobacco cessation interventions: A systematic review

Suzanne Tanya Nethan et al. Indian J Med Res. 2018 Oct.

Abstract

Background & objectives: Smokeless tobacco (SLT) consumption is a global health issue with about 350 million users and numerous adverse health consequences like oral cancer and myocardial disorders. Hence, cessation of SLT use is as essential as smoking cessation. An update on the available literature on SLT cessation intervention studies is provided here.

Methods: Through an extensive literature search on SLT cessation intervention studies, using keywords such as smokeless tobacco, cessation, interventions, quitlines, brief advice, nicotine replacement therapy, nicotine gum, nicotine lozenge, nicotine patch, bupropion, varenicline, mHealth, etc., 59 eligible studies were selected. Furthermore, efficacy of the interventions was assessed from the reported risk ratios (RRs) [confidence intervals (CIs)] and quit rates.

Results: Studies were conducted in Scandinavia, India, United Kingdom, Pakistan and the United States of America, with variable follow up periods of one month to 10 years. Behavioural interventions alone showed high efficacy in SLT cessation; most studies were conducted among adults and showed positive effects, i.e. RR [CI] 0.87 [0.7, 1.09] to 3.84 [2.33, 6.33], quit rate between 9-51.5 per cent, at six months. Regular telephone support/quitlines also proved beneficial. Among pharmacological modalities, nicotine lozenges and varenicline proved efficacious in SLT cessation.

Interpretation & conclusions: Globally, there is limited information available on SLT cessation intervention trials, research on which must be encouraged, especially in the low-resource, high SLT burden countries; behavioural interventions are most suitable for such settings. Appropriate training/sensitization of healthcare professionals, and school-based SLT use prevention and cessation programmes need to be encouraged.

Keywords: Behavioural; intervention; nicotine replacement therapy; smokeless tobacco; tobacco dependence; tobacco use cessation.

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Conflict of interest statement

None

Figures

Figure
Figure
Flow chart showing search strategy. *These were the number of articles which were chosen for screening of their abstracts after excluding other articles deemed irrelevant based on their titles.
See this image and copyright information in PMC

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