How effective are behavioural and pharmacological interventions for the treatment of smokeless tobacco cessation?
The evidence for the use of pharmacotherapies is insufficient to provide clear guidelines for practice. The inference of the effect size of behavioural interventions for increasing smokeless tobacco abstinence rates was weakened by the limited methodological quality of some of these trials, including loss to follow-up and potential baseline differences between the groups. Moreover, there is the possibility publication bias may also have impacted on the results.
Smokeless tobacco is tobacco that is consumed orally, not burned. A variety of types of smokeless tobacco is consumed throughout the world, and it is an important worldwide public health issue. In the US, the principal types of smokeless tobacco are chewing tobacco (cut tobacco leaves) and snuff (moist ground tobacco). In Sweden, snus (finely ground moist tobacco) is used. In India, smokeless tobacco contains tobacco leaf mixed with other ingredients, such as areca nut and lime.1 In Sudan, toombak is made from a fermented ground powdered tobacco mixed with sodium bicarbonate.2 Use of smokeless tobacco can lead to nicotine addiction, and long-term use can lead to health problems, including periodontal disease, cancer, and cerebrovascular and cardiovascular disease.