Interventions for smokeless tobacco use cessation
Abstract
Background
Use of smokeless tobacco (ST) can lead to nicotine addiction and long‐term use can lead to health problems including periodontal disease and cancer.
Objectives
To assess the effects of behavioural and pharmacologic interventions for the treatment of ST use.
Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, Web of Science, PsycINFO, Dissertation Abstracts Online, and Scopus. Date of last search: March, 2007.
Selection criteria
Randomized trials of behavioural or pharmacological interventions to help users of ST to quit with follow up of at least six months.
Data collection and analysis
Two authors independently extracted data.
Main results
Two trials of bupropion SR did not detect a benefit of treatment at six months or longer (Odds Ratio (OR) 0.86, 95% Confidence Interval (CI): 0.47 to 1.57). Four trials of nicotine patch did not detect a benefit (OR 1.16, 95% CI: 0.88 to 1.54), nor did two trials of nicotine gum (OR 0.98, 95% CI: 0.59 to 1.63). There was statistical heterogeneity among the results of 12 behavioural interventions included in the meta‐analyses. Six trials showed significant benefits of intervention. In post‐hoc subgroup analyses, behavioural interventions which include telephone counselling or an oral examination may increase abstinence rates more than interventions without these components.
Authors' conclusions
Behavioural interventions should be used to help ST users to quit and telephone counselling or an oral examination may increase abstinence rates. Pharmacotherapies have not been shown to affect long‐term abstinence.
PICO
Plain language summary
Are there ways to help people stop using smokeless tobacco
All of the included intervention studies have been conducted in the United States where ST includes ground tobacco (snuff) and chewing tobacco. Nicotine replacement therapy (patches or gum), and bupropion have not been shown to help people to stop using ST. Dentists and hygienists may help their patients to stop, especially when they show them the damage that ST causes in their mouths. Telephone counselling may assist ST users in quitting. More and larger studies are needed.
