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Intervention Review

Interventions for smokeless tobacco use cessation

  1. Jon Ebbert1,*,
  2. Victor M Montori2,
  3. Kristin S Vickers-Douglas3,
  4. Patricia C Erwin4,
  5. Lowell C Dale1,
  6. Lindsay F Stead5

Editorial Group: Cochrane Tobacco Addiction Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 19 JUL 2007

DOI: 10.1002/14651858.CD004306.pub3

Database Title

Additional Information

How to Cite

Ebbert J, Montori VM, Vickers-Douglas KS, Erwin PC, Dale LC, Stead LF. Interventions for smokeless tobacco use cessation. Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD004306. DOI: 10.1002/14651858.CD004306.pub3.

Author Information

  1. 1

    Mayo Clinic, Department of Primary Care Internal Medicine, Rochester, MN, USA

  2. 2

    Mayo Clinic, Division of Endocrinology, Department of Internal Medicine, Rochester, MN, USA

  3. 3

    Mayo Clinic, Nicotine Dependence Center, Rochester, MN, USA

  4. 4

    Mayo Clinic, Mayo Clinic Libraries, Division of Education, Rochester, MN, USA

  5. 5

    University of Oxford, Department of Primary Health Care, Oxford, UK

*Jon Ebbert, Department of Primary Care Internal Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN, 55905, USA. ebbert.jon@mayo.edu.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JAN 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

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 strategy

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.

 

Plain language summary

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  2. Abstract
  3. 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.

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