Division of Clinical Oncology, ICMR-National Institute of Cancer Prevention & Research, Noida, India.
School of Preventive Oncology, Patna, India.
Indian J Med Res. 2018 Oct;148(4):396-410. doi: 10.4103/ijmr.IJMR_1983_17.
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.
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.
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.
无烟烟草（SLT）的消费是一个全球性的健康问题，全球约有 3.5 亿使用者，存在许多不良健康后果，如口腔癌和心肌紊乱。因此，停止使用 SLT 与停止吸烟同样重要。本文提供了关于 SLT 戒断干预研究的最新文献综述。
通过广泛搜索关于 SLT 戒断干预研究的文献，使用了如无烟烟草、戒断、干预、戒烟热线、简短建议、尼古丁替代疗法、尼古丁口香糖、尼古丁含片、尼古丁贴剂、安非他酮、伐伦克林、移动医疗等关键词，共筛选出 59 项符合条件的研究。此外，根据报告的风险比（RR）[置信区间（CI）]和戒烟率评估干预措施的效果。
研究在斯堪的纳维亚、印度、英国、巴基斯坦和美国进行，随访时间从一个月到 10 年不等。单独的行为干预在 SLT 戒断方面显示出较高的效果；大多数研究都是在成年人中进行的，结果显示出积极的效果，即 RR[CI]为 0.87[0.7,1.09]至 3.84[2.33,6.33]，戒烟率为 9-51.5%，在六个月时。定期电话支持/戒烟热线也被证明是有益的。在药物治疗方面，尼古丁含片和伐伦克林被证明对 SLT 戒断有效。
全球范围内，关于 SLT 戒断干预试验的信息有限，必须鼓励开展相关研究，特别是在资源匮乏、SLT 负担高的国家；行为干预最适合这些环境。需要鼓励对医疗保健专业人员进行适当的培训/提高认识，并开展学校为基础的 SLT 使用预防和戒断计划。
