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Interventions for smokeless tobacco use cessation
J O Ebbert1, L C Rowland, V Montori
1Department of Internal Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA. ebbert.jon@mayo.edu
Behavioral interventions are effective for smokeless tobacco (ST) cessation, particularly those including oral examinations and feedback. Pharmacotherapies have not demonstrated long-term benefits for quitting ST.
Area of Science:
- Public Health
- Addiction Medicine
- Oral Health
Background:
- Smokeless tobacco (ST) use is a significant cause of nicotine addiction.
- ST use is linked to severe health issues, including periodontal disease and oral cancer.
Purpose of the Study:
- To evaluate the effectiveness of behavioral and pharmacotherapeutic interventions for treating smokeless tobacco (ST) use.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs) assessing interventions for ST cessation.
- Searched multiple databases including Cochrane, MEDLINE, EMBASE, CINAHL, and PsycINFO up to February 2004.
- Included RCTs with a minimum six-month follow-up period.
Main Results:
- Pharmacotherapies such as bupropion, nicotine patch, and nicotine gum did not show significant long-term benefits for ST cessation.
- Behavioral interventions demonstrated varied results, with some trials showing significant benefits.
- A post-hoc analysis revealed that behavioral interventions incorporating oral examination and feedback on mucosal changes were effective (OR 2.41, 95% CI: 1.79 to 3.24).
Conclusions:
- Behavioral interventions are recommended for individuals seeking to quit smokeless tobacco (ST).
- Current evidence does not support the long-term efficacy of pharmacotherapies for ST cessation.
- Further large-scale trials are necessary to investigate the role of pharmacotherapies in ST cessation.
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