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Related Experiment Video

Updated: Mar 31, 2026

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Interventions for smokeless tobacco use cessation.

Jon O Ebbert1, Muhamad Y Elrashidi, Lindsay F Stead

  • 1Division of Primary Care Internal Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, Minnesota, USA, 55905.

The Cochrane Database of Systematic Reviews
|October 27, 2015
PubMed
Summary

Smokeless tobacco (ST) cessation may be aided by varenicline and nicotine lozenges, with behavioral interventions also showing promise. However, evidence for nicotine lozenges is limited, and effective components of behavioral interventions require further clarification.

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Area of Science:

  • Public Health
  • Addiction Medicine
  • Behavioral Science

Background:

  • Smokeless tobacco (ST) use is linked to dependence and severe health issues, including cancer and cardiovascular disease.
  • Effective interventions are crucial for ST cessation to mitigate long-term health risks.

Purpose of the Study:

  • To evaluate the efficacy of behavioral and pharmacological interventions for smokeless tobacco (ST) cessation.
  • To synthesize evidence from randomized controlled trials assessing ST cessation treatments.

Main Methods:

  • Systematic review and meta-analysis of 34 randomized trials involving over 16,000 participants.
  • Inclusion criteria required interventions for ST cessation with at least six months follow-up.
  • Outcomes were summarized using risk ratios (RRs) with fixed-effect modeling for pooled analyses.

Main Results:

  • Varenicline demonstrated moderate evidence of increased ST abstinence (RR 1.34).
  • Nicotine lozenges showed a potential benefit in tobacco abstinence (RR 1.36), though confidence is low.
  • Behavioral interventions showed significant heterogeneity; those including telephone support appeared more effective.

Conclusions:

  • Varenicline and nicotine lozenges may support smokeless tobacco cessation.
  • Behavioral interventions, particularly those with telephone support, show potential for aiding ST quit attempts.
  • Further research is needed to clarify the specific components of behavioral interventions that drive success and to strengthen evidence for nicotine lozenges.