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Behavioral Interventions for Smokeless Tobacco Cessation.

Suzanne Tanya Nethan1, Dhirendra Narain Sinha2, Shashi Sharma3

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Behavioral interventions effectively aid smokeless tobacco (SLT) cessation in adults globally, including in developing nations. However, these interventions show limited effectiveness for youth cessation worldwide.

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Area of Science:

  • Public Health
  • Behavioral Science
  • Tobacco Control

Background:

  • Smokeless tobacco (SLT) consumption is increasing globally, particularly in the WHO South-East Asian region.
  • SLT use poses significant health risks to consumers.
  • Existing reviews often focus on developed countries, necessitating a broader, global perspective.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy of behavioral interventions for smokeless tobacco (SLT) cessation.
  • To assess the effectiveness of these interventions in both developed and developing countries, including for adults and youth.
  • To provide a global update on SLT cessation strategies.

Main Methods:

  • Systematic review and meta-analysis of SLT cessation studies using behavioral interventions.
  • Inclusion criteria: minimum 6-month follow-up, reported risk ratios (RR) and 95% confidence intervals (CI), published 1992-2017.
  • Analysis categorized by country income (developed/developing) and age group (adults/youth); publication bias assessed using Begg's test.

Main Results:

  • Nineteen studies with 24,498 participants were included.
  • Behavioral interventions were effective for adult SLT cessation globally (RR=1.63), in developed (RR=1.39), and developing countries (RR=2.79).
  • Interventions were not effective for youth SLT cessation in developed (RR=1.39) or developing countries (RR=0.87). Publication bias was noted.

Conclusions:

  • Behavioral interventions as a standalone method are effective for adult smokeless tobacco cessation in both developed and developing countries.
  • Healthcare providers should be trained and encouraged to offer these interventions.
  • Further research may be needed to understand effective cessation strategies for youth.