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Evidence summaries

Interventions for Smokeless Tobacco Use Cessation

Cessation counselling, brief advice, and varenicline each appears to be effective for smokeless tobacco cessation compared with minimal or no support, or placebo. Nicotine replacement therapy may be effective for smokeless tobacco cessation compared with placebo or no medication. Level of evidence: "B"

The certainty of evidence is downgraded by imprecision or heterogeneity.

Summary

A Cochrane review [Abstract] 1 included 43 studies with a total of 20 346 subjects assessing smokeless tobacco cessation. Those products are consumed orally or nasally and do not involve combustion or heating at the time of use. There was moderate-certainty evidence of increased quit rates from counselling compared with minimal support (RR 1.76, 95% CI 1.44 to 2.16; I²=69%; 21 studies, n=7417; downgraded because of heterogeneity), brief advice compared with no support (RR 1.24, 95% CI 1.03 to 1.48; I²=49%; 7 studies, n=6271; downgraded because of imprecision), and varenicline compared with placebo (RR 1.35, 95% CI 1.08 to 1.68; I²=0%; 2 studies, n=508; downgraded because of imprecision). There was low-certainty evidence (downgraded because of imprecision and risk of bias) of increased quit rates from nicotine replacement therapy compared with placebo or no medication (RR 1.18, 95% CI 1.05 to 1.33; I²=39%; 11 studies, n=2826).

Clinical comments

Note

Date of latest search: 2025-08-21

    References

    • Livingstone-Banks J, Vidyasagaran AL, Croucher R, et al. Interventions for smokeless tobacco use cessation. Cochrane Database Syst Rev 2025;4(4):CD015314 [PubMed]

Primary/Secondary Keywords