Behavioural Interventions for Smokeless Tobacco Cessation
摘要
Smokeless tobacco (ST) use remains a significant public health challenge, particularly in South Asia, where diverse products such as naswar, gutkha/gutka/ghutka, paan (betel-quid), and khaini are widely consumed and significantly associated with oral cancers and other diseases. Dental professionals are one of the first to notice mucosal or periodontal tissue changes in the oral cavity due to tobacco use and are uniquely placed to support ST cessation. This chapter explores the role of dental professionals and dental/dental affiliated settings, in delivering behavioural interventions to aid cessation. This chapter reviews key approaches, including brief advice, individual and group counselling, motivational interviewing, telephone-based support, and self-help materials. While evidence suggests that these interventions can increase quit rates, most studies are from high-income countries, especially the United States. This limits the relevance of findings for regions like South Asia, where ST use is ingrained in the culture, cessation services are negligible, and clinical infrastructure is limited. Brief and structured behavioural interventions have shown promise even in resource-constrained settings. However, successful implementation requires attention to cultural sensitivities and logistic challenges such as lack of time and private space in dental clinics. This chapter emphasizes the need for context-specific strategies and more local research to inform practice. By integrating behavioural support into routine dental practice, dental professionals can play a critical role in reducing the burden of ST use.