Next review: To be scheduled

This guidance aims to help people of South Asian origin who are living in England to stop using traditional South Asian varieties of smokeless tobacco. The phrase 'of South Asian origin' refers here to people with ancestral links to Bangladesh, India, Nepal, Pakistan or Sri Lanka.

The term 'smokeless tobacco', as it is used in this guidance, refers to 3 broad types of products:

  • Tobacco with or without flavourants, for example: misri India tobacco (powdered) and qimam (kiman).
  • Tobacco with various alkaline modifiers, for example: khaini, naswar (niswar, nass) and gul.
  • Tobacco with slaked lime as an alkaline modifier and areca nut, for example: gutkha, zarda, mawa, manipuri and betel quid (with tobacco).

Products, like ‘snus’ or similar oral snuff products are not included.

The guidance is for commissioners and providers of tobacco cessation services (including stop smoking services), health education and training services, health and wellbeing boards and health and social care practitioners.

It is also for all those with public health as part of their remit, in particular, the health of South Asian communities. The guidance may also be of interest to local authority elected members and members of the public.

The 6 recommendations cover:

  • assessing local need
  • working with local South Asian communities
  • commissioning smokeless tobacco services
  • providing brief advice and referral: dentists, GPs, pharmacists, and other health professionals
  • specialist tobacco cessation services (including stop smoking services)
  • training for practitioners.

This guideline was previously called smokeless tobacco cessation: South Asian communities.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE) accreditation logo