Introduction: scope and purpose of this guidance
This guidance aims to help people of South Asian origin to stop using smokeless tobacco. The 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.
The phrase 'of South Asian origin' is used in this guidance to mean people with ancestral links to Bangladesh, India, Nepal, Pakistan or Sri Lanka.
The term 'smokeless tobacco' is used in this guidance to refer to any type of product containing tobacco that is placed in the mouth or nose and not burned and which is typically used in England by people of South Asian origin. (See section 1 for more on these products.) It does not include products that are sucked, like 'snus' or similar oral snuff products. (Under UK law it is an offence to supply tobacco for oral use unless it is intended to be smoked or chewed.)
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. They may be working within the NHS, local authorities or the wider public, private, voluntary and community sectors. This includes:
directors of public health
GPs and their staff
dentists, dental nurses, dental hygienists
community pharmacists, health visitors, midwives, nurses and other health professionals
community and faith leaders
The guidance may also be of interest to local authority elected members, people who want to stop using smokeless tobacco, their families and other members of the public.
The Department of Health (DH) asked the National Institute for Health and Clinical Excellence (NICE) to produce this guidance.
The recommendations are based on the best available evidence. They were developed by the Public Health Interventions Advisory Committee (PHIAC).
Members of PHIAC are listed in appendix A.
The guidance was developed using the NICE public health intervention process. See appendix B for details.
Supporting documents used to prepare this document are listed in appendix E.
The evidence that PHIAC considered included: reviews of the evidence, economic modelling and the testimony of expert witnesses. Further detail on the evidence is given in the considerations section (section 3) and in appendices B and C.
In some cases, the evidence was insufficient and PHIAC has made recommendations for future research.
The guidance complements NICE guidance on smoking cessation (for further details, see section 7).