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26-09-2012 | General practice | Article

GPs urged to act on smokeless tobacco


Full guidance

medwireNews: GPs should take action on smokeless tobacco use among South Asian patients, according to new guidance from NICE.

The regulator says that outside of specialised services, there is a lack of awareness about the use of products, such as paan, gutka and betel quid, which can lead to mouth and oropharyngeal cancer, dental disease, heart attacks, strokes and pregnancy complications.

"We hope that this guidance will inform health professionals of the risks posed by these products, so they can take action by asking patients of South Asian origin if they use smokeless tobacco, making sure they are aware of the health risks, and where appropriate referring people for support to help them stop using these products," said Professor Mike Kelly, Director of the NICE Centre for Public Health Excellence in a press release.

Use by South Asian people is thought to be highest among women, people of Bangladeshi origin and those in older age and low socioeconomic groups.

Many users perceive the products to have health benefits, such as easing indigestion or curing bad breath, and they may not be aware that they contain tobacco. NICE says that the majority of packets are sold without regulatory health warnings. However, it is thought that smokeless tobacco use among South Asian women is responsible for their 3.7-fold greater risk of oral cancer compared with other women.

The guidance also recommends that commissioners create specific services for South Asian smokeless tobacco users that are integrated with stop smoking services and arrange training for healthcare professionals to help them identify and assist patients to quit.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Kirsty Oswald