NICE highlights dangers of smokeless tobacco products

SMOKELESS tobacco products pose a continuing threat to health in South Asian communities across England, according to new NICE guidance.

Products such as paan, gutka, shupari, and betel quid are associated with serious health problems such as oral cancer, heart attack and stroke, and problems in pregnancy – contrary to popular perceptions that they are healthy or beneficial.

Use of these products is thought to be one of the main reasons why South Asian women are nearly four times more likely to develop oral cancers than women from other ethnic groups in England. Smokeless tobacco use is often highest among older women of South Asian descent, but in some parts of the UK, a high percentage of young South Asians are also reported as using these products.

NICE recommends that dentists, GPs, pharmacists, dental and GP practice nurses, midwives, health visitors and other health professional provide advice and referral for smokeless tobacco cessation. The guidance also recommends ensuring that any materials on smokeless tobacco cessation refer to the products using the names people use locally. They should provide information about the risks associated with smokeless tobacco and should challenge perceived benefits of smokeless tobacco (for example, that it is an appropriate way to ease indigestion or dental pain, or that it helps freshen the breath).

Professor Mike Kelly, Director of the NICE Centre for Public Health Excellence, said: "This guidance is an important opportunity to highlight the range of serious health risks associated with smokeless tobacco products, such as paan or gutkha, which are used by some people of South Asian origin. Often the people using these products aren't aware that they contain tobacco, nor that they could be at greater risk of oral cancers or cardiovascular disease.

"There's also low awareness of the health problems caused by these smokeless tobacco products within mainstream NHS services. 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."

Access the guidance at http://guidance.nice.org.uk/PHG/Wave23/20