New NICE guidance to help people stop using traditional South Asian varieties of smokeless tobacco


NICE have published public health guidance and a new care pathway to help people of South Asian origin who are living in England to stop using traditional South Asian varieties of smokeless tobacco.

These publications are focused on people with ancestral links to Bangladesh, India, Nepal, Pakistan or Sri Lanka and smokeless tobacco products such as Paan, Gutka, Shupari, and Betel Quid.

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.

The 6 recommendations cover:

  1. Assessing local need
  2. Working with local South Asian communities
  3. Commissioning smokeless tobacco services
  4. Providing brief advice and referral: dentists, GPs, pharmacists, and other health professionals
  5. Specialist tobacco cessation services (including stop smoking services)
  6. Training for practitioners

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.


Smokeless tobacco cessation: South Asian communities (PDF). NICE public health guidance 39, Sep 2012.

Smokeless tobacco cessation: South Asian communities overview. NICE pathway, Sep 2012.

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Andre Tomlin

André Tomlin is an Information Scientist with 20 years experience working in evidence-based healthcare. He's worked in the NHS, for Oxford University and since 2002 as Managing Director of Minervation Ltd, a consultancy company who do clever digital stuff for charities, universities and the public sector. Most recently André has been the driving force behind the Mental Elf and the National Elf Service; an innovative digital platform that helps professionals keep up to date with simple, clear and engaging summaries of evidence-based research. André is a Trustee at the Centre for Mental Health and an Honorary Research Fellow at University College London Division of Psychiatry. He lives in Bristol, surrounded by dogs, elflings and lots of woodland!

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