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Smokeless Tobacco Cessation - South Asian Communities (PH 39)


National Institute for Health and Clinical Excellence (NICE)

Subject Keywords: Smoking cessation
Type: Guideline
Region: United Kingdom

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.



Rights: © NICE
Suggested citation:

National Institute for Health and Clinical Excellence (NICE). (2012) Smokeless Tobacco Cessation - South Asian Communities (PH 39) [Online]. Available from: [Accessed: 23rd July 2019].


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