An epidemic that deserves more attention: epidemiology, prevention, and treatment of smokeless tobacco.
Smokeless tobacco (ST) use is common, especially in southern and rural areas. It is expected to become more popular with the recent move to sell more ST in areas where indoor smoking is banned. ST use usually starts in adolescence, which places this group at high risk. Nicotine dependence occurs almost exclusively in people who start using ST in their adolescent years, so it is crucial to prevent the introduction of ST to this age group. The debate over whether ST is a gateway to smoking or a bridge to quitting has not been fully answered. ST should not replace smoking where indoor smoking is banned. ST is less harmful than smoking, but nicotine replacement therapy (NRT) is much safer than ST. NRT and bupropion are helpful in the treatment of ST dependence by decreasing withdrawal symptoms and preventing weight gain after cessation.
Arabi
Ziad
Z
Department of General Internal Medicine, Geriatrics, and Health Policy Research at University of Louisville, Louisville, KY 40202, USA. ziadarabi@yahoo.com
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001521:Behavior Therapy; D016642:Bupropion / Q000627:therapeutic use; D002648:Child; D004196:Disease Outbreaks / Q000517:prevention & control; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D009059:Mouth Diseases / Q000453:epidemiology; D009538:Nicotine / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D012737:Sex Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
D018765:Dopamine Uptake Inhibitors; D018722:Nicotinic Agonists; D016642:Bupropion; D009538:Nicotine