Description:
<jats:title>ABSTRACT</jats:title><jats:p><jats:bold>Aims </jats:bold> Spit tobacco use is prevalent in the United States and is associatedwith adverse health consequences. Health‐care providers have neitherevidence summaries nor evidence‐based guidelines to assist themin treating patients who use spit tobacco.</jats:p><jats:p><jats:bold>Design </jats:bold> We completed a systematic review of the literature to determinethe efficacy and safety of pharmacological and behavioral interventionsfor the treatment of spit tobacco use.</jats:p><jats:p><jats:bold>Findings </jats:bold> We found six randomized controlled trials testing pharmacological interventionsand eight testing behavioral interventions. Using random‐effects meta‐analyses,bupropion sustained‐release (SR) increased point prevalence tobaccoabstinence at 12 weeks [odds ratio (OR) 2.1; 95% confidenceinterval (CI), 1.0–4.2]. Nicotine replacementtherapy with patch or gum increased point prevalence tobacco abstinenceat 6 months (OR 1.3; 95% CI, 1.0–1.6).Behavioral interventions increased long‐term (6 month)point prevalence tobacco abstinence (OR 1.7; 95% CI, 1.1–2.9).Studies including an oral examination followed by feedback to thepatient had the highest treatment effect.</jats:p><jats:p><jats:bold>Conclusions </jats:bold> Behavioral interventions for ST users are effective for increasing STabstinence rates. Bupropion SR is probably effective and nicotinereplacement therapy may be effective. This evidence from randomizedcontrolled trials provides health‐care professionals with informationnecessary to effectively treat spit tobacco use.</jats:p>