Adapting a behavioural support intervention for smokeless tobacco cessation in South Asians

无烟烟草是一种含有烟草的产品，放在嘴里或鼻子里，但在使用时不会燃烧。全世界约有3亿人消费无烟烟草，使用无烟烟草会导致心脏病、中风以及口腔癌、食道癌和胰腺癌。它的使用特别普遍，并被认为是南亚裔人（包括生活在英国的人）的社会接受。根据最新的研究，行为咨询可以帮助那些对无烟烟草上瘾的人戒烟。然而，这项研究主要在美国和欧洲人群中进行，与使用更多成瘾性和危险产品的南亚人几乎无关。此外，南亚人使用无烟烟草具有很强的社会文化层面，在行为咨询中需要考虑到这一点。英国的咨询师在向南亚裔无烟烟草使用者提供行为咨询时，通常会修改他们的建议。然而，在实践中存在差异，没有标准的协议或任何证据证明经调整的方法的有效性。我们的目标是确定行为咨询所需的修改，使其更有效，可行和接受南亚人在支持他们戒烟无烟烟草。我们会先找一个专家小组，在辅导会上提出所需的修改。然后，我们将分别在英国和巴基斯坦的两个卫生机构向无烟烟草使用者提供这些产品。

Smokeless tobacco is a product containing tobacco, placed in the mouth or nose but not burned at the time of use. Consumed by approximately 300 million people worldwide, smokeless tobacco use leads to heart disease, stroke, and cancer of the mouth, oesophagus and pancreas. Its use is particularly common and considered socially acceptable among people of South Asian-origin including those living in the UK. According to latest research, behavioural counselling helps people addicted to smokeless tobacco in quitting. However, this research, mainly conducted in the US and European populations, is of little relevance to South Asians who use more addictive and hazardous products. Moreover, smokeless tobacco use among South Asians has strong socio-cultural dimensions, which need to be considered in behavioural counselling. Counsellors in the UK commonly modify their advice when offering behavioural counselling to smokeless tobacco users of South Asian-origin. However, there are variations in practice, and no standard protocol or any evidence for the effectiveness of an adapted approach. We aim to identify the modification required in behavioural counselling to make it more effective, feasible and acceptable to South Asians in supporting them to quit smokeless tobacco. We will first get a group of experts to propose required modifications in the counselling sessions. We will then offer these to smokeless tobacco users in two health facilities in the UK and in Pakistan respectively.