{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:29:52Z","timestamp":1792171792230,"version":"4.4.0"},"reference-count":52,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T00:00:00Z","timestamp":1716163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and aims<\/jats:title><jats:p>Smokeless tobacco (ST) use in South Asia is high, yet interventions to support its cessation are lacking. We tested the feasibility of delivering interventions for ST cessation in South Asia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We used a 2\u00a0\u00d7\u20092 factorial design, pilot randomized controlled trial with a duration of 26\u2009weeks, including baseline and follow\u2010up (6, 12 and 26\u2009weeks) assessments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two primary health\u2010care facilities each in Dhaka (Bangladesh) and Karachi (Pakistan) and a walk\u2010in cancer screening clinic in Noida (India) took part.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Adult daily ST users willing to make a quit attempt within 30\u2009days. Of 392 screened, 264 participants [mean age: 35\u2009years, standard deviation\u2009=\u200912.5, 140 (53%) male] were recruited between December 2020 and December 2021; 132 from Bangladesh, 44 from India and 88 from Pakistan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Participants were randomized to one of three treatment options [8\u2010week support through nicotine replacement therapy (NRT, <jats:italic>n<\/jats:italic>\u00a0=\u200966), a behavioural intervention for smokeless tobacco cessation in adults (BISCA, <jats:italic>n<\/jats:italic>\u00a0=\u200966) or their combination (<jats:italic>n<\/jats:italic>\u00a0=\u200966)] or the control condition of very brief advice (VBA) to quit (<jats:italic>n<\/jats:italic>\u00a0=\u200966).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Recruitment and retention, data completeness and feasibility of intervention delivery were evaluated. Biochemically verified abstinence from tobacco, using salivary cotinine, was measured at 26\u2009weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>Retention rates were 94.7% at 6\u2009weeks, dropping to 89.4% at 26\u2009weeks. Attendance in BISCA pre\u2010quit (100%) and quit sessions (86.3%) was high, but lower in post\u2010quit sessions (65.9%), with variability among countries. Adherence to NRT also varied (45.5% Bangladesh, 90% India). Data completion for key variables exceeded 93% among time\u2010points, except at 26\u2009weeks for questions on nicotine dependence (90%), urges (89%) and saliva samples (62.7%). Among follow\u2010up time\u2010points, self\u2010reported abstinence was generally higher among participants receiving BISCA and\/or NRT. At 26\u2009weeks, biochemically verified abstinence was observed among 16 (12.1%) participants receiving BISCA and 13 (9.8%) participants receiving NRT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This multi\u2010country pilot randomized controlled trial of tobacco cessation among adult smokeless tobacco users in South Asia demonstrated the ability to recruit and retain participants and report abstinence, suggesting that a future definitive smokeless tobacco cessation trial is viable.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16515","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T04:10:02Z","timestamp":1716264602000},"page":"1366-1377","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Behavioural support and nicotine replacement therapy for smokeless tobacco cessation in Bangladesh, India and Pakistan: A pilot randomized controlled trial"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2253-3911","authenticated-orcid":false,"given":"Faraz","family":"Siddiqui","sequence":"first","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Kanaan","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Croucher","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Bauld","sequence":"additional","affiliation":[{"name":"Usher Institute and Behavioural Research UK University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fariza","family":"Fieroze","sequence":"additional","affiliation":[{"name":"ARK Foundation  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant","family":"Kumar","sequence":"additional","affiliation":[{"name":"National Institute of Cancer Prevention Research  Noida India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laraib","family":"Mazhar","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varsha","family":"Pandey","sequence":"additional","affiliation":[{"name":"National Institute of Cancer Prevention Research  Noida India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cath","family":"Jackson","sequence":"additional","affiliation":[{"name":"Valid Research Ltd  Wetherby UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rumana","family":"Huque","sequence":"additional","affiliation":[{"name":"ARK Foundation  Dhaka Bangladesh"},{"name":"University of Dhaka  Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romaina","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1529-7778","authenticated-orcid":false,"given":"Kamran","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of York  York UK"},{"name":"Hull York Medical School  York UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"ASTRA Global Health Research Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,20]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"CDCTobaccoFree. Centers for Disease Control and Prevention.2019[cited 2020 Apr 21].Smokeless Tobacco. Available at:https:\/\/www.cdc.gov\/tobacco\/data_statistics\/fact_sheets\/smokeless\/index.htm. Accessed 15 January 2024."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-020-01677-9"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lansea.2022.100088"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntx276"},{"key":"e_1_2_10_6_1","unstructured":"Global Adult Tobacco Survey Factsheets[internet].World Health Organization. [cited 20 March 2024]. Available at:https:\/\/www.who.int\/teams\/noncommunicable-diseases\/surveillance\/systems-tools\/global-adult-tobacco-survey. Accessed 15 January 2024."},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2011-050148"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(23)00205-X"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijph.IJPH_233_17"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntab065"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k4878"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijtb.2021.08.027"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fct.2018.05.004"},{"key":"e_1_2_10_14_1","unstructured":"HatsukamiD ZellerM GuptaP ParascandolaM AsmaS.Smokeless tobacco and public health: a global perspective.2014. Available at:https:\/\/stacks.cdc.gov\/view\/cdc\/43373. Accessed 15 January 2024."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_149_18"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-21-0567"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69249-0"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntu255"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205120"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aogh.2016.07.005"},{"key":"e_1_2_10_22_1","unstructured":"World Health Organization (WHO).WHO Framework Convention on Tobacco Control[internet]. WHO Regional Office for South\u2010East Asia;2004. Available at:https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/206081\/B3677.pdf. Accessed 15 January 2024."},{"key":"e_1_2_10_23_1","unstructured":"World Health Organization (WHO).MPOWER: a Policy Package to Reverse the Tobacco Epidemic2008. Available at:https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/43888\/9789241596633_eng.pdf. Accessed 15 January 2024."},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/tc-2022-057669"},{"key":"e_1_2_10_25_1","article-title":"Interventions for smokeless tobacco use cessation","volume":"10","author":"Ebbert JO","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.2165\/11598450-000000000-00000"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD015314"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntt115"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-208732"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3177-8"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-005-0184-3"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2012.04085.x"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2014.06.021"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40814-022-01146-5"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2006.01461.x"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2004.00995.x"},{"key":"e_1_2_10_37_1","unstructured":"R Core Team.R: A Language and Environment for Statistical Computing [internet].2017. Available at:https:\/\/www.r-project.org\/"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1989.tb03059.x"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.17382"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/1757975913499800"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2005.12.015"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-004-1923-6"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2010.03226.x"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntq050"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955-014-0181-5"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.04.014"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-3-26"},{"key":"e_1_2_10_48_1","unstructured":"StataCorp.Stata Statistical Software.College Station TX: StataCorp LLC;2019."},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-9-201305070-00006"},{"key":"e_1_2_10_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntt211"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2012.03819.x"},{"key":"e_1_2_10_52_1","article-title":"Nicotine receptor partial agonists for smoking cessation","volume":"5","author":"Livingstone\u2010Banks J","year":"2023","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_53_1","article-title":"Electronic cigarettes for smoking cessation","volume":"11","author":"Hartmann\u2010Boyce J","year":"2022","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.16515","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T07:17:32Z","timestamp":1719904652000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.16515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,20]]},"references-count":52,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1111\/add.16515"],"URL":"https:\/\/doi.org\/10.1111\/add.16515","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,20]]},"assertion":[{"value":"2023-10-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}