Smokeless Tobacco dependence and cessation measures in India

India being the largest smokeless tobacco (SLT) producer and consumer in the South East Asia Region (SEAR) entitled with a range of products. SLT consumption is very common because it is associated with socio-economic and cultural perspectives in the India. After the implementation of the first treaty of the World Health Organization Framework Convention on Tobacco Control (WHO-FCTC), public health standards were reaffirmed and improvised through successful implementation of articles since 2007 as reported in the global progress factsheet. Many measures have been implemented for achieving the success of WHO-FCTC in India and to control the huge disease burden induced by tobacco use. The objective of the present study was to understand and explore the factors involved in the SLT demand reduction by revealing the dependence and cessation implementation in India in the context of strategies and policies. For this study, we searched for SLT dependence and SLT cessation literature survey in PubMed and obtained 102 literatures consisting of studies and reviews, which were further scrutinized by excluding the reviews, studies conducted abroad and studies conducted within the last 5 years (after 2015). No statistical significance was observed in comparison of National to International SLT dependence and an attempt to quit SLT following the tenure of a year. This is in-line with GATS-2 and international data. We have also discussed a diverse approach in the control of SLT at different levels-such as SLT users, healthcare professional, policy advocates supplier, labeling, legal policies, and educating at various platforms. Effective strategies for the cessation of SLT is mandatory with proper guidance for the manufacturer, users and sellers in controlling SLT products