Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026
Non-cigarette tobacco cessation support in England: current provision, confidence, and barriers identified in a cross-sectional survey of healthcare professionals involved in smoking cessation support.
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Byun Yo Seop, Taylor Eve, Shahab Lion, East Katherine, Brown Jamie, Tattan-Birch Harry, Cox Sharon, Mishu Masuma Pervin, Hammond David, Jackson Sarah E
Аннотация
INTRODUCTION: While cigarette smoking remains the dominant form of tobacco use in England, a range of other tobacco products are also used. Evidence on demand for non-cigarette tobacco cessation support-and on providers' preparedness and barriers to offering such support-remains limited.
METHODS: We conducted a cross-sectional online survey of professionals involved in smoking cessation support in England (n = 96). For each specific non-cigarette tobacco product (cigars, cigarillos, shisha, pipes, bidis, chewing tobacco, dry snuff, moist snuff/dip, and heated tobacco), the survey assessed awareness, perceived harms, demand for cessation support, interventions offered, training and confidence, and perceived barriers to providing support.
RESULTS: Awareness was universal for cigars, pipes, and shisha; high for chewing tobacco (87.5%), heated tobacco (77.1%), and cigarillos (71.9%); and lower for dry snuff (56.3%), bidis (33.3%), and moist snuff/dip (26.0%). Client demand for cessation support was low: 20.8% of participants reported requests at least monthly for cigars and ≤13.5% for other products. Support was mainly behavioral and nicotine replacement therapy-based, with few (<25%) offering other pharmacotherapies. Most participants who offered support used the same approach as for cigarettes (>90% across products), with few having received product-specific training (2.1%-19.8% of all participants). The main barriers included perceived lack of demand (46.9%), training (44.8%), and knowledge (43.8%); open-ended responses also emphasized that commissioning constraints excluded non-cigarette products.
CONCLUSIONS: Healthcare professionals in England report limited demand for cessation support for non-cigarette tobacco products, which may partly reflect service reach and commissioning constraints rather than lack of need. Few report receiving product-specific training; most apply standard cigarette cessation approaches or are not commissioned to provide support.
IMPLICATIONS: Healthcare professionals involved in smoking cessation support in England often lack the training, knowledge, and funding to support people to quit non-cigarette tobacco. Including these products in service plans and commissioning would enable them to give proper support.
METHODS: We conducted a cross-sectional online survey of professionals involved in smoking cessation support in England (n = 96). For each specific non-cigarette tobacco product (cigars, cigarillos, shisha, pipes, bidis, chewing tobacco, dry snuff, moist snuff/dip, and heated tobacco), the survey assessed awareness, perceived harms, demand for cessation support, interventions offered, training and confidence, and perceived barriers to providing support.
RESULTS: Awareness was universal for cigars, pipes, and shisha; high for chewing tobacco (87.5%), heated tobacco (77.1%), and cigarillos (71.9%); and lower for dry snuff (56.3%), bidis (33.3%), and moist snuff/dip (26.0%). Client demand for cessation support was low: 20.8% of participants reported requests at least monthly for cigars and ≤13.5% for other products. Support was mainly behavioral and nicotine replacement therapy-based, with few (<25%) offering other pharmacotherapies. Most participants who offered support used the same approach as for cigarettes (>90% across products), with few having received product-specific training (2.1%-19.8% of all participants). The main barriers included perceived lack of demand (46.9%), training (44.8%), and knowledge (43.8%); open-ended responses also emphasized that commissioning constraints excluded non-cigarette products.
CONCLUSIONS: Healthcare professionals in England report limited demand for cessation support for non-cigarette tobacco products, which may partly reflect service reach and commissioning constraints rather than lack of need. Few report receiving product-specific training; most apply standard cigarette cessation approaches or are not commissioned to provide support.
IMPLICATIONS: Healthcare professionals involved in smoking cessation support in England often lack the training, knowledge, and funding to support people to quit non-cigarette tobacco. Including these products in service plans and commissioning would enable them to give proper support.