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July 11, 2026Open Access

Nurse-led tobacco and areca-nut cessation interventions for oral potentially malignant disorders: a systematic review

Key Points

The review aims to assess the effectiveness of nurse-led tobacco and areca-nut cessation interventions in managing oral potentially malignant disorders.
Followed PRISMA 2020 guidelines for systematic review.
Included 18 studies (10 RCTs, 5 quasi-experimental, 3 cohort) with 7,856 adults diagnosed with OPMDs.
Evaluated outcomes included abstinence and lesion regression following nurse-led interventions compared to usual care.
Nurse-led interventions achieved higher abstinence rates (28–52%) compared to usual care (12–25%).
Lesion regression was observed in 46–65% of intervention participants.
Improvements in quality of life, adherence, and knowledge were noted.

Abstract

Oral potentially malignant disorders (OPMDs), including oral submucous fibrosis, leukoplakia, lichen planus, and erythroplakia, are established precursors of oral cancer, particularly in regions with high tobacco and areca-nut use. Nurses are well positioned to deliver cessation support, yet evidence regarding their effectiveness in OPMD management limited evidence exists on effectiveness in OPMD management. Also This review evaluated the effectiveness of nurse-led tobacco and areca-nut cessation interventions in adults with OPMDs. Following PRISMA 2020 guidelines and PROSPERO registration (CRD420251136386), electronic databases and grey literature were searched through December 2024. Also moderate heterogeneity was observed across studies. Eligible studies included adults with clinically diagnosed OPMDs receiving nurse-led cessation interventions (counseling, motivational interviewing, or nicotine replacement therapy referral) compared with usual care or other providers. Primary outcomes were abstinence and lesion regression or progression. Due to substantial heterogeneity, findings were narratively synthesized. Eighteen studies (10 randomized controlled trials, 5 quasi-experimental studies, and 3 cohort studies; n = 7,856) were included. Nurse-led interventions achieved higher abstinence rates (28–52% across studies) than usual care (12–25%). Lesion regression occurred in 46–65% of intervention participants. Improvements in quality of life, adherence, and knowledge were also reported. Overall risk of bias was low to moderate. Nurse-led cessation interventions appear to be feasible and potentially effective strategies for improving behavioral and lesion-related outcomes in patients with OPMDs. However, the findings should be interpreted with caution due to the limitations of the available evidence. Integrating such models into oral health and cancer control programs may contribute to preventive oncology efforts in high-burden settings, although further high-quality research is needed to confirm their effectiveness. This review is registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD420251136386.

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