Self-help programs help smokeless tobacco users quit

December 17, 2000

Few resources exist to help smokeless tobacco users quit, but low-cost self-help approaches may work to fill this gap, according to a new study.

"Our study demonstrated that low-cost minimal interventions done by mail and phone can help a sizable proportion of smokeless tobacco users quit," said lead author Herbert H. Severson, PhD.

"Until now, there have not been any studies of low-intensity self-help interventions for smokeless users," said Severson, a research scientist at the Oregon Research Institute in Eugene.

Use of smokeless tobacco, sold as snuff or chewing tobacco, is on the rise in the U.S. Its regular use "represents a significant health risk," according to a Surgeon General's report cited in the study. Snuff or chewing tobacco use is associated with pre-cancerous oral lesions, cancer in the oral cavity and nicotine dependence, according to the study.

Severson and colleagues tested either of two self-help approaches on approximately 1,000 smokeless tobacco users. Most were male, as smokeless tobacco use is predominantly a male habit. The researchers sent half of the participants a self-help manual and the other half a manual supplemented by an instructional video and two telephone counseling sessions.

Six months later, both self-help approaches had helped a significant number of the study participants quit snuff or chewing tobacco. The two approaches were not equally successful, however -- study participants who had received the phone calls and video in addition to the manual had significantly higher quit rates than those who received the manual alone, the researchers found.

The researchers report their results in the current issue of the journal Nicotine and Tobacco Research.

"This intervention program, which is effective, low cost and convenient for a largely rural smokeless tobacco user population could provide a model of public health," said Severson.

Severson and colleagues weren't able to determine the relative impacts of the video and the telephone counseling, but they suspect the telephone counseling was particularly helpful.

The brief counseling calls focused on guiding study participants to verbalize their reasons for quitting, share these reasons with family and friends, choose a quit method and date, handle withdrawal symptoms, use oral substitutes such as nicotine gum or mint chew and view relapses as learning experiences instead of failures, according to the study.

"The key may be getting the participants to verbally report that they will set a quit date and use oral substitutes," said Severson.

The researchers noted several limitations to their study. They did not compare their group of study participants with an untreated group, as many studies do. Also, since the study participants responded to ads or media announcements in order to join the study, they may have been particularly motivated to quit.

"Despite its limitations, our study suggests smokeless tobacco users are responsive to offers of cessation assistance, and we should work to provide this aid to the millions of Americans who use snuff and chew," Severson concluded.
The study was funded by a grant from the National Cancer Institute.

Nicotine & Tobacco Research is the official peer-reviewed quarterly journal of the Society for Research on Nicotine and Tobacco. For information about the journal, contact Gary E. Swan, PhD, at (650) 859-5322.

Posted by the Center for the Advancement of Health For more research news and information, go to our special section devoted to health and behavior in the "Peer-Reviewed Journals" area of Eurekalert!, For information about the Center, call Petrina Chong, (202) 387-2829.

Center for Advancing Health

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