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2014 Call for Applications

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Smokeless tobacco cessation among lumber mill employees

Institution: University of Southern California
Investigator(s): Clyde Dent, Ph.D.
Award Cycle: 1997 (Cycle 6) Grant #: 6RT-0195 Award: $625,257
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards
Abstracts

Initial Award Abstract
More than 300 studies have identified the side effects and risks of smokeless tobacco use, including nicotine addiction. Smokeless tobacco is commonly used where smoking is a fire hazard, such as farming, mining, milling, and forestry. The lumber industry is a major, traditional, market for smokeless tobacco sales. The high rate of long-term use among lumber mill employees places them at a substantial risk for the harmful consequences from tobacco use.

Studies using smokers indicate twice the quit rates with the use of a nicotine patch over behavior modification strategies alone. It is believed that addition of the patch is effective because it reduces withdrawal symptoms, while allowing patients to develop and practice ways to cope without tobacco. Although nicotine patches have been shown to be successful in helping smokers quit, no studies have looked at their effectiveness with smokeless tobacco users.

The main objective of the present study is to provide a test of the effectiveness of tobacco quitting program which uses: (1) a company-wide promotion for program enrollment, (2) a multiple session, behavior modification program, and (3) an active versus drug-free nicotine patch.

We hypothesize that the addition of an "active" nicotine patch to a behavioral modification program will double the quit rate of participating employees, compared to those using a drug-free patch. The current study fills a need for the usefulness of nicotine patches for smokeless tobacco users.

Final Report
The objective of the current project was to evaluate the effectiveness of a cessation program using nicotine replacement products, such as nicotine patches and gum, for smokeless tobacco users trying to quit.

In the first phase of the project, a comprehensive program based was developed and used at a lumbermill work site. The program was an onsite, five session, behavioral program over 10 weeks focusing on quitting the use of smokeless tobacco. As part of the program, patches were used for 10 weeks, half with and half without nicotine. We found that lumbermill work site mangers, supervisors, and employees appeared to be interested and cooperative in this type of program. We found that participants in the program who were using the patches with nicotine were quitting their use of smokeless tobacco at higher rates than those that were not, 36% verses 18% at three months, and 45% verse 13% at six months.

In the second phase of the study, we tested the use of nicotine gum. Participants received the same 10-week behavioral program as in the first study, but all participants used an active nicotine patch and also used either nicotine gum or non-nicotine containing herbal gum together with the patch. The recruitment strategy for this study used radio, newspaper and television ads to offer the program to residents' countywide. Sessions took place at a central location (the local cancer society headquarters). Response to this offering was positive, with over 150 persons wishing to participate. The results of the second study showed that quit rates at 3 months were higher, 58%, with a patch plus either type of gum than with a patch alone (36%). At six months, the quit rates for the two studies were the same (45%).

The current study fills a need for evidence of effective, smokeless tobacco cessation strategies using nicotine replacement therapy.
Publications