title: Concomitant use of cigarettes and smokeless tobacco: prevalence, correlates, and predictors of tobacco cessation.
abstract: BACKGROUND
  This study examined the characteristics, tobacco use patterns over time, and predictors of tobacco cessation among concomitant users of cigarettes and smokeless tobacco.
  
  
  METHODS
  Participants were employed adults residing in the southeastern United States who participated in the Working Well cancer prevention trial. Participants were assessed at baseline and followed-up 4 years later.
  
  
  CONCLUSIONS
  The study yielded several key findings: (a) the prevalence of concomitant smoking and smokeless tobacco use was high among males and nonexistent among females, (b) the characteristics of concomitant users were relatively distinct from those of both smokers and smokeless tobacco users, (c) concomitant users exhibited substantial variability in their tobacco use patterns and were less likely to stop using tobacco than were smokers or smokeless tobacco users, (d) indicators of nicotine dependence predicted tobacco cessation for both smokers and smokeless tobacco users, but were largely unrelated to tobacco cessation among concomitant users, and (e) demographics, environmental variables, and measures derived from the transtheoretical model were not consistent predictors of tobacco cessation after controlling for nicotine dependence.
authors.affiliation: The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA. dwetter@mdanderson.org
authors.forename: David W
authors.initials: DW
authors.lastname: Wetter
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: McClure
authors.forename: Carl
authors.initials: C
authors.lastname: de Moor
authors.forename: Ludmila
authors.initials: L
authors.lastname: Cofta-Gunn
authors.forename: Scott
authors.initials: S
authors.lastname: Cummings
authors.forename: Paul M
authors.initials: PM
authors.lastname: Cinciripini
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Gritz
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017533:Marital Status; D015337:Multicenter Studies as Topic; D009369:Neoplasms / Q000517:prevention & control; D011237:Predictive Value of Tests; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation; D015144:Southeastern United States / Q000453:epidemiology; D014030:Tobacco, Smokeless