Smokeless tobacco cessation in military personnel: a randomized controlled trial.
BACKGROUND
Military personnel are twice as likely as civilians to use smokeless tobacco (ST). This study evaluated the efficacy of a minimal-contact ST cessation program in military personnel.


METHODS
Participants were recruited from 24 military dental clinics across the United States during annual dental examinations. Participants were 785 active-duty military personnel who were randomly assigned to receive a minimal-contact behavioral treatment (n = 392) or usual care (n = 393). The behavioral treatment included an ST cessation manual, a videotape cessation guide tailored for military personnel, and three 15-min telephone counseling sessions using motivational interviewing methods. Usual care consisted of standard procedures that are part of the annual dental examination, including recommendations to quit using ST and referral to extant local tobacco cessation programs. Participants were assessed at 3 and 6 months after enrollment.


RESULTS
Participants in the ST cessation program were significantly more likely to be abstinent from all tobacco, as assessed by repeated point prevalence at both 3 and 6 months (25.0%), and were significantly more likely to be abstinent from ST use for 6 months, as assessed by prolonged abstinence (16.8%), compared with participants in usual care (7.6% and 6.4%, respectively).


CONCLUSIONS
These results indicate that a minimal-contact behavioral treatment can significantly reduce ST use in military personnel and has the potential for widespread dissemination. If ST users were identified in dental visits and routinely referred to telephone counseling, this could have a substantial benefit for the health and well-being of military personnel.
Severson
Herbert H
HH
Oregon Research Institute, 1715 Franklin Boulevard, Eugene, OR 97403, USA. herb@ori.org
Peterson
Alan L
AL
Andrews
Judy A
JA
Gordon
Judith S
JS
Cigrang
Jeffrey A
JA
Danaher
Brian G
BG
Hunter
Christine M
CM
Barckley
Maureen
M
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003376:Counseling / Q000379:methods; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008889:Military Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D020377:Self Efficacy; D012657:Self-Help Groups; D012944:Social Support; D020340:Tobacco Use Cessation / Q000379:methods*; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy*; D014030:Tobacco, Smokeless; D016896:Treatment Outcome; D014481:United States