title: Smokeless tobacco cessation in military personnel: a randomized controlled trial.
abstract: 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.
authors.affiliation: Oregon Research Institute, 1715 Franklin Boulevard, Eugene, OR 97403, USA. herb@ori.org
authors.forename: Herbert H
authors.initials: HH
authors.lastname: Severson
authors.forename: Alan L
authors.initials: AL
authors.lastname: Peterson
authors.forename: Judy A
authors.initials: JA
authors.lastname: Andrews
authors.forename: Judith S
authors.initials: JS
authors.lastname: Gordon
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cigrang
authors.forename: Brian G
authors.initials: BG
authors.lastname: Danaher
authors.forename: Christine M
authors.initials: CM
authors.lastname: Hunter
authors.forename: Maureen
authors.initials: M
authors.lastname: Barckley
mesh_terms: 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