title: A cessation program for snuff-dippers with long-term, extensive exposure to Swedish moist snuff: A 1-year follow-up study.
abstract: OBJECTIVE
  Smokeless tobacco (Swedish moist 'snus') users are often strongly addicted to nicotine. Compared to the large number of smoking-cessation studies, there have been few evaluated clinical cessation programs in conjunction with nicotine replacement therapy (NRT). The aim of this study was to evaluate a cessation program for snus users with a weekly use of >2 cans/week for >10 years.
  
  
  METHODS
  A prospective, open, non-randomized intervention trial was undertaken including baseline oral examination and soft tissue biopsy, minor physical examination, brief cessation advice, NRT recommendations and five prospective follow-up visits within 12 months. Individual cessation counseling was given, together with oral examination in the dental office. Fifty snus users with a minimum consumption of 100 g/week who were actively seeking cessation treatment were recruited through advertising. Self-reported abstaining, including random-sample biochemical verification, and NRT use were evaluated at 6 weeks and 3, 6 and 12 months.
  
  
  RESULTS
  At the 3-, 6- and 12-month visits, 58%, 46% and 30% of subjects, respectively were tobacco-abstinent. All nicotine abstinence was randomly controlled during the study except at 12 months, where all subjects claiming abstinence were confirmed biochemically and clinically.
  
  
  CONCLUSIONS
  Smokeless tobacco cessation achieved together with suitable NRT seems a promising way to improve a persistent tobacco-free condition.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Institute of Odontology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. mats.wallstrom@odontologi.gu.se
authors.forename: Mats
authors.initials: M
authors.lastname: Wallström
authors.forename: Gunilla
authors.initials: G
authors.lastname: Bolinder
authors.forename: Bengt
authors.initials: B
authors.lastname: Hassèus
authors.forename: Jan-M
authors.initials: JM
authors.lastname: Hirsch
mesh_terms: D000328:Adult; D003376:Counseling; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D009538:Nicotine / Q000031:analogs & derivatives / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use*; D011109:Polymethacrylic Acids / Q000627:therapeutic use; D011145:Polyvinyls / Q000627:therapeutic use; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013548:Sweden; D020340:Tobacco Use Cessation / Q000379:methods; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000188:drug therapy / Q000628:therapy*; D014030:Tobacco, Smokeless; D016896:Treatment Outcome
chemical_list: D018722:Nicotinic Agonists; D011109:Polymethacrylic Acids; D011145:Polyvinyls; D009538:Nicotine