Comparing an immediate cessation versus reduction approach to smokeless tobacco cessation.
BACKGROUND
Relatively few studies have investigated pharmacological or behavioral treatment of smokeless tobacco (ST) users who do not have immediate quit plans. In this study, we compared a reduction treatment approach with an immediate cessation approach in a population of ST users who reported no immediate plans to quit.


METHODS
Subjects randomly assigned to the immediate cessation condition set a quit date soon after enrollment and were offered 2 weeks of nicotine patch therapy to help in their cessation efforts. Subjects assigned to the ST reduction group were provided with their choice of either 4 mg nicotine lozenge or ST brand switching to help them reduce their ST use or levels of nicotine exposure, respectively. Quit date was 6 weeks after the onset of treatment. Follow-up was at 12 weeks and 26 weeks postenrollment and 26 weeks postquit.


RESULTS
Both 7-day point prevalence abstinence and prolonged abstinence rates following the quit date were significantly higher in the immediate cessation group versus the reduction group at 12 and 26 weeks (all p values ≤ .04) and for prolonged abstinence at 6 months postquit (p = .002). Significant reductions in ST use among nonquitters were observed for both groups (p < .0001) with no differences between groups.


CONCLUSIONS
Our study demonstrated that immediate cessation with an established quit date resulted in greater cessation success than a gradual reduction approach among ST users who do not have an immediate quit plan but are motivated to quit.
Tobacco Research Programs, University of Minnesota, 717 Delaware Street SE, Minneapolis, MN 55414, USA.
Katherine R
KR
Schiller
Xianghua
X
Luo
Amanda J
AJ
Anderson
Joni A
JA
Jensen
Sharon S
SS
Allen
Dorothy K
DK
Hatsukami
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009538:Nicotine / Q000627:therapeutic use*; D020340:Tobacco Use Cessation / Q000379:methods*; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000188:drug therapy*; D014030:Tobacco, Smokeless; D016896:Treatment Outcome
D009538:Nicotine