title: Cigarette smoking cessation attempts among current US smokers who also use smokeless tobacco.
abstract: BACKGROUND
  Concurrent use of cigarettes and smokeless tobacco is common, but little is known regarding the association of smokeless tobacco use with cigarette smoking cessation. Dual users may have lower cigarette consumption levels, which may also play a role in smoking cessation.
  
  
  METHODS
  The 2010-2011 Tobacco Use Supplement to the Current Population Survey included 26,760 current cigarette smokers, of which 675 concurrently used smokeless tobacco. We compared characteristics of the most recent cigarette smoking quit attempt of the past year between dual users and exclusive smokers, using multivariate regression.
  
  
  RESULTS
  Dual users (45%) were more likely than exclusive smokers (37%) to have made a cigarette smoking quit attempt during the previous year (p<0.01), even after adjusting for demographic differences and cigarette dependence levels (ORadj 1.33, 95% CI 1.15-1.53). Half (48%) of dual users who made a quit attempt tried to quit "by switching to smokeless tobacco". However, once in a quit attempt, dual users relapsed more quickly than exclusive smokers (Cox regression HRadj 1.13, 95% CI 1.02-1.26). There was no difference in 30-day abstinence rates on the most recent quit attempt (ORadj 1.09, 95% CI 0.88-1.37). For both groups, the best predictor of past 30-day abstinence was cigarette consumption level.
  
  
  CONCLUSIONS
  Current cigarette smokers who also use smokeless tobacco are more likely to have tried to quit, but relapse more quickly than exclusive smokers, and are not more likely to have attained 30day smoking cessation. Prospective studies at the population level are needed.
authors.affiliation: Cancer Prevention and Control Division, Moores UCSD Cancer Center, University of California, 3855 Health Sciences Dr. MC 0901, La Jolla, CA 92093-0901, United States; Division of Biostatistics and Bioinformatics, UCSD, La Jolla, CA 92093, United States; Department of Family Medicine and Public Health, UCSD, La Jolla CA 92093, United States. Electronic address: kmesser@ucsd.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Messer
authors.affiliation: Cancer Prevention and Control Division, Moores UCSD Cancer Center, University of California, 3855 Health Sciences Dr. MC 0901, La Jolla, CA 92093-0901, United States; Department of Family Medicine and Public Health, UCSD, La Jolla CA 92093, United States.
authors.forename: Maya
authors.initials: M
authors.lastname: Vijayaraghavan
authors.affiliation: Cancer Prevention and Control Division, Moores UCSD Cancer Center, University of California, 3855 Health Sciences Dr. MC 0901, La Jolla, CA 92093-0901, United States.
authors.forename: Martha M
authors.initials: MM
authors.lastname: White
authors.affiliation: Cancer Prevention and Control Division, Moores UCSD Cancer Center, University of California, 3855 Health Sciences Dr. MC 0901, La Jolla, CA 92093-0901, United States; Department of Family Medicine and Public Health, UCSD, La Jolla CA 92093, United States.
authors.forename: Yuyan
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States.
authors.forename: Cindy
authors.initials: C
authors.lastname: Chang
authors.affiliation: National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, Room 5213, Bethesda, MD 20892-9561, United States.
authors.forename: Kevin P
authors.initials: KP
authors.lastname: Conway
authors.affiliation: National Institutes of Health, National Cancer Institute, Division of Cancer Control and Population Sciences, 9609 Medical Center Drive, Rockville, MD 20850, United States.
authors.forename: Anne
authors.initials: A
authors.lastname: Hartman
authors.affiliation: Center for Tobacco Products, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States.
authors.forename: Megan J
authors.initials: MJ
authors.lastname: Schroeder
authors.affiliation: National Institute on Drug Abuse, National Institutes of Health, 6001 Executive Boulevard, Room 5213, Bethesda, MD 20892-9561, United States.
authors.forename: Wilson M
authors.initials: WM
authors.lastname: Compton
authors.affiliation: Cancer Prevention and Control Division, Moores UCSD Cancer Center, University of California, 3855 Health Sciences Dr. MC 0901, La Jolla, CA 92093-0901, United States; Department of Family Medicine and Public Health, UCSD, La Jolla CA 92093, United States.
authors.forename: John P
authors.initials: JP
authors.lastname: Pierce
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Poly-tobacco use; Smokeless tobacco; Smoking cessation