Andrews, J.A., Severson, H.H., Akers, L., Lichtenstein, E., & Barckley, M.F. (2000). Who enrolls in a self-help cessation program for smokeless tobacco users? Addictive Behaviors 25:1-8.
To further our understanding of the representativeness of the smokeless tobacco (SLT) user recruited to various treatment settings, and to suggest gaps in services available to SLT users, we first compared participants who enrolled in a self-help cessation program with two samples of non-treatment-seeking SLT users: SLT users identified through a Random Digit Dialing Survey, and SLT users who came to one of 75 dental practices for a routine cleaning visit. We found that those in the self-help SLT cessation program were older, more educated, more likely to have made a serious quit attempt, and used more SLT weekly than those who did not seek treatment. Secondly, we compared SLT users seeking treatment in three different treatment settings varying in accessibility and intensity: self-help study participants, SLT users enrolled in a clinic-based study, and callers to the California Help Line for SLT cessation. Participants differed across the three studies on demographics, some measures of dependence, and history of SLT use.
Severson, H.H., Andrews, J.A., Lichtenstein, E., Gordon, J.S., Barckley, M., & Akers, L. (2000). A self-help cessation program for smokeless tobacco users: Comparison of two interventions. Nicotine & Tobacco Research, 2(4): 373-380.
While the use of smokeless tobacco products has increased, there has been a paucity of research evaluating cessation interventions to help users quit. This study is the first randomized trial evaluating two levels of self-help cessation intervention with adult smokeless tobacco users. Smokeless users in five Northwest states were solicited to call a toll-free number, and 1,069 users were randomized to receive one of two interventions, Manual Only (MAN) or Assisted Self Help (ASH), in which participants received a video and two supportive phone calls in addition to the manual. The study demonstrated that low-cost minimal interventions done by mail and phone can help a sizable proportion of SLT users quit both SLT and all tobacco use. Follow-up data at 6 months showed that subjects in the ASH condition had a significantly higher quit rate for both smokeless (23.4% vs. 18.4%, p < .05) and all tobacco use (21.1% vs. 16.5%, p < .05), using an intent-to-treat model. Further analysis revealed that use of the recommended cessation procedures mediated the effect of intervention condition on outcomes. This may be the result of phone counselors getting subjects to carry out behavioral cessation procedures. Public health implications for this intervention are discussed.