Abstract:
BACKGROUND:Observational studies and a few clinical trials suggest that use of low nitrosamine smokeless tobacco (snus) can facilitate smoking cessation. To better understand the real-world impact of snus on smoking behaviour, a large-scale, long-term clinical trial of naturalistic snus use among smokers is needed. STUDY DESIGN:A nationwide clinical trial compared abstinence outcomes among smokers who were randomised to receive free samples of snus versus not. Participants (N=1236) were recruited throughout the US and assessed for 1 year following a 6-week naturalistic sampling period, with high retention throughout. Primary outcomes included self-reported quit attempts, floating abstinence (any 7-day period of non-smoking) and 7-day point-prevalence abstinence at 6 months and 12 months. Secondary outcomes were changes in smoking, motivation and confidence to quit and adverse events. No tobacco industry support was provided. RESULTS:Within snus group, 82% used at least once, and 16% were using regularly at end of sampling period. Compared to control participants, smokers in the snus group were less likely to make any quit attempt (RR=0.83; 95% CI 0.70 to 1.00), and any 24 h quit attempt (RR=0.77; 95% CI 0.63 to 0.95). There were no group differences on any measure of abstinence. CONCLUSIONS:Provision of snus in a naturalistic context resulted in minimal uptake, and as a whole, undermined quit attempts and did not increase smoking abstinence. Results do not support the unguided, free provision of snus among smokers not motivated to quit as a means to facilitate quit attempts. TRIAL REGISTRATION NUMBER:NCT01509586, Results.
journal_name
Tob Controljournal_title
Tobacco controlauthors
Carpenter MJ,Wahlquist AE,Burris JL,Gray KM,Garrett-Mayer E,Cummings KM,Alberg AJdoi
10.1136/tobaccocontrol-2015-052783subject
Has Abstractpub_date
2017-03-01 00:00:00pages
202-209issue
2eissn
0964-4563issn
1468-3318pii
tobaccocontrol-2015-052783journal_volume
26pub_type
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