Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
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In 2005, approximately 2.3% of U. S. adults used smokeless tobacco. Moist snuff leads all types of smokeless tobacco in revenues and marketing expenditures. ⋯ The study findings indicate that moist snuff brands varied widely in content of rapidly absorbed, addictive un-ionized nicotine (500-fold range) and of carcinogenic TSNAs (18-fold range). Product characteristics such as packaging and moisture content appeared to be correlated with concentrations of un-ionized nicotine, and flavor characteristics of low-priced brands may correlate with TSNA concentrations. These findings warrant further study in light of (a) the marketing of smokeless tobacco for use in places where smoking is prohibited, (b) the promotion of smokeless tobacco as a harm-reduction product, and (c) the ever-expanding number of highly flavored smokeless varieties brought to the market.
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Smoking is the leading cause of preventable death in the United States and has been linked to several dire health consequences including cancer and cardiovascular disease. However, knowledge of the associated risks of tobacco use may not be evenly distributed within the population. We analyzed data from the National Cancer Institute's Health Information National Trends Survey (HINTS, 2003) to characterize current knowledge of cancer prevention and smoking risk in the adult U. ⋯ Knowledge of lung cancer mortality was lower among females (OR = 0.38), older adults (OR age 65-79 = 0.69; OR age 80+ = 0.48), and non-Hispanic Blacks (OR = 0.64). GIS analyses revealed lower knowledge of smoking risk and higher tobacco use in the regions with higher tobacco production and higher tobacco-related mortality. Disparities in tobacco-related knowledge, morbidity, and mortality underscore the need for continued development and delivery of effective prevention and treatment interventions to reduce the population burden of tobacco-related disease.
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Randomized Controlled Trial
A randomized controlled trial of Telephone Counseling with smokeless tobacco users: the ChewFree Minnesota study.
Although a considerable body of evidence supports telephone quit lines for smoking cessation, much less is known about the effectiveness of proactive Telephone Counseling with smokeless tobacco (ST) users. We conducted a randomized controlled trial comparing Telephone Counseling with the distribution of a self-help manual for ST cessation. We recruited 406 adult ST users throughout the state of Minnesota and randomized them to receive either: (a) a self-help manual (Manual only) or (b) a self-help manual plus proactive telephone-based cessation counseling (Telephone Counseling). ⋯ We found older age, lower dependency, and increased readiness predicted quitting success. Proactive telephone-based counseling is an effective strategy for improving cessation rates among ST users. Future research should determine the components contributing to the intervention success.
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Clinical Trial
Potential reduced exposure products (PREPs) for smokeless tobacco users: clinical evaluation methodology.
Several potential reduced exposure products (PREPs) for smokeless tobacco (SLT) users are marketed in the United States, though their effects are largely unknown. These products include some that are low in tobacco-specific nitrosamines (TSNs), like Stonewall, a pressed tobacco tablet, and General snus, a moist snuff product produced in Sweden. Methodology assessing the toxicant exposure and effects of cigarette-like PREPs for smokers has been developed, and might be modified for use in evaluating PREPs for SLT users. ⋯ Compared with own brand, Stonewall was associated with lower levels of cotinine and NNAL, while General snus was associated with similar levels of cotinine and lower levels of NNAL. Abstinence symptoms generally did not differ across tobacco conditions. These results show that clinical laboratory methods can be used to evaluate the toxicant exposure and abstinence symptom suppression associated with PREPs for SLT users.
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Smokers' expected outcomes of using nicotine dependence medications may act as barriers to their use. In Study 1, 27 smokers were interviewed. Framework analysis was used to identify key themes in smokers' expectations of using nicotine dependence medications. ⋯ Effectiveness outcome expectations were strong predictors of intentions, whereas outcome expectations that these medications are desirable were additional predictors. Expectations of effectiveness appear to be influenced by the ability of the medications to control cravings to smoke. Interventions aimed at increasing the likelihood with which smokers use nicotine dependence medications may be more successful if they address these expectations.