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Lozenges, Tobacco-Free Snuff Help Tobacco Chewers Quit

Mail Puch barn (Liz West/Flickr)Researchers at the Mayo Clinic in Rochester, Minnesota found nicotine lozenges and tobacco-free snuff could get smokeless tobacco users to quit their habits, even when some users started out with no intention of quitting. The team led by Mayo Clinic’s Jon Ebbert published its findings in this month’s issue of the journal Addictive Behaviors (paid subscription required).

Smokeless tobacco comes in two basic forms: chewing tobacco and snuff. Chewing tobacco is taken as loose leaves or from a mass of leaves called a plug, and placed between the cheek and lower lip. Snuff is finely cut or powdered tobacco, with a pinch placed between the cheek and gum or behind the lip. Nicotine from both types of tobacco is absorbed through the lining of the mouth. National Cancer Institute that funded the study says at least 28 chemicals in smokeless tobacco have been found to cause cancer, including oral, esophageal, and pancreatic cancer.

The team that included colleagues from the Oregon Research Institute in Eugene recruited 81 users of smokeless tobacco in a study that compared the relative effectiveness of nicotine lozenges and tobacco-free snuff. The group of participants, none of whom expressed an interest in quitting their smokeless tobacco in the next 30 days, were divided about evenly between 40 who received 4-milligram nicotine lozenges and 41 who were given tobacco-free snuff.

In addition to the smokeless tobacco substitutes, all study participants were given 8 weeks of treatment and behavioral counseling on tobacco reduction strategies with a follow-up after 26 weeks. The researchers tracked the use of smokeless tobacco at 8, 12, and 26 weeks. Smokeless tobacco abstinence, when reported, was confirmed biochemically.

The results showed both the lozenge and tobacco-free snuff participants significantly reduced their smokeless tobacco habits, measured in terms of cans used per week and dips per day, which the researchers found were sustained through the end of the study. Some 12 percent of the study participants quit using smokeless tobacco completely, while another one-third of the participants reduced their use of smokeless tobacco by 75 percent after 26 weeks. Both substitute forms appeared to work about equally as well.

“The reason why that is so striking and important to us is these patients had no intention of quitting,” says addiction expert Ebbert. “Through the process of just reducing their tobacco, participants wanted to quit and were successful in doing so.”

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Photo: Liz West/Flickr

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