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Nicotine & Tobacco Research Advance Access originally published online on April 24, 2009
Nicotine & Tobacco Research 2009 11(6):730-738; doi:10.1093/ntr/ntp057
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© The Author 2009. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Smokeless tobacco cessation in military personnel: A randomized controlled trial

Herbert H. Severson, Alan L. Peterson, Judy A. Andrews, Judith S. Gordon, Jeffrey A. Cigrang, Brian G. Danaher, Christine M. Hunter and Maureen Barckley

Herbert H. Severson, Ph.D., Oregon Research Institute, Eugene, OR
Alan L. Peterson, Ph.D., Wilford Hall Medical Center, San Antonio, TX and University of Texas Health Science Center at San Antonio, San Antonio, TX
Judy A. Andrews, Ph.D., Oregon Research Institute, Eugene, OR
Judith S. Gordon, Ph.D., Oregon Research Institute, Eugene, OR
Jeffrey A. Cigrang, Ph.D., Wilford Hall Medical Center, San Antonio, TX
Brian G. Danaher, Ph.D., Oregon Research Institute, Eugene, OR
Christine M. Hunter, Ph.D., Wilford Hall Medical Center, San Antonio, TX and National Institutes of Health, Bethesda, MD
Maureen Barckley, M.S., Oregon Research Institute, Eugene, OR

Corresponding Author: Herbert H. Severson, Ph.D., Oregon Research Institute, 1715 Franklin Boulevard, Eugene, OR 97403, USA. Telephone: 541-484-2123; Fax: 541-484-1108; E-mail: herb{at}ori.org


  Abstract

Introduction: Military personnel are twice as likely as civilians to use smokeless tobacco (ST). This study evaluated the efficacy of a minimal-contact ST cessation program in military personnel.

Methods: Participants were recruited from 24 military dental clinics across the United States during annual dental examinations. Participants were 785 active-duty military personnel who were randomly assigned to receive a minimal-contact behavioral treatment (n = 392) or usual care (n = 393). The behavioral treatment included an ST cessation manual, a videotape cessation guide tailored for military personnel, and three 15-min telephone counseling sessions using motivational interviewing methods. Usual care consisted of standard procedures that are part of the annual dental examination, including recommendations to quit using ST and referral to extant local tobacco cessation programs. Participants were assessed at 3 and 6 months after enrollment.

Results: Participants in the ST cessation program were significantly more likely to be abstinent from all tobacco, as assessed by repeated point prevalence at both 3 and 6 months (25.0%), and were significantly more likely to be abstinent from ST use for 6 months, as assessed by prolonged abstinence (16.8%), compared with participants in usual care (7.6% and 6.4%, respectively).

Discussion: These results indicate that a minimal-contact behavioral treatment can significantly reduce ST use in military personnel and has the potential for widespread dissemination. If ST users were identified in dental visits and routinely referred to telephone counseling, this could have a substantial benefit for the health and well-being of military personnel.

Received: August 14, 2008; Accepted: February 6, 2009
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