RT Journal Article
SR Electronic
T1 Snus undermines quit attempts but not abstinence: a randomised clinical trial among US smokers
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP 202
OP 209
DO 10.1136/tobaccocontrol-2015-052783
VO 26
IS 2
A1 Carpenter, Matthew J
A1 Wahlquist, Amy E
A1 Burris, Jessica L
A1 Gray, Kevin M
A1 Garrett-Mayer, Elizabeth
A1 Cummings, K Michael
A1 Alberg, Anthony J
YR 2017
UL http://tobaccocontrol.bmj.com/content/26/2/202.abstract
AB 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.