In her study, Dr. Hatsukami randomly assigned a total of 402 smokeless tobacco users to one of 4 treatments: active nicotine patch, inactive patch, a combination of active patch and a non-nicotine mint snuff, or a combination of inactive patch and mint snuff. All participants received initial counseling on smokeless tobacco cessation methods and a self-help manual to take home prior to beginning treatment. On their quit date, patients began using their assigned treatments and continued for 10 weeks. During treatment, participants met weekly with counselors for brief support sessions. Results were assessed 15, 25, 36, and 62 weeks after participants stopped using smokeless tobacco. The study found that both the active patch and mint snuff reduced craving and withdrawal symptoms, such as irritability, frustration, anger, anxiety, and depressed mood. Withdrawal symptoms generally peaked during the first week after use was stopped. Only the active patch improved rates of continuous abstinence at 10 and 15 weeks following cessation. By the 23rd week, the differences in abstinence rates among all treatments had become marginal, although active patch users were still slightly more likely to be abstinent. At 62 weeks following cessation, no significant differences in abstinence were observed for any of the treatment conditions.
Many individuals use smokeless tobacco despite its obvious drawbacks because they are hooked on nicotine, a highly addictive drug. More about Amazon of smoke supplies
“A number of studies have shown that the nicotine patch is more effective than a placebo patch in sustaining long-term abstinence from cigarette smoking, but the patch appeared to be effective with smokeless tobacco users only during the period of actual patch use and shortly thereafter,” notes Dr. Hatsukami. “We don’t know if this means we need to use the patch for longer periods of time with smokeless tobacco users or if sensory or behavioral aspects of smokeless tobacco use, such as putting something in one’s mouth, may be as important as the nicotine in sustaining use,” she says. The fact that a nicotine-free mint snuff also reduced withdrawal symptoms illustrates the potential importance of the sensory aspects of smokeless tobacco in sustaining its use, she says. Previous research does suggest that intensive, multicomponent, behavioral treatment may help smokeless tobacco users to sustain abstinence over the longer term, she says.
“Many questions about smokeless tobacco use and its treatment remain unanswered,” Dr. Hatsukami says. “We really need to learn more about all the dimensions of smokeless tobacco use to develop effective treatments that are better tailored to this underserved population,” she says.