A pilot study of smokeless tobacco in smoking cessation.

PURPOSE The substitution of smokeless tobacco for cigarette smoking is a harm reduction alternative for inveterate smokers and reduces others' passive exposure to smoke. Two million smokers have used smokeless tobacco to quit on their own, but no formal program has employed this method of smoking cessation. We conducted a pilot study to determine if smokeless tobacco could be successfully employed in a smoking cessation program. PATIENTS AND METHODS Subjects attended a lecture about the health effects of all forms of tobacco use and about the use of smokeless tobacco as an aid to quit smoking. The study population consisted of 63 evaluable subjects. Follow-up was accomplished by quarterly telephone interviews. Smoking abstinence was confirmed at 1 year by measurement of expired air carbon monoxide. RESULTS At 1 year, 31% of men and 19% of women had attained smoking cessation, for an overall success rate of 25%. An additional 7% of subjects had reduced their cigarette consumption by at least 50%. CONCLUSION This study suggests that the use of smokeless tobacco warrants evaluation as a potential smoking cessation strategy.