Cancer Control Research
5R03CA059244-02
Riley, William T.
LONGITUDINAL STUDY OF SMOKELESS TOBACCO QUITTERS
AbstractThe primary purpose of this proposal is to study prospectively smokeless
tobacco users attempting cessation of use and determine factors
predictive of relapse and abstinence. One hundred and fifty snuff users
will be recruited. Prior to attempting to quit, subjects will be
interviewed to assess history and extent of snuff use, use of other
substances, cues or triggers of use, knowledge of health risks, history
of previous quit attempts, and proposed self-determined strategies and
self-efficacy to quit. Saliva cotinine levels and a measure of nicotine
addiction also will be obtained prior to the subject's attempt at
quitting. Subjects will then be followed for one year after their quit
date and assessed at days 7, 30, 90, 180 and 365. Longitudinal
assessment will include self-report of withdrawal symptoms, use of other
substances, snuff use and relapse conditions in relapsers, and useful
strategies used to remain abstinent in abstainers. Saliva samples will
be obtained at each assessment but only one of the five samples will be
selected for cotinine analysis; the other samples will serve as a bogus
condition to enhance validity of the self-reports. Using logistic
regressions and survival analyses, initial variables will be used as
predictors of subsequent relapse or abstinence. We hypothesize that
relapse will be predicted by greater recent use of snuff, higher
addiction scores, lower perceived health risk, greater use of other
substances, more social contacts who use snuff, greater cues for use
(particularly internal cues), more previous failures at quitting, and
lower self-efficacy at quitting. Higher initial cotinine levels also
should be predictive of early relapse. The results of this study will
aid our understanding of snuff addiction and relapse, which should result
in more effective interventions for this major cause of oral and
pharyngeal cancers.
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