Developing smokeless tobacco products for smokers: an examination of tobacco industry documents

Carpenter, Charles M.; Connolly, Greg; Ayo‐Yusuf, Olalekan A.; Wayne, Geoffrey Ferris

doi:10.1136/tc.2008.026583

Cited by 124 publications

(110 citation statements)

References 9 publications

(8 reference statements)

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“…Because of the high ST use among males in rural high schools and the potential reach of such a nurse-led program, the public health impact would be significant even with modest ST use cessation rates. Such programs are needed to help stop transition from experimental ST use to tobacco dependence and to counter the tobacco industry's marketing of new moist snuff products with increased levels of free nicotine content (Alpert, Koh, & Connolly, 2008) designed to appeal to youth and new users (Carpenter, Connolly, Ayo-Yusef, & Ferris Wayne, 2009). …”

Section: Discussionmentioning

confidence: 99%

Smokeless tobacco cessation cluster randomized trial with rural high school males: Intervention interaction with baseline smoking

Walsh

Langer

Kavanagh

et al. 2010

Nicotine & Tobacco Research

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Methods Study design, power analysis, and eligibilityThis stratified randomized controlled trial was approved by the Institutional Review Board at the University of California, San Francisco. Given a two-sided alpha = .05 chi-square test adjusted for clustering within high schools with an intracluster correlation of .02, a total sample size of 40 high schools each with an average enrollment of 150 male ST users was estimated to be needed to provide 90% power to detect a significant difference AbstractIntroduction: Adolescent males in rural areas use smokeless tobacco (ST). We assessed the efficacy of a school-based nursedirected ST intervention among rural high school males.Methods: Study high schools were randomly selected from a public high school list of California rural counties. Consenting high schools were stratified by school size and randomly assigned within strata to intervention or no-intervention groups. After gaining parental consent, male students completed baseline and 1-year follow-up questionnaires. The intervention included peer-led educational sessions and an oral exam by the school nurse who also provided brief tobacco cessation counseling. We used binary generalized estimating equation (GEE) models accounting for clustering within schools to test no difference between groups after adjusting for year in high school using both completers only and multiple imputation for those lost to follow-up. Subgroup analyses assessed Baseline Factor × Group interaction in GEE models.Results: Twenty-one rural counties (72%), 41 randomly selected high schools (56%), and 4,731 male students (50%) participated with 65% retention. Nonsmoking ST users in the intervention group were significantly more likely to stop using ST at follow-up than those in the no-intervention group; there was no intervention effect among baseline ST users who also smoked. A higher percentage of baseline nonsmoking ST users reported smoking at follow-up than baseline non-ST-using smokers who reported using ST.Discussion: A school-based nurse-directed ST cessation program was efficacious among rural nonsmoking ST-using high school males. The potential program reach holds significant public health value. Baseline ST use facilitated smoking at follow-up.

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Section: Discussionmentioning

confidence: 99%

Smokeless tobacco cessation cluster randomized trial with rural high school males: Intervention interaction with baseline smoking

Walsh

Langer

Kavanagh

et al. 2010

Nicotine & Tobacco Research

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“…Second, both cigarettes and ST are being heavily marketed by the tobacco companies, and the two largest cigarette manufacturers in the United States now virtually control the entire U.S. ST market . Industry documents suggest that cigarette manufacturers are not going to abandon cigarettes but, rather, promote ST products as situational substitutes and complementary products (Carpenter, Connolly, Ayo-Yusuf, & Wayne, 2009;Tomar et al, 2010). Third, available evidence suggests that the risk posed by concomitant use of cigarettes and ST may be greater than smoking cigarettes alone (Teo et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Impact of Differing Definitions of Dual Tobacco Use: Implications for Studying Dual Use and a Call for Operational Definitions

Klesges

Ebbert

Morgan

et al. 2011

Nicotine &Amp; Tobacco Research

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Introduction: Concomitant use of two forms of tobacco is an increasing public health concern, yet there is little consensus regarding a consistent definition of so-called "dual use." We defined dual use as cigarette and smokeless tobacco (ST) consumption with either product used daily or nondaily. Methods:We analyzed a cohort of 36,013 Air Force recruits. We categorized dual tobacco use across 2 dimensions, type of tobacco products (cigarettes, ST, or others), and the frequency of use (daily vs. nondaily). We determined how varying the definition impacted the prevalence estimates and evaluated the prevalence estimate based on our recommended definition of dual use. Multivariate logistic regression analysis was used to evaluate the risk profile of dual users of ST and cigarettes versus mono users of ST and mono users of cigarettes. Results:Varying definitions of dual use vary prevalence estimates 50-fold (0.5%-25.3%). Including only ST and cigarettes narrows the prevalence estimate to less than 4-fold (2.0%-9.7%). Dual users are more likely to be young Caucasian males, with lower education, and from families with relatively higher incomes. Compared with mono users, dual users of cigarettes and ST have a distinct pattern of risk profiles. Conclusions:Depending on the definition of dual use, markedly different prevalence and risk profiles are observed. Dual users of ST and cigarettes are a unique group of tobacco users. We propose a common definition of dual use to advance our understanding of this unique group.

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“…Although the United States and many other countries strictly regulate tobacco marketing in traditional media, such as print ads and television, the sprawling nature of the Internet along with Major cigarette companies have noticed ST's market potential and are now turning their attention to ST (Carpenter et al, 2009;Mejia & Ling, 2010). The proliferation of ST marketing and development of new smokeless products has raised concerns that smokeless products will discourage people from quitting tobacco completely and undermine the effectiveness of smoking bans (Mejia & Ling, 2010).…”

Section: Introductionmentioning

confidence: 99%

Portrayal of Smokeless Tobacco in YouTube Videos

Bromberg

Augustson

Backinger³

2011

Nicotine & Tobacco Research

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Developing smokeless tobacco products for smokers: an examination of tobacco industry documents

Abstract: ABSTRACT

Cited by 124 publications

References 9 publications

Smokeless tobacco cessation cluster randomized trial with rural high school males: Intervention interaction with baseline smoking

Smokeless tobacco cessation cluster randomized trial with rural high school males: Intervention interaction with baseline smoking

Impact of Differing Definitions of Dual Tobacco Use: Implications for Studying Dual Use and a Call for Operational Definitions

Portrayal of Smokeless Tobacco in YouTube Videos

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