Smokeless Tobacco Cessation among Youth
Dr. Walsh is conducting three related projects on smokeless tobacco cessation among youth, one studying the effects of concurrent smoking on tobacco use cessation, one examining the efficacy of using athletic trainers to promote smokeless tobacco cessation and one on smokeless tobacco cessation among rural high school baseball players.
Smokeless Tobacco Cessation Cluster Randomized Trial with Rural High School Males: Intervention Interaction with Baseline Smoking: (1) To determine the efficacy of a school-based, nurse-directed ST cessation program among male students in 41 high schools in rural areas of California; and (2) to assess patterns of ST use in relation to smoking and to examine product switching from baseline to 1 year follow-up. Non-smoking ST users in the intervention group were significantly more likely to stop using ST (dip/chew) at follow-up than those in the control group. Significantly more high school ST users started smoking than smokers who started using ST; thus ST appears to be a gateway to cigarettes (not harm reduction from cigarettes) in rural high school males.
An Athletic Trainer-mediated Spit Tobacco Cessation Program: To examine whether an athletic trainer-directed spit (smokeless) tobacco intervention (3-hour videoconference, an oral-cancer screening with feedback, and brief counseling during the preseason health screenings, athletic trainer support for cessation, and a peer-led educational baseball team meeting) could decrease initiation and promote cessation of ST use among male collegiate baseball athletes. The intervention was significantly effective in preventing incident ST use, but did not significantly increase cessation beyond that experienced by the control group. The latter finding is inconsistent with previous studies and may be explained by spillover of the intervention to control colleges, other antitobacco activity in control colleges, and/or the small sample of dependent ST users enrolled in the study.
Spit Tobacco (ST) Cessation: Rural High School Baseball Athletes: The major goals of this project are to determine the efficacy of a school-based, nurse-directed, peer- and dentist-assisted ST intervention program among male students in rural areas of California and the relationship between ST use and smoking. This intervention was effective in promoting ST cessation, but was ineffective in preventing initiation of ST use by nonusers.