Although overall rates of cigarette smoking have declined over the past 40 years, the use of spit tobacco (ST) has tripled. The use of ST can lead to nicotine addiction and physical dependence. ST use is known to increase the risk of periodontal disease and oral cancer. Moreover, ST use increases the risk for cancer of the esophagus, larynx, stomach and pancreas and the risk of cardiovascular disease. Effective interventions are needed to assist ST users to stop. Bupropion, a monocyclic anti- depressant that inhibits the neuronal re-uptake of norepinephrine and dopamine and may also selectively inhibit neuronal nicotinic receptors, has demonstrated efficacy for smoking cessation. In a placebo-controlled pilot study, we have shown possible treatment effects of sustained release bupropion (SR) in ST user.
Our aims are: 1) To evaluate the efficacy of a 12-week course of bupropion SR rates of abstinence from all tobacco use; 2) To evaluate the efficacy of a 12-week course of bupropion SR compared to placebo on the end of treatment and 12- month rates of abstinence from all tobacco use; 2) To evaluate the efficacy of a 12-week course of bupropion SR compare to placebo on the end of treatment and 12-month rates of abstinence from ST; 3) To determine what baseline characteristics in addition to medication assignment are associated with abstinence from all tobacco and from ST, at the end of treatment and at 12 months; 4) To determine the association between baseline urine tobacco alkaloids with self-reported tobacco use behavior and level of nicotine dependence assessed using the Fagerstrom Tolerance Questionnaire modified for ST users; 6) To determine if ST users successful in abstaining from ST switch to a nicotine-replacement product or a different tobacco product (cigarettes, pipe, or cigars). In a randomized, double-blind, placebo-controlled trial, we will compare bupropion SR to placebo in 320 regular users of ST. Active or placebo bupropion will be taken for a total of 12 consecutive weeks starting one week before the target quit date. Behavioral intervention will be provided for all subjects.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA090884-03
Application #
6741957
Study Section
Special Emphasis Panel (ZRG1-RPHB-2 (01))
Program Officer
Djordjevic, Mirjana V
Project Start
2002-05-01
Project End
2006-04-30
Budget Start
2004-05-01
Budget End
2005-04-30
Support Year
3
Fiscal Year
2004
Total Cost
$636,482
Indirect Cost
Name
Mayo Clinic, Rochester
Department
Type
DUNS #
006471700
City
Rochester
State
MN
Country
United States
Zip Code
55905
Ebbert, Jon O; Severson, Herbert H; Danaher, Brian G et al. (2012) A comparison of three smokeless tobacco dependence measures. Addict Behav 37:1271-7
Ebbert, Jon O; Glover, Elbert D; Shinozaki, Eri et al. (2008) Predictors of smokeless tobacco abstinence. Am J Health Behav 32:735-40
Dale, Lowell C; Ebbert, Jon O; Glover, Elbert D et al. (2007) Bupropion SR for the treatment of smokeless tobacco use. Drug Alcohol Depend 90:56-63
Thomas, Janet L; Ebbert, Jon O; Patten, Christi A et al. (2006) Measuring nicotine dependence among smokeless tobacco users. Addict Behav 31:1511-21
Ebbert, Jon O; Carr, Alan B; Dale, Lowell C (2004) Smokeless tobacco: an emerging addiction. Med Clin North Am 88:1593-605
Moyer, Thomas P; Charlson, Joel R; Enger, Robert J et al. (2002) Simultaneous analysis of nicotine, nicotine metabolites, and tobacco alkaloids in serum or urine by tandem mass spectrometry, with clinically relevant metabolic profiles. Clin Chem 48:1460-71