The past several years have witnessed an increased public concern over the use of smokeless tobacco. Recent surveys estimate that approximately 12 million Americans are regular users. It is now widely recognized that regular use of smokeless tobacco products results in addiction to nicotine, and that continued use is linked to a variety of diseases, the most significant of which is oral cancer. Despite a growing awareness and concern over smokeless tobacco use, very little research has been conducted on smokeless tobacco cessation. The goal of this Phase II project is to continue our efforts to develop an effective, commercially viable self-help program for smokeless tobacco cessation that is based on the use of a credit-card-size computer-- LifeSign--that was developed originally as a self-help program for smoking cessation. LifeSign uses a tiny computer to implement a gradual withdrawal program that is tailored to the user's own baseline pattern of use and that adjusts on the basis of the user's ability to keep pace with the program. The proposed project includes making software and hardware modifications to the basic LifeSign program; comparing the effectiveness of the LifeSign smokeless tobacco program (LSTP) with a manual-based self-help smokeless tobacco cessation program in a multi-site, randomized clinical trial over a one-year follow-up period; and, on the basis of results of the clinical trial, preparing a design specification for a commercial version of the LSTP.
