Using Smokeless Tobacco Products With Lower Nicotine Levels to Reduce Negative Effects of Smokeless Tobacco Use (Brandswitch)
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ClinicalTrials.gov Identifier: NCT00218244 |
Recruitment Status :
Completed
First Posted : September 22, 2005
Last Update Posted : January 10, 2017
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Condition or disease | Intervention/treatment | Phase |
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Tobacco Use Disorder | Other: Lower Nicotine Smokeless Tobacco Product Other: Behavioral Counseling | Phase 1 Phase 2 |
Spit tobacco presents as many health risks to its users as smoking tobacco. It affects the cardiovascular system and may be associated with heart disease, stroke, and high blood pressure. Long-term effects of spit tobacco use include tooth abrasion, gum recession, mouth disease, bone loss in the jaw, yellowing of the teeth, and chronic bad breath. Although a significant number of ST users recognize the importance of quitting, many either do not want to quit or feel it is impossible. For these individuals, tobacco reduction may be an important transitional goal, either prior to quitting, or as a treatment endpoint; however, approaches to help ST users reach this goal have not been studied. This study will assess the effectiveness of limiting ST nicotine intake in reducing levels of exposure to tobacco and associated toxicity, as well as enhancing motivation to either quit or sustain lower levels of nicotine intake.
Participants in this open-label study will be randomly assigned to one of three treatment conditions: switching to an ST brand with less concentrated nicotine and controlling for ST use; switching to an ST brand with less concentrated nicotine, combined with no limit on ST intake; or continued use of usual ST brand with no limit on intake (control group). Participants in both brand-switching conditions will use ST brands that have 50% less nicotine than their usual ST brands for the first 4 weeks. For the next 4 weeks, participants in the brand-switching conditions will use ST brands that have 75% less nicotine that their usual ST brands. Study visits will ocur once weekly during the 8-week treatment period. The number of participants who do not complete treatment, reduce nicotine intake, or quit completely will be assessed at Week 8 and at follow-up visits, which will be held 12 and 26 weeks following the completion of treatment.
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 56 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Treatment of Smokeless Tobacco Users: Use of Nicotine Replacement Products to Reduce Smokeless Tobacco Use |
Study Start Date : | August 2001 |
Actual Primary Completion Date : | November 2004 |
Actual Study Completion Date : | November 2004 |

Arm | Intervention/treatment |
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Active Comparator: 1 Controlled use
Reduction in tobacco toxicants by switching to a lower nicotine tobacco product under a controlled use condition.
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Other: Lower Nicotine Smokeless Tobacco Product
Skoal for 50% reduction;Skoal bandits for 75% reduction.
Other Name: Skoal and Skoal Bandits |
Active Comparator: 2 Uncontrolled use
Reduction in tobacco toxicants by switching to a lower nicotine tobacco product under an uncontrolled use condition.
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Other: Lower Nicotine Smokeless Tobacco Product
Skoal for 50% reduction;Skoal bandits for 75% reduction.
Other Name: Skoal and Skoal Bandits |
Placebo Comparator: 3 Behavioral
Reduction in smokeless tobacco use using behavioral techniques only.
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Other: Behavioral Counseling
Behavioral counseling alone for reduction in tobacco use. |
- Percent reduction in ST use [ Time Frame: 26 weeks ]
- Toxicity profile of carcinogen metabolites [ Time Frame: 26 weeks ]
- Number of unsuccessful quit attempts [ Time Frame: 26 weeks ]
- Abstinence from ST use (measured at Week 8, and 12 and 26 weeks following treatment completion) [ Time Frame: 26 weeks ]
- Motivation and self-efficacy (measured at Week 8, and 12 and 26 weeks following treatment completion) [ Time Frame: 26 weeks ]

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Ages Eligible for Study: | 18 Years to 70 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Not interested in quitting ST use within 90 days of study entry
- Has been using ST at least six times a day for 6 months prior to study entry
- Agrees to use an effective form of contraception throughout the study
Exclusion Criteria:
- Current use of other tobacco or nicotine products
- Pregnant or breastfeeding
- Any unstable medical condition
- Use of any medication that may affect tobacco use or be affected by reduction of tobacco use
- DSM-IV diagnosis of any psychiatric disorders or substance abuse disorders within 6 months prior to study entry
- Use of any psychotropic medications within 6 months prior to study entry

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00218244
United States, Minnesota | |
University of Minnesota | |
Minneapolis, Minnesota, United States, 55455 |
Principal Investigator: | Dorothy Hatsukami, PhD | University of Minnesota |
Responsible Party: | Dorothy Hatuskami, University of Minnesota |
ClinicalTrials.gov Identifier: | NCT00218244 |
Other Study ID Numbers: |
NIDA-14404-1 R01-14404-1 DPMC |
First Posted: | September 22, 2005 Key Record Dates |
Last Update Posted: | January 10, 2017 |
Last Verified: | June 2008 |
Brand Switching, smokeless tobacco use |
Tobacco Use Disorder Substance-Related Disorders Chemically-Induced Disorders Mental Disorders Lobeline Nicotine Ganglionic Stimulants Autonomic Agents |
Peripheral Nervous System Agents Physiological Effects of Drugs Nicotinic Agonists Cholinergic Agonists Cholinergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Respiratory System Agents |