Computerized scheduled gradual reduction for smokeless tobacco cessation: development and preliminary evaluation of a self-help program

This paper chronicles the development and feasibility testing of a computerized scheduled gradual reduction program for smokeless tobacco cessation. During Study 1, the LifeSign smoking cessation computer was adapted for use with smokeless tobacco by pairing it with an electronic timer. The computer recorded frequency of dips during a baseline phase and prompted for tobacco use during a gradual reduction phase. The timer was used to track the length of dips during baseline and to hold them to a fixed length during the reduction phase. Abstinence rates among 60 male daily smokeless tobacco users who received the program were 29% at 3-month follow-up (biochemically validated) and 19% at 12-month follow-up. Self-reported changes in topography of tobacco use were consistent with the scheduled reduction protocol. Study 2 evaluated a prototype computer that tracked both frequency and duration of dips during baseline and gradually reduced both parameters during the reduction phase. Among 19 subjects who received the program, self-reported abstinence rates were 56% at end of treatment and 11% at 12-month follow-up. Results of these two studies demonstrate the feasibility of computerized scheduled gradual reduction for smokeless tobacco cessation and provide a basis for further product development.