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 computer ized scheduled gradual reduction program for smokeless tobacco cessation. D uring 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 tobacc o use during a gradual reduction phase. The timer was used to track the len gth of dips during baseline and to hold them to a fixed length during the r eduction phase. Abstinence rates among 60 male daily smokeless tobacco user s who received the program were 29% at 3-month follow-up (biochemically val idated) 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 re duction phase. Among 19 subjects who received the program, self-reported ab stinence rates were 56% at end of treatment and 11% at 12-month follow-up. Results of these two studies demonstrate the feasibility of computerized sc heduled gradual reduction for smokeless tobacco cessation and provide a bas is for further product development. (C) 2000 Elsevier Science Ltd. All righ ts reserved.