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Prev Med. 2009 Aug-Sep;49(2-3):229-32. doi: 10.1016/j.ypmed.2009.07.012. Epub 2009 Jul 23.

Are smokers receptive to using smokeless tobacco as a substitute?

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Program in Public Health, College of Health Sciences, University of California, Irvine, 100 Theory, Suite 100, Irvine, CA 92697-7555, USA.



Few studies have addressed the feasibility of promoting smokeless tobacco as an alternative for smokers. This study was intended to assess the characteristics and degree to which smokers from California are receptive to using the substitute for harm reduction.


Daily cigarette smokers (n=2995) were selected from the 2005 California Tobacco Survey. Using ordinal logistic regression, four sets of variables (demographics, tobacco use, motivations and intentions to quit smoking) were examined as predictors of the outcome, willingness to use a form of smokeless tobacco perceived to be less harmful than cigarettes.


A majority of smokers (75.6%) expressed no interest in the tobacco substitute. Contrary to expectation, few of the measures for demographics, tobacco use and motivations to quit smoking were significantly correlated with the outcome. Irrespective of prior use of nicotine replacement therapy, smokers were more receptive if they had previously attempted to quit, or were currently attempting to reduce their consumption of cigarettes.


Smokeless tobacco is an unacceptable alternative for most California smokers. But, the expected correlates, notably gender, accounted for minimal variability in SLT receptiveness, an observation that challenges concerns about the product's limited appeal to any one group.

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