Effects of sensory and behavioral substitutes following an experimentally induced stressor among abstinent smokeless tobacco users

Despite the well-known health risks associated with smokeless tobacco use, much is unresolved with respect to effective treatment for use of this substance. The present study examined the impact of a nicotine-free smokeless tobacco substitute and confectionary chewing gum on craving, withdrawal, and anxiety among 24 smokeless tobacco users following 24 hours of nicotine abstinence and a laboratory stressor. Although chewing gum did not impact withdrawal, craving, or anxiety compared to a no-product control condition, smokeless tobacco substitute administration resulted in a reduction of withdrawal and craving levels compared to the control condition following 24 hours of abstinence. Furthermore, significantly lower levels of craving and withdrawal were observed in both smokeless tobacco and smokeless tobacco substitute conditions compared to the control condition following the stressor. Results indicate that although general oral stimulation (eg, chewing gum) was not effective in reducing symptoms related to nicotine withdrawal, smokeless tobacco substitute use appears to be helpful in reducing withdrawal levels post-stressor. These data suggest that use of a smokeless tobacco substitute may be an effective aid in helping individuals wishing to quit, especially when managing stressors.