The effects of sensory and behavioral substitutes on craving, withdrawal, and laboratory-induced anxiety after smokeless tobacco deprivation

Smokeless or spit tobacco is used by millions of people each year. This extensive use of smokeless tobacco is of concern due to its harmful effects on health including cancers of the mouth and throat. Therefore, smokeless tobacco is a national health problem in need of effective treatment strategies. Although numerous studies have shown that sensory and behavioral substitutes are effective with cigarette smokers, limited research exists in the utility of sensory and behavioral substitutes among individuals who use smokeless tobacco. The present study examined the sensory and behavioral properties of a nicotine-free, herbal smokeless tobacco substitute (BACCOFF™; Ralston, Inc, Selma, AL) and chewing gum among 24 smokeless tobacco users in order to determine the effect these products had on craving for smokeless tobacco, withdrawal symptoms, and laboratory-induced anxiety after ovemight abstinence. Results suggest that general oral stimulation and the relaxing effects of chewing gum may not reduce withdrawal or craving levels after 24 hours of abstinence or in response to a stressor among smokeless tobacco users. However, the smokeless tobacco substitute reduced both craving and withdrawal levels after 24 hours of abstinence compared to a control condition. This suggests that the sensory and behavioral properties specific to the experience of smokeless tobacco (e.g., handling a tin or placing a dip in one's mouth) are important in the reduction of withdrawal levels and craving among smokeless tobacco users.