Smoking Cessation With Smokeless Tobacco, Nicotine Tablets and Nicotine Patches

Smoking Cessation by Nurses With Smokeless Tobacco Buccal Tablets, Nicotine Buccal Tablets, Nicotine Patches With Repeated Therapy Every 6 Months for 2 Years

To test if smokeless tobacco is more effective than nicotine buccal tablets in smoking cessation compared with a control group with low dose nicotine patches.

Also retreatment will be tested with smokeless tobacco every 6 months in failures for 1½ year. Adherence to the program will be enhanced by assessment of cholesterol, blood pressure, lung function and body weight every 6 months for 2 years.

This is an open randomized controlled trial with 3 groups testing smokeless tobacco in smoking cessation: 200 smokers will get smokeless tobacco for 3 months, 200 will get nicotine buccal tablets for 3 months and 200 will get 7-mg nicotine patches for 3 months (control arm). After ½, 1 and 1½ a year failures will get smokeless tobacco in the first 2 groups, while only 7 mg nicotine patches in control group until 1½ year where failures in this group also will get smokeless tobacco. Every ½ year cholesterol, blood pressure, lung function and BMI will be assessed and used to enhance adherence of the participants in this trial.

Inclusion Criteria:

• smokers (>7 cig/day)
• Healthy
• Allowed: treated hypertension, diabetes treated with tablets, increased cholesterol,other "mild" diseases
• mild asthma and COPD,
• Motivated to quit smoking
• Motivated to follow the protocol
• Motivated to use medication in this trial

Exclusion Criteria:

• Severe diseases
• Psychiatric diseases
• Used NRT or Zyban the last 2 weeks
• Stopped smoking >2 days during last 3 months
• More than 6 alcoholic drinks per day
• Smokes other products than cigarettes
• Pregnant of lactating