A specific format was followed that included (a) asking about tobacco use status, (b) discussing selleck kinase inhibitor motivations for tobacco reduction, (c) discussing encountered problems, (d) problem-solving difficult situations or compliance issues, and (e) providing support. For individuals wanting to quit after the 8-week period, counseling involved(a) discussing reasons for wanting to quit and potential obstacles; (b) discussing the content of the treatment manual, Tough Enough to Quit Snuff, including preparation for the quit day, identification of high risk situations, and strategies to deal with these situations; and (c) identifying sources of support. Follow-up A follow-up session occurred at Week 12. Subjects were asked to monitor ST and other tobacco use for the prior week using daily diary cards.

They were also asked to provide first morning urine. Participants received $10 per each clinic visit during treatment, $25 per follow-up visit, and $150 bonus for attending all the visits and complying with the study requirements. Statistical analysis Baseline demographics were tabulated for treatment groups using summary statistics. Tins per week, dips per day, and mean concentrations of cotinine and NNAL through Week 12 were calculated with baseline values assumed for missing data. Outcomes were analyzed using an intention-to-treat approach. The primary hypothesis tested was whether the treatment group had different effects on level of ST reduction at the end of 4 and 8 weeks and at the 12-week follow-up.

Analysis of ST use and exposure measures used linear mixed models to investigate whether the two interventions had different effects on ST use reduction (Cnaan, Laird, & Slasor, 1997; Littell, Pendergast, & Natarajan, 2000; Schluchter, 1988). Analyses modeled the repeated measures in reported ST use and concentrations of total cotinine and NNAL at each visit (baseline and Weeks 4, 8, and 12). Covariates included main effects for the discrete time and the treatment group as well as interactions between treatment group and time. Models were fitted using restricted maximum likelihood to estimate covariance structure for within-subject responses. The percentage of each group achieving targeted reduction level at the end of 4 (��50%), 8 (��75%), and 12 (��50%) weeks was calculated and compared using chi-square test.

The analysis of the percentage in each group that achieved the targeted reduction level at the end of 4 (��50%), 8 (��50% and ��75%), and 12 (��50%) weeks compared the success rates for the different treatment groups using a logistic regression model. We examined both ��50% and ��75% reduction at 8 weeks although the targeted reduction was 75% because 50% is the typical outcome of reduction studies. Generalized linear mixed model was used to model the probability of achieving the reduction target at each follow-up visit (Weeks AV-951 4, 8, and 12).