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An athletic trainer mediated spit tobacco cessation program

Institution: University of California, San Francisco
Investigator(s): Margaret Walsh, MS, EdD
Award Cycle: 1998 (Cycle 7) Grant #: 7RT-0058 Award: $490,546
Subject Area: Tobacco-Use Prevention and Cessation
Award Type: Research Project Awards

Initial Award Abstract
More than 12 million people in the United States used Spit (Smokeless) Tobacco (ST) in 1985, 6 million of whom used it at least weekly. The negative health risks associated with ST use include oral cancer, oral leukoplakia, periodontal recession, and nicotine dependence. College athletes are known to be frequent users of ST and are a population at high risk for ST use and its associated negative health effects. The most recent national surveys of substance use among college athletes report that ST use is high and is the only "socials" drug that substantially increased in use by student athletes from 1985 to 1993.

In a survey of college certified athletic trainers, we found that 100% of those responding indicated they would like more training on tobacco cessation techniques and would be willing to work with a local dentist to promote ST cessation among athletes. Based on the rationale that college athletic trainers address health issues with athletes on a regular basis and have expressed interest in promoting tobacco use prevention and cessation among student athletes, our specific aim is to determine the effectiveness of an innovative, ST intervention program to help college athletes who use ST quit their tobacco habit and to help those that are nonusers to remain tobacco free. The intervention would include: (1) an oral exam, advice to quit or not to start tobacco use, brief counseling and the offer of NRT by dental professionals during the pre-season health screenings facilitated by the athletic trainer; (2) follow-up by the athletic trainer on the quit date of users trying to quit and in three group booster sessions scheduled one week apart; (3) confidential athletic trainer referral of athletes wishing more intensive support and problem-solving to ST cessation counselors in the community by the athletic trainer; and, (4) a peer-led educational session during a team meeting. This partnership between college athletic trainers, peer leaders, local dental and dental hygiene societies, and ST cessation counselors in the community will provide various levels of support for athletes who wish to stop their tobacco addiction. The college athletic trainer, however, will assume a leadership role by providing first-level ST cessation counseling and ongoing support and motivation for the quitting process. Thirty colleges with baseball and football athletes will be assigned by chance to either the intervention or no intervention group. ST initiation rates and quit rates at 3 and 12 months after start of study will be compared between groups. We also will identify the characteristics of the individuals that were associated with and the predictors of their successful quitting of ST use. If the intervention is shown to be effective then it may be helpful to other ST users who wish to quit using ST, especially other athletes associated with team sports.