Smokeless tobacco treatment: Measures, interventions, recommendations, and future directions

Herbert H. Severson, Judith S. Gordon, Laura Akers, Devon Noonan

Research output: Chapter in Book/Report/Conference proceedingChapter


There are almost 9 million regular smokeless tobacco (ST) users in the United States. Because ST products, manufacturing methods, distribution, use patterns, regulations, and research differ by country, this chapter focuses on interventions in the United States and is limited to studies in adults. The challenges of measuring use and dependence are discussed, and tools appropriate to particular forms of ST products and conditions of use are assessed. The various behavioral and pharmacological interventions for which reliable data exist are evaluated, and recommendations for intervention methods and research are offered. In general, research has yielded good evidence and support for several methods, with some outcomes exceeding those for smoking cessation. However, refinement of existing methods and delivery systems is needed, as well as innovation in methods. Future directions in which studies and therapeutic applications might go are projected.

Original languageEnglish (US)
Title of host publicationSmokeless Tobacco Products
Subtitle of host publicationCharacteristics, Usage, Health Effects, and Regulatory Implications
Number of pages33
ISBN (Electronic)9780128181591
ISBN (Print)9780128181584
StatePublished - Jan 21 2020


  • Bupropion
  • Fagerström tolerance questionnaire for smokeless tobacco (FTQ-ST)
  • Nicotine dependence
  • Oklahoma scale for smokeless tobacco dependence (OSSTD)
  • Severson Smokeless tobacco dependency scale (SSTDS)
  • Smokeless tobacco products
  • Tobacco cessation
  • Tobacco-specific nitrosamines (TSNA)
  • Varenicline

ASJC Scopus subject areas

  • General Chemistry


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