Use of smokeless tobacco (ST; e.g. oral snuff, chewing tobacco) increases
the risk of developing oral cancers, nicotine addiction, and other health
problems. Among American college men ST rates range from 4 to 22 percent,
whereas surveys of male college athletes show that 17 to 54 percent use
ST. From 1985-1993 rates Of ST use by athletes have increased.
Interventions to modify ST use have typically been aimed at individuals
and groups. These programs have had modest effects on long term
cessation. Other impacts of these programs have not been assessed.
Evidence indicates that restrictive worksite smoking policies can have
a positive impact on smoking and smoking related behaviors. Policies that
restrict ST use are a potentially effective strategy for changing adult
ST behaviors. There have been no systematic studies of the effects of
organizational policies regulating ST use or the strategies used to
The proposed study will assess the effects of an ST restrictive
organizational policy on ST use and related behaviors. The study will
focus on the National Collegiate Athletic Association's (NCAA) 1994 ban
prohibiting tobacco use, including ST, during practices and competition.
The specific objectives of the study are to assess the effects of the ban
on: 1) the contexts in which ST is used 2) overall consumption of ST 3)
ST cessation attempts 4) changes in users' motivation to alter ST
behavior and 5) maintenance of abstinence among those who quit ST.
institutional and individual mediators of outcomes will be identified.
The quasi-experimental study design combines features of a Recurrent
Institutional Cycle Design and a Repeated Treatment Design. Cross-
sectional and cohort data will be collected. Sixty four NCAA schools
stratified by geographic region and competitive division (I,II, or III)
will be randomly selected. Five thousand athletes in sports at highest
risk for ST use (e.g.,wrestlers, baseball, football, and mens' tennis
players) will participate in a self-administered survey of their own ST
use, cessation attempts, ST related cognitions, team ST use, and
perceptions of the NCAA ban. Coaches will be surveyed on local
interpretation and implementation of the ban (i.e., handling of
infractions, local availability of treatment, etc.). in year one all
athletes will be surveyed twice. Measures will be repeated in year two.
At a selected school self-reported ST use will be validated via salivary
cotinine assay and intraoral examination. The study has been endorsed by
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