Skip to main content
An official website of the United States government
Grant Details

Grant Number: 5R01CA090884-04 Interpret this number
Primary Investigator: Dale, Lowell
Organization: Mayo Clinic Rochester
Project Title: Efficacy of Bupropion for Treating Spit Tobacco Users
Fiscal Year: 2005


Although overall rates of cigarette smoking have declined over the past 40 years, the use of spit tobacco (ST) has tripled. The use of ST can lead to nicotine addiction and physical dependence. ST use is known to increase the risk of periodontal disease and oral cancer. Moreover, ST use increases the risk for cancer of the esophagus, larynx, stomach and pancreas and the risk of cardiovascular disease. Effective interventions are needed to assist ST users to stop. Bupropion, a monocyclic anti- depressant that inhibits the neuronal re-uptake of norepinephrine and dopamine and may also selectively inhibit neuronal nicotinic receptors, has demonstrated efficacy for smoking cessation. In a placebo-controlled pilot study, we have shown possible treatment effects of sustained release bupropion (SR) in ST user. Our aims are: 1) To evaluate the efficacy of a 12-week course of bupropion SR rates of abstinence from all tobacco use; 2) To evaluate the efficacy of a 12-week course of bupropion SR compared to placebo on the end of treatment and 12- month rates of abstinence from all tobacco use; 2) To evaluate the efficacy of a 12-week course of bupropion SR compare to placebo on the end of treatment and 12-month rates of abstinence from ST; 3) To determine what baseline characteristics in addition to medication assignment are associated with abstinence from all tobacco and from ST, at the end of treatment and at 12 months; 4) To determine the association between baseline urine tobacco alkaloids with self-reported tobacco use behavior and level of nicotine dependence assessed using the Fagerstrom Tolerance Questionnaire modified for ST users; 6) To determine if ST users successful in abstaining from ST switch to a nicotine-replacement product or a different tobacco product (cigarettes, pipe, or cigars). In a randomized, double-blind, placebo-controlled trial, we will compare bupropion SR to placebo in 320 regular users of ST. Active or placebo bupropion will be taken for a total of 12 consecutive weeks starting one week before the target quit date. Behavioral intervention will be provided for all subjects.


A comparison of three smokeless tobacco dependence measures.
Authors: Ebbert J.O. , Severson H.H. , Danaher B.G. , Schroeder D.R. , Glover E.D. .
Source: Addictive behaviors, 2012 Nov; 37(11), p. 1271-7.
EPub date: 2012-06-21.
PMID: 22762958
Related Citations

Predictors of smokeless tobacco abstinence.
Authors: Ebbert J.O. , Glover E.D. , Shinozaki E. , Schroeder D.R. , Dale L.C. .
Source: American journal of health behavior, 2008 Nov-Dec; 32(6), p. 735-40.
PMID: 18442352
Related Citations

Bupropion SR for the treatment of smokeless tobacco use.
Authors: Dale L.C. , Ebbert J.O. , Glover E.D. , Croghan I.T. , Schroeder D.R. , Severson H.H. , Hurt R.D. .
Source: Drug and alcohol dependence, 2007-09-06; 90(1), p. 56-63.
EPub date: 2007-03-13.
PMID: 17353101
Related Citations

Measuring nicotine dependence among smokeless tobacco users.
Authors: Thomas J.L. , Ebbert J.O. , Patten C.A. , Dale L.C. , Bronars C.A. , Schroeder D.R. .
Source: Addictive behaviors, 2006 Sep; 31(9), p. 1511-21.
EPub date: 2006-01-04.
PMID: 16386854
Related Citations

Smokeless tobacco: an emerging addiction.
Authors: Ebbert J.O. , Carr A.B. , Dale L.C. .
Source: The Medical clinics of North America, 2004 Nov; 88(6), p. 1593-605.
PMID: 15464115
Related Citations

Simultaneous analysis of nicotine, nicotine metabolites, and tobacco alkaloids in serum or urine by tandem mass spectrometry, with clinically relevant metabolic profiles.
Authors: Moyer T.P. , Charlson J.R. , Enger R.J. , Dale L.C. , Ebbert J.O. , Schroeder D.R. , Hurt R.D. .
Source: Clinical chemistry, 2002 Sep; 48(9), p. 1460-71.
PMID: 12194923
Related Citations

Back to Top