***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the potential efficacy of bupropion sustained release when used in combination with minimal counseling for moist snuff cessation in males . METHODS A double-blind , placebo-controlled 3-month trial . The active treatment group ( n = 35 ) received bupropion SR at 150 mg/qd day for the first 3 days , then beginning day 4 through day 49 ( 7 weeks ) 150 mg/ b.i.d . The placebo group ( n= 35 ) received 1 tablet qd for 3 days and beginning day 4 through day 49 , 1 tablet/b.i.d . RESULTS Bupropion 300 mg/day ( 150 b.i.d . ) produced significantly higher quit rates for smokeless tobacco cessation at the end of treatment ( 7 weeks ) than placebo ( p = 0.04 ) with an OR of 2.73 . CONCLUSION Bupropion SR appears to be effective for smokeless tobacco cessation Smokeless tobacco ( ST ) is associated with adverse health consequences yet treatment re sources for ST are not widely available . Cost-effective behavioral interventions incorporating self-help material s and counseling calls have been demonstrated to reduce ST use rates and can be easily disseminated , but the feasibility and effectiveness of incorporating pharmacotherapy into this approach have not been evaluated . We conducted a clinical pilot study r and omizing 60 patients to 12 weeks of the 4-mg nicotine lozenge or placebo delivered through the mail . All subjects received an assisted self-help intervention ( ASH ) with telephone support . At the end of the medication phase , lozenges were being used by 63 % of subjects in the 4-mg nicotine lozenge group and 43 % in placebo . The nicotine lozenge decreased composite withdrawal symptoms and adverse events were minimal . No significant differences were observed in abstinence rates between the two groups at 3 or 6 months . We conclude that the mailing of nicotine lozenges to ST users is a feasible and safe strategy the efficacy of which needs to be evaluated To examine the effectiveness of advising patients who use tobacco to quit , the authors conducted a r and omized clinical trial to test a brief office-based intervention with all tobacco users in 75 fee-for-service dental practice s in Oregon . The authors found that the dental hygienist-delivered intervention was effective in getting smokeless tobacco users to quit at three and 12 months and to sustain abstinence at both three and 12 months . They found that the program was not effective for cigarette smokers . The authors discuss the public health implication s of program dissemination and widespread program adoption Long-term smokeless tobacco ( ST ) use is associated with cardiovascular disease and cancer , but not all ST users want to quit . Previous studies have evaluated the effectiveness of nicotine lozenges and tobacco-free snuff for reducing ST use among ST users not ready to quit , but no comparative effectiveness trials of these two products have been conducted . We conducted a multicenter , r and omized clinical pilot study evaluating the comparative effectiveness of the 4-mg nicotine lozenge and tobacco-free snuff for reducing ST use and increasing tobacco abstinence among ST users with no intention of quitting in the next 30 days . Participants received 8 weeks of treatment and behavioral counseling on tobacco reduction strategies with follow-up to 26 weeks . We r and omized 81 participants ( 40 nicotine lozenges , 41 tobacco-free snuff ) . No significant differences in reduction were observed between the two groups at weeks 8 , 12 , and 26 . No significant differences were observed between groups in nicotine withdrawal or tobacco craving . However , both groups significantly reduced ( p<.001 ) ST use in cans/week and dips/day from baseline which was sustained through the end-of- study . The observed biochemically-confirmed abstinence rates at week 26 were similar between groups ( 12 % vs. 12 % , one-tailed p=.615 ) . The 4-mg nicotine lozenge and the tobacco-free snuff both appear to be effective and comparable for reducing ST use among ST users not ready to quit in the next 30 days We describe a r and omized trial design ed to evaluate the effectiveness of a smokeless tobacco cessation intervention delivered by dental hygienists as part of a patient 's regularly scheduled cleaning visit . Seventy-five practice s were r and omized to continue their usual care ( n=25 ; 239 smokeless tobacco using patients enrolled ) or to receive training to provide a tobacco cessation intervention ( n=50 ; 394 smokeless tobacco using patients enrolled ) . Patient reports indicated that the training program was successful in getting hygienists to implement the intervention . The intervention produced a strong effect on sustained quitting for smokeless tobacco users but had no impact on secondary outcomes , including unsuccessful quit attempts , future intent to quit using smokeless tobacco , and change in readiness to quit using . Frequency of smokeless tobacco use and receipt of specific components of the intervention , including the video and written material s , predicted sustained cessation . Since this intervention was delivered by dental hygienists as part of a patient 's regularly scheduled cleaning visit , it is easily disseminable Abstract Objective . Smokeless tobacco ( Swedish moist ‘ snus ’ ) users are often strongly addicted to nicotine . Compared to the large number of smoking-cessation studies , there have been few evaluated clinical cessation programs in conjunction with nicotine replacement therapy ( NRT ) . The aim of this study was to evaluate a cessation program for snus users with a weekly use of > 2 cans/week for > 10 years . Material and methods . A prospect i ve , open , non-r and omized intervention trial was undertaken including baseline oral examination and soft tissue biopsy , minor physical examination , brief cessation advice , NRT recommendations and five prospect i ve follow-up visits within 12 months . Individual cessation counseling was given , together with oral examination in the dental office . Fifty snus users with a minimum consumption of 100 g/week who were actively seeking cessation treatment were recruited through advertising .  Self-reported abstaining , including r and om- sample biochemical verification , and NRT use were evaluated at 6 weeks and 3 , 6 and 12 months . Results . At the 3- , 6- and 12-month visits , 58 % , 46 % and 30 % of subjects , respectively were tobacco-abstinent . All nicotine abstinence was r and omly controlled during the study except at 12 months , where all subjects cl aim ing abstinence were confirmed biochemically and clinical ly . Conclusion . Smokeless tobacco cessation achieved together with suitable NRT seems a promising way to improve a persistent tobacco-free condition Oral cancer is caused by chewing and smoking of tobacco . To assess the feasibility of primary prevention of oral cancer , two cohorts were studied in base-line surveys and then followed up annually for 10-yr in Ernakulam district of Kerala state . The intervention cohort consisted of 12212 tobacco users aged 15 yr and over , who were exposed to a concentrated program of education against tobacco use .  The control cohort was a non-concurrent cohort of 6075 tobacco users studied using similar methods but with a minimal amount of advice against tobacco use . The stoppage of tobacco use increased and the incidence rate of leukoplakia decreased significantly and substantially in the intervention cohort compared to the control cohort . The decrease in the incidence of leukoplakia was indicative of the decrease in the risk of oral cancer since the two were intimately related . This study demonstrated feasibility of primary prevention of oral cancer Few pharmacological therapies have been shown to increase abstinence rates among spit tobacco ( ST ) users .  Bupropion has been shown to be effective in increasing abstinence rates among smokers but has not been studied in ST users . Sixty-eight adult ( aged > or = 18 years old ) regular users of ST who were motivated to stop using ST were enrolled in a r and omized , double-blind , placebo-controlled pilot study of bupropion sustained release ( SR ) or placebo for 12 weeks . The primary endpoint was 1-week , biochemically confirmed point-prevalence tobacco abstinence rate at the end of treatment ( week 12 ) . Nicotine withdrawal symptoms and weight change were assessed . At the end of 12 weeks of therapy , the point-prevalence tobacco abstinence rate was 44 % in the bupropion group and 26 % in the placebo group ( p = 0.064 ) . At 24 weeks following initiation of medication , the point-prevalence abstinence rate was 29 % for both groups . After 7 weeks of medication , subjects on bupropion reported significantly less ( p < or = 0.034 ) nicotine withdrawal than placebo . The mean weight change from baseline to end of treatment was + 0.7 + /- 1.9 kg for bupropion and + 4.4 + /- 2.4 kg for placebo ( p = 0.03 ) . The 6-month weight change for continuously abstinent subjects was 3.4 + /- 3.6 kg in the bupropion group and 6.2 + /- 5.0 kg in the placebo group ( p = 0.49 ) . Bupropion may increase abstinence rates in ST users and appears to attenuate weight gain during ST abstinence . Larger r and omized , controlled trials of bupropion for ST users are needed The purpose of this study was to examine the effects of 2 mg of nicotine polacrilex versus placebo gum and of group behavioral treatment versus minimal contact on cessation of smokeless tobacco use . Participants ( N = 210 ) were r and omly assigned 1 of the 4 treatment conditions . Withdrawal symptoms were assessed throughout the treatment . Follow-up assessment s were made at 1 , 6 , and 12 months posttreatment . Survival curve analysis showed that any of the 3 treatment groups involving group behavioral therapy or placebo gum were equally effective and superior to the minimal contact plus 2 mg of nicotine gum treatment in terms of abstinence . On the other h and , withdrawal symptoms were significantly reduced by nicotine gum , compared with placebo during the initial phases of cessation . The ineffectiveness of nicotine gum on treatment outcome may be attributed to its similarity with smokeless tobacco Background Tobacco use kills half a million people every month , most in low – middle income countries ( LMICs ) . There is an urgent need to identify potentially low-cost , scalable tobacco cessation interventions for these countries . Objective To evaluate a brief community outreach intervention delivered by health workers to promote tobacco cessation in India . Design Cluster-r and omised controlled trial . Setting 32 low-income administrative blocks in Delhi , half government authorised ( ‘ resettlement colony ’ ) and half unauthorised ( ‘ J.J. cluster ’ ) communities . Participants 1213 adult tobacco users . Interventions Administrative blocks were computer r and omised in a 1:1 ratio , to the intervention ( 16 clusters ; n=611 ) or control treatment ( 16 clusters ; n=602 ) , delivered and assessed at individual level between 07/2012 and 11/2013 . The intervention was single session quit advice ( 15 min ) plus a single training session in yogic breathing exercises ; the control condition comprised very brief quit advice ( 1 min ) alone . Both were delivered via outreach , with contact made though household visits . Measurements The primary outcome was 6-month sustained abstinence from all tobacco , assessed 7 months post intervention delivery , biochemically verified with salivary cotinine . Results The smoking cessation rate was higher in the intervention group ( 2.6 % ( 16/611 ) ) than in the control group ( 0.5 % ( 3/602 ) ) ( relative risk=5.32 , 95 % CI 1.43 to 19.74 , p=0.013 ) . There was no interaction with type of tobacco use ( smoked vs smokeless ) . Results did not change material ly in adjusted analyses , controlling for participant characteristics . Conclusions A single session community outreach intervention can increase tobacco cessation in LMIC . The effect size , while small , could impact public health if scaled up with high coverage . Trial registration number IS RCT CN23362894 The sizeable percentage of adults who use smokeless tobacco ( ST ) represents an important public health target since the majority of ST users have a strong desire to quit , but many lack re sources . We tested the impact of an interactive , tailored Web-based intervention ( Enhanced Condition ) versus a more linear , text-based website ( Basic Condition ) in a r and omized trial with 2523 adult ST users . As is common in Internet-based research , there was considerable attrition : follow-up rates at 3 months , 6 months , and for both 3 and 6 months were 48 % , 45 % and 34 % , respectively . Results using repeated point prevalence of all tobacco use at 3 and 6 months showed that participants in the Enhanced Condition quit at significantly higher rates than those in the Basic Condition . Using a Complete Case analysis , abstinence was 40.6 % in the Enhanced Condition vs. 21.2 % in the Basic Condition ( p < .001 ) . Using intent-to-treat analysis , quit rates were 12.6 % vs. 7.9 % , respectively ( p < .001 ) . Similar results were obtained for only ST use . Unobtrusive 
    Output:
    
Regular telephone support/quitlines also proved beneficial .