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To the Editor: An estimated 6.9 million people in the United States use smokeless tobacco, such as chewing tobacco or snuff. The health risks associated with smokeless tobacco use include increased rates of oropharyngeal cancer and increased subsequent cigarette smoking.¹ Despite the widespread use of smokeless tobacco, relatively few data have appeared in the literature regarding treatment of addiction to it.^2-3 We describe a case of successful treatment of smokeless tobacco use with an approach that combined pharmacotherapy and behavior modification.

Report of a Case.

A 31-year-old man had an 11-year history of using 1 can per day of smokeless tobacco and denied any history of smoking. The patient previously had made several attempts to stop use of smokeless tobacco with nicotine patches and abrupt cessation but had only limited success for a short time. He agreed to a trial of bupropion hydrochloride and a 4-week course of behavior modification. These sessions covered effective . . . [Full Text of this Article]