Introduction Promising Web-based interventions for smokeless tobacco cessation have emerged. We describe a randomized controlled trial (RCT) testing the relative benefits of adding the nicotine lozenge as an adjunct to the MyLastDip Web-based smokeless tobacco cessation intervention. Methods 407 smokeless tobacco users who wanted to quit were recruited, screened online, and randomly assigned to one of two conditions: (a) the interactive MyLastDip Web-based intervention (Web Only; n =202), or (b) the website plus the offer of nicotine lozenges (Web+Lozenge; n =205). MyLastDip program content is grouped according to three sequential frames: preparing to quit, quitting, and staying quit. If a participant reported a lapse then the program would provide tailored content on lessons learned and starting over (“retooling”). The primary outcome was 7-day point prevalence tobacco abstinence measured at follow-up assessments that occurred 3months and 6months post-enrollment. Results Assessment completion rates were 71.5% at 3months, 72.9% at 6months, and 65.1% for both 3 and 6months, and did not differ by condition. Using Intent to Treat analyses, the Web+Lozenge condition was associated with a significantly higher 7-day point prevalence tobacco abstinence rate than the Web Only condition at 3months (43.4% vs. 29.7%, p =.004), at the combined 3 and 6month assessment of repeated point prevalence (35.6% vs. 23.3%, p =.007), but not at 6months (44.4% vs. 35.1%, p =.057). Similar results were obtained for smokeless tobacco abstinence. Participants reported being satisfied with their programs and the Web+Lozenge condition participants visited the MyLastDip program more often (p <.001). A composite engagement measure of the number and duration of program visits was positively related to 6-month tobacco abstinence (p =.009). Conclusions Consistent with previous research, the MyLastDip Web-based tobacco cessation intervention encouraged long-term levels of tobacco and smokeless tobacco abstinence. The addition of nicotine lozenges significantly improved both participant engagement and self-reported 7-day point prevalence tobacco abstinence at 3months and when considering 3- and 6-month repeated point prevalence tobacco abstinence. 
Randomized controlled trial examining the adjunctive use of nicotine lozenges with MyLastDip: An eHealth smokeless tobacco cessation intervention