{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:42:00Z","timestamp":1771922520982,"version":"3.50.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>First Responders are three times more likely to use smokeless tobacco than those in the general population and very few targeted cessation interventions are available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The #EnufSnuff.TXT First Responder text-based intervention (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f30), which includes an optional reduction component and tailored text-messages for cessation, was administered alongside the Enough Snuff Intervention (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f30), which includes a cessation booklet and general support texts. Both groups received a 4-week supply of 4\u202fmg Nicotine Replacement Therapy (NRT) lozenges to assist with cessation. We surveyed participants 30\u202fdays post-intervention initiation to assess feasibility, acceptability, and Smokeless Tobacco cessation outcomes. A subset of participants participated in qualitative interviews to assess feedback on the intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion\/conclusion<\/jats:title>\n                    <jats:p>\n                      Feasibility benchmarks for recruitment, retention, and engagement were met. Both programs helped First Responders quit. The respective quit rate for #EnufSnuff.TXT-FR arm was higher compared to Enough Snuff was 40%\n                      <jats:italic>vs<\/jats:italic>\n                      33% (OR\u202f=\u202f1.33,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.5925; RR\u202f=\u202f1.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.5935) for the intent-to-treat cases and 52%\n                      <jats:italic>vs<\/jats:italic>\n                      44% (OR\u202f=\u202f1.41,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.5555; RR\u202f=\u202f1.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.5570) for the completers. A text-based cessation intervention was found to be feasible and represents a scalable intervention approach and both interventions produced high quit rates. Larger scale efficacy testing is warranted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/clinicaltrials.gov\/study\/NCT05111041?term=NCT05111041&amp;amp;rank=1<\/jats:ext-link>\n                      , identifier NCT05111041.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1699800","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T15:52:31Z","timestamp":1768837951000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["#EnufSnuff.TXT-FirstResponder: a pilot randomized controlled trial of a text message intervention for smokeless tobacco cessation among First Responders"],"prefix":"10.3389","volume":"13","author":[{"given":"Devon","family":"Noonan","sequence":"first","affiliation":[{"name":"Duke University School of Nursing","place":["Durham, NC, United States"]},{"name":"Duke Cancer Institute","place":["Durham, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura J.","family":"Fish","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute","place":["Durham, NC, United States"]},{"name":"Department of Family Medicine and Community Health, Duke University","place":["Durham, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan G.","family":"Silva","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing","place":["Durham, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Da Costa","sequence":"additional","affiliation":[{"name":"College of Health and Human Sciences, Western Carolina University","place":["Cullowhee, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leigh Ann","family":"Simmons","sequence":"additional","affiliation":[{"name":"University of California Davis Betty Irene Moore School of Nursing","place":["Sacramento, CA, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norma","family":"Garcia Ortiz","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing","place":["Durham, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Courtney","family":"Swinkels","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing","place":["Durham, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daum","family":"Jung","sequence":"additional","affiliation":[{"name":"Duke University School of Nursing","place":["Durham, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert H.","family":"Severson","sequence":"additional","affiliation":[{"name":"Oregon Research Institute","place":["Eugene, OR, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn I.","family":"Pollak","sequence":"additional","affiliation":[{"name":"Duke Cancer Institute","place":["Durham, NC, United States"]},{"name":"Department of Population Health Sciences, Duke University","place":["Durham, NC, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1002\/ajim.23311","article-title":"Trends of cigarette smoking and smokeless tobacco use among U.S. firefighters and law enforcement personnel, 1992\u20132019","volume":"65","author":"Phan","year":"2022","journal-title":"Am J Ind 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