Cancer Risk and the Epidemic of Smokeless Tobacco in the US Fire Service

Principal Investigator: Nattinee Jitnarin

Awarded to NDRI-USA

Smokeless tobacco (SLT) use rates within the U.S. Fire Service are substantially higher than those among  other civilian occupations. Fire Service’s SLT use has resulted in health disparities, with minority male  firefighters 10 times more likely to use SLT than male minorities in the general population. Given firefighting  alone increases risk for cancers which have been linked to SLT use, it is critical that occupational research  address this preventable cancer risk. Unlike other occupational groups with high SLT use (i.e., the military),  there are no tailored interventions for the fire service. This project will use formative research to examine  firefighters’ occupational norms, attitudes, beliefs/perceptions about cancer and SLT use, examine cultural and  structural barriers to cessation, and ways to motivate firefighters to quit and promote abstinence. This project  will tailor Enough Snuff (a military SLT cessation program), and create one for firefighters (FIRE­SLT). FIRESLT will be beta­tested in order to examine its feasibility prior to implementing the intervention on a larger  scale. 

For more information: Abstract

  • About NDRI
          Since 1967, National Development and Research Institutes, Inc. (NDRI), a private, not-for-profit 501(c)(3) organization, has conducted substance use and other bio-behavioral research nationwide and throughout the world.

          Drawing on the expertise of our interdisciplinary professional staff and our partners such as medical centers, treatment and prevention programs, universities, CBOs, industry and government NDRI has advanced public health across diverse populations including high-risk and underserved persons, uniformed services, youth and veterans.

          In addition to its focus on addiction, NDRI, organized under specialized institutes, has generated scientific discoveries associated with infectious diseases (particularly HIV and Hepatitis C), overdose, chronic pain, prevention of cardiovascular disease and cancer, tobacco control and criminal justice.


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