The Dangers of Chewing Tobacco
USA Baseball Medical/Safety Advisory Committee
Moist or dry snuff or "dip" is thin ground tobacco placed between the gum and cheek. Chewing tobacco or "chew" and loose leaf tobacco is similarly placed. These are the forms of spit tobacco employed for centuries and were identified with baseball beginning as early as the 1850's.
Initially dry, dusty playing fields and a need to keep the glove moist were the impetus for the use of spit tobacco. It rapidly became part of the tradition of baseball. The early 1900's saw the identification of spitting with the spread to tuberculosis and a decrease in use occurred, but the tradition remained with baseball until the 1950's when cigarettes gained popularity. The sense that spit tobacco was safer than cigarettes led to resurgence of use in the 1970's and 1980's.
It was estimated that in the 1980's there were 12 million users of spit tobacco and 3 million consumers were less than 21 years of age. In a 1985 survey of male college baseball players, 40% used spit tobacco regularly as compared to only 3% who smoked cigarettes.
The Youth Risk Behavior Study 1990-1991 found that 20% of males between the ages of 9-12 used spit tobacco. In 1991, a threefold increase in use was detected between 1972-1991 in 18-24 year old males. Studies from individual states indicate that 55% of children under age 15 use spit tobacco, and in Oklahoma, 13% of 3rd graders, 22% of the 7th graders, 23% of 9th graders and 40% of 11th graders were users.
The traditional association of chew with baseball, along with assumption that spit tobacco is safe, must be changed. As described in an N.I.H. consensus report, smokeless tobacco is causally related to cancer of the oral cavity, gum disease and nicotine addiction. Eight to ten chews per day equals 30-40 cigarettes per day and nicotine levels attained create addiction and can produce withdrawal symptoms with cessation of the product. Gum disease, tooth loss, pre-cancerous lesions such as leukoplakia, and eventually cancerous lesions can arise in the oral cavity, involving all organs.
Some evidence exists that regular use can create an acceleration of coronary and peripheral blood vessel disease, diminished blood flow to the heart muscle, delay in wound healing create reproductive disturbances, induce esophageal reflux and cause peptic ulcer disease.
There are many reasons offered by athletes for the use of tobacco. These include, among others, relaxation, relief of boredom, and engaging in a ritual of the sport. Some athletes believe that spit tobacco improves performance, but what occurs is an increase in blood pressure and pulse rather than an increase in reaction time or level of skill.
Due to the significant medical problems that can occur, it is the recommendation of the USA Baseball Medical and Safety Advisory Committee that:
1. All tobacco should be banned from use in the amateur baseball environment. The bans must be associated with well defined disciplinary measures. These measures should not be ignored and must be enforced. Everybody associated with the game including coaches, players, umpires, grounds crew, etc. should be included in the ban.
2. Physicians should be alert for physical findings, such as stained teeth or leukoplakia, that would raise the issue of the use of spit tobacco. If found and the athlete is identified as a user, the parent and athlete should be counseled on the medical problems that can occur. The athlete should be advised that performance will not improve and that bad breath, spitting, stained teeth, etc., is socially unacceptable and that serious dental problems and cancer can occur. Additionally, nicotine withdrawal support should be considered, if needed, including the use of nicotine patches if indicated.
3. Professional athletes should be encouraged to discontinue the use of smokeless tobacco especially when performing in front of the public. Young athletes are often influenced by their role models. Free samples, provided by various companies, should not be allowed in the clubhouse and athletes should avoid products that promote use by artificial flavoring and gradually increasing levels of nicotine.
4. Team managers should reinforce the medical concerns regarding the use of tobacco and be consistent in disciplinary approaches. Teammates should be encouraged to support and assist the athlete who is attempting to discontinue use of tobacco. If the athlete is unaware of the potential problems associated with tobacco use, a team manager should solicit information from a local physician or from the USA Baseball Medical and Safety Advisory Committee.
5. The childhood use of chewing gum or candy that provides the appearance of chew deserves review to determine if it will promote a later use of smokeless tobacco.
USA Baseball strongly endorses the use of educational materials to describe the risks of spit tobacco. The use of spit tobacco is banned by any athlete selected to a play for a USA Baseball National Team.
Several educational products have been developed by the The National Cancer Institute and other organizations. For more information on the dangers of spit tobacco and how your child can get help, please contact:
NSTEP - Oral Health America 211 East Chicago Avenue, Suite 820 Chicago, Illinois 60611 (312)787-6270
Romano and Associates, Inc. 10630 Little Patukent Parkway Columbia, Md. 21044 (410) 730-4133