Smokeless tobacco can take you out of the game

Marshall Posner, MD, says that the first step in reducing oral cancer risk is to avoid tobacco use altogether.

Another baseball season is under way and fans are heading to the ballpark to watch their favorite players hit home runs, steal bases, and argue over what's fair and foul.

Unfortunately, they will also see something else that many consider to be "foul" — players chewing tobacco.

Dana-Farber Cancer Institute and the Massachusetts Dental Society (MDS) are partnering to spread the word that chewing tobacco, otherwise known as spit, dip, chew, or smokeless tobacco, is not a safe alternative to smoking. In fact, it's very addictive and a serious health risk.

According to a Massachusetts survey released earlier this spring, teens may be turning away from cigarettes to other forms of tobacco, including smokeless tobacco.

The report was funded by the United States Centers for Disease Control and conducted by state education and health departments.

The survey asked middle- and high-school students about their tobacco habits and found that for the first time, students are using smokeless tobacco and cigars more than cigarettes.

Of those high-schoolers who were surveyed, 16 percent admitted to smoking cigarettes in the past 30 days, while 17.6 percent admitted to using other tobacco products, such as smokeless tobacco.

"Chewing tobacco is the most dangerous form of tobacco because it comes in contact directly with the oral mucosa," states David P. Lustbader, DMD, an MDS Trustee and an oral and maxillofacial surgeon at South Shore Oral Surgery Associates.

"Smokeless tobacco is also the hardest form of tobacco to quit, due to its high nicotine content."

More than 30,000 Americans each year are diagnosed with oral cancer. Because it can spread so quickly, only slightly more than half will survive more than five years.

"Nicotine and the other tars in chewing tobacco change the cells throughout the mouth and tongue and lead to cancer," adds Marshall R. Posner, MD, director of the Head and Neck Oncology Center at Dana-Farber Cancer Institute in Boston.

"The treatment for oral cancer can include radical and deforming surgery," warns Dr. Posner. "And once the cells change, they never go away, so tobacco is a 'gift' that keeps on giving long after chewing or dipping has stopped."

Chewing tobacco can cause:

• Increased risk of cancer of the mouth and pharynx;
• Cracking or bleeding lips and gums;
• Stained teeth;
• Receding gums, which can eventually lead to tooth loss;
• Increased heart rate, high blood pressure, and irregular heartbeats, all leading to an increased risk of heart attacks and brain damage.

Dr. Posner and Dr. Lustbader encourage people who chew tobacco to quit, explaining that the first step in reducing the risk of developing oral and head and neck cancers is to avoid tobacco use altogether.

They also stress that those who chew tobacco should see their dentist or doctor immediately if they develop any type of mouth sore or lesion, which can develop into cancer.

For more information on oral cancer and smokeless tobacco, call the Massachusetts Dental Society at (800) 342-8747 or visit www.massdental.org.

Dana-Farber Cancer Institute (www.dana-farber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute. It is the top ranked cancer center in New England, according to U.S. News & World Report, and one of the largest recipients among independent hospitals of National Cancer Institute and National Institutes of Health grant funding.

The Massachusetts Dental Society is a 5,000-member professional association and statewide constituent of the American Dental Association. Established in 1864, the MDS is an organization dedicated to improving the oral health of the public in the Commonwealth of Massachusetts, and also advancing the professional development of its membership through initiatives in education, advocacy, and promotion of the highest professional standards.