Smokeless tobacco is a losing game

As another baseball season begins, fans will be 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 many consider to be foul — players chewing tobacco.

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

According to the National Spit Tobacco Education Program (NSTEP), the nicotine content in a can of dip or snuff is approximately 144 milligrams, which is equal to about 80 cigarettes — or four packs of cigarettes.

"Smokeless tobacco is absorbed quickly and directly through the inside of the mouth, making it very dangerous," states Dr. Michael Kahn, an MDS member and chair of Tufts University School of Dental Medicine's Department of Oral Pathology.

According to a 2005 survey by the Centers for Disease Control and Prevention, approximately 12,000 male high school students in Massachusetts reported using chewing tobacco on at least one of the 30 days preceding the survey. Furthermore, many health care groups fear that due to the increasing number of smoking bans now in effect, this number could rise.

Meanwhile, tobacco control advocates and health care providers are watching as a new smokeless tobacco "pouch" is being marketed to the public. Users swallow the tobacco juices produced as the pouch rests on the gum line. Anti-smokeless tobacco advocates fear that teenagers will be attracted to the pouch because it is easier to conceal and not as offensive.

"The more you use tobacco or dip, the greater the chance of getting cancer," says Marshall Posner, MD, director of the Head and Neck Oncology Center at Dana-Farber Cancer Institute in Boston. "The treatment for oral cancer includes radical and deforming surgery. The changes in the cells never go away, so tobacco is a 'gift' that keeps on giving long after chewing or dipping has stopped."

Chewing tobacco can cause:

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

Dr. Kahn and Dr. Posner 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 mouth sores or lesions, 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), a designated comprehensive cancer center by the National Cancer Institute.

The Massachusetts Dental Society is a non-profit organization dedicated to improving the oral health of the public and professional development of its member dentists through initiatives in education, advocacy, and promotion of the highest professional standards.