Smokeless tobacco use among teens on the rise, even among athletes

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Image derived from SETShots via Flickr

The use of snuff and other smokeless tobacco products by American high school students is up significantly, even among high school athletes typically more inclined than their peers to be health conscious, federal health officials say.

In fact, athletes are more likely to use smokeless tobacco than their non-athlete classmates, according to a recently published study.

The findings were drawn from the Youth Risk Behavior Survey (YRBS) conducted by the Centers for Disease Control and Prevention. The survey found that 8.8 percent of high school students reported using smokeless tobacco in 2013, up from 8.2 percent in 2001. Among high school athletes, the rise was steeper. A total of 11.1 percent of high school athletes reported using smokeless tobacco in 2013, up from 10 percent in 2001.

By comparison, 5.9 percent of non-athletes used smokeless tobacco in high school, a rate that has remained constant in recent years, the YRBS data said. The increase in the use of smokeless tobacco products such as chewing tobacco, snuff and dip (moist snuff) products runs counter to a broader more hopeful trend, the researchers noted in their findings, published in September in the CDC’s Morbidity and Mortality Weekly Report (MMWR).

Overall, tobacco use has seen a steep decline among American high school students in recent years.

Fewer than one-quarter (22.4 percent) of high school students reported using any kind of tobacco products in 2013, down significantly since 2001, when more than one third (33.9 percent) said they smoked or used smokeless tobacco.

Over time, athletes have remained less likely to smoke but more likely to use smokeless tobacco than their non-athlete peers, the study found. Researchers suggested the athletes may view smokeless tobacco as a healthier alternative to cigarettes.

“Athletes might be more likely to use certain tobacco products, such as smokeless tobacco, if they perceive them to be harmless; however smokeless tobacco is not safe and is associated with increased risk for pancreatic, esophageal, and oral cancers,” the authors wrote, noting that use of smokeless tobacco might also be seen as socially acceptable or even a way to enhance athletic performance. “Smokeless tobacco use among professional athletes is an important issue because they are often considered role models by youth.”

Some of these role models have themselves come out against smokeless tobacco. In June of last year, Baseball Hall-of-Famer Tony Gwynn died of salivary gland cancer, a disease he attributed to his longtime use of chewing tobacco.

Then, World Series-winning pitcher Curt Schilling disclosed that he was fighting oral cancer. He too blamed the disease on smokeless tobacco.

This spring, Schilling published a “Letter to My Younger Self” as a warning to teens.

“Dear 16-year-old Curt,” began the piece which ran in the online magazine Players’ Tribune:

Tomorrow at lunch, a kid is going to dare you to take a dip of Copenhagen. If you say yes, like I did, you’ll be addicted for the rest of your life. Well, the rest of your life up to the point when you are diagnosed with cancer.

I get what you’re thinking. You’re 16 — you’re invincible, just like all your buddies. If you were to jump ahead 33 years, you couldn’t write a better dream than the one your life is going to be.

With one exception.

If you say yes tomorrow, you will become addicted to chewing tobacco and you will get mouth cancer.

National, state and local health organizations have used such stories to talk about the dangers of smokeless tobacco. See this AHCJ tip sheet for more resources.

In the MMWR article, researchers emphasized the importance of such messages. “These findings suggest that opportunities exist for development of stronger tobacco control and prevention measures targeting youth athletes regarding the health risks associated with all forms of tobacco use.”

Smokeless tobacco has been banned in the minor leagues for more than twenty years. It is restricted but not prohibited in major league baseball.  Earlier this year, San Francisco became the first U.S. city to pass a law (which will go into effect on Jan. 1) prohibiting the use of smokeless tobacco at all baseball fields and other athletic facilities. Boston’s city council also approved a ban in early September.

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