A new University of California San Francisco
(UCSF) study found that high school baseball players who use spit
tobacco are nearly twice as likely to stop using spit tobacco when
dentists or dental hygienists, as well as their teammates, actively
intervene than when they receive no intervention.
The study, funded by the Tobacco Surtax Fund of the State of
California, was first reported at the 1998 International Association
for Dental Research Meeting in Nice, France. Results showed that 27%
of athletes using spit tobacco stopped using the potentially
cancer-causing substance for at least 1 year when dental health
professionals, with the help of teammates, intervened. (About 14% of
the athletes who received no intervention quit using spit tobacco,
which includes chewing tobacco and snuff.)
The study tracked baseball players at 44 high schools throughout
rural California. Dental health professionals intervened at 22 of
those schools, and no intervention took place at the other 22.
High school baseball players who participated in a peer-led
team discussion of the negative health effects of spit tobacco use,
and who received an oral cancer screening exam by a dentist or dental
hygienist who pointed out to players sores in their mouths related to
spit use and advised them to stop their tobacco use, were twice as
likely to stop using than those players who received nothing,
said Margaret Walsh, EDD, UCSF professor of dental public health and
the studys principal investigator.
Aggressive Involvement by Dental Professionals Important
Because dentists and dental hygienists regularly examine oral
tissues, they are the appropriate health professionals to advise
youths on the dangers of spit tobacco and the benefits of quitting,
Walsh said. The studys results also showed that oral health
experts must become more aggressively involved in teaching youths the
risk of using spit tobaccoand hopefully help them quit as a
result. That is particularly important, because the early onset of
the spit tobacco habit among young athletes can lead to a dangerous
long-term nicotine addiction; it increases the potential that the
athletes will be exposed to the high concentration of carcinogens in
spit tobacco for many years.
Most precancerous lesions caused by spit tobacco, called leukoplakia,
are typically found on the inside of the cheek or lip tissue and go
away without treatment if tobacco use stops. However, about 5% to 20%
of those precancerous lesions may become malignant. By the time that
happens, the disease already has become very serious.
Treatment of oral cancer involves disfiguring surgery, which
gives you a 50% chance of living 5 years, said Walsh.
Without surgery, youre dead in one.
Study Targeted High School Baseball Players in Rural Areas
The study focused on high school baseball players because of the high
use of spit tobacco among baseball playersa habit that often
starts in high school. About 67% of the students who participated in
those screenings had the lesions, which generally cause a change in
the color and texture of cheek tissue.
At those screenings, the oral health professionals also discussed
with students the risks of using tobacco, and offered them help with
quitting. Students then participated in informational and discussion
groups led by teammates who had been recruited by researchers after
fellow students identified those teammates as being among the peers
they most admired. In those sessions, students watched an antitobacco
video designed for baseball players, saw graphic slides of oral
cancer, participated in question-and-answer sessions, and discussed
symp-toms of nicotine withdrawal, such as irritability and anxiety.
Walsh noted that rural youths are more prone to use spit tobacco than
are urban youths. Previous studies have shown that about 46% of
baseball players in Californias rural and urban high schools
have used spit tobacco. Comparisons of the two groups show that 57%
of athletes in rural high schools have used chewing tobacco vs 38% in
Co-researchers included Joan F. Hilton, SCD, MPH, UCSF assistant
professor or epidemiology; James Ellison, DDS, UCSF assistant
clinical professor of dentistry; Lauren Gee, MPH, UCSF senior
statistician, department of biostatistics; Margaret A. Chesney,PhD,
UCSF adjunct professor of medicine; Curtis Henke, PhD, UCSF assistant
adjunct professor of medicine; and Virginia Ernster, PhD, UCSF
professor and vice-chair of epidemiology and biostatistics.