When a senior at Minnewaska Area High School was suspended from the basketball team recently after running afoul of Minnesota State High School League rules on tobacco use, it brought attention to an often under-recognized issue: the use of chewing tobacco, particularly among young men.
To recap: Basketball player Shane Bosek served a two-week suspension and was removed as a team captain after 12 tins of smokeless tobacco were found in his car during a random check at the school last month. Although he’s 18 and didn’t break the law, tobacco use of any kind is still against the rules for students participating in League-sanctioned sports.
Call it the other tobacco – the one that doesn’t quite get the same amount of attention as cigarettes.
Indeed, there seems to be a unique and rather specific culture surrounding the use of chewing tobacco, aka chew, plug, dip, smokeless tobacco, snus, etc. It’s often associated with baseball: Watch any major league baseball game and you’re likely to spot it – that wad tucked inside a player’s cheek that looks like an extra-large mouthful of bubble gum but probably came from a tin of Skoal instead.
Chew also seems to enjoy a manly, outdoorsy image. According to recent new state-by-state statistics, smokeless tobacco use among American adults is highest in Wyoming, where one in six men dips tobacco. The reason? So-called rodeo culture is thought to be the influence.
A few facts about smokeless tobacco use:
– It’s less than half as common as cigarettes and is found mostly among men. It’s estimated that somewhere between 6 and 9 percent of adult American men use chewing tobacco. Women use smokeless tobacco too but in much fewer numbers; the prevalence is believed to be less than 1 percent.
– Its use is surprisingly high among teens. When the CDC released the results of its National Youth Tobacco Survey for 2009, the findings indicated that 11.1 percent of high school-aged boys and 1.5 percent of high school girls were current users of smokeless tobacco. Among middle school students who were surveyed, 4.1 percent of the boys and 1.2 percent of the girls reported using smokeless tobacco at least once in the past 30 days.
– The most recent Minnesota Student Survey suggests the incidence in Minnesota is similar. Among 12th-grade boys, 6 percent said they used smokeless tobacco daily during the preceding month, and 2 to 3 percent reported using it anywhere from three to 29 days during the past month.
– About half of smokeless tobacco users start when they’re in their teens. Products often are marketed with mint, fruit or other candy-like flavors that tend to appeal to young people.
– Teens who use smokeless tobacco appear to be more likely to smoke cigarettes as well.
– Young adult men ages 18 to 25 are another demographic group that’s prone to using smokeless tobacco. Nor is it uncommon to find chew users in workplace settings such as woodworking factories or grain elevators, where smoking is hazardous.
– Even though smokeless tobacco isn’t inhaled, it can be addictive. The nicotine is absorbed through the lining of the mouth and thence into the bloodstream. Researchers have found comparable levels of nicotine in the blood of both smokeless tobacco and cigarette users. Some studies also have found that the nicotine from smokeless tobacco lingers in the bloodstream longer than that from cigarettes.
– Use of smokeless tobacco, especially long-term use, comes with a number of health risks. Cancer of the mouth, throat, lips, tongue and esophagus is one of them. The sugar and other irritants in the tobacco can lead to tooth decay and gum disease. Smokeless tobacco use also has been linked with an increased risk of heart disease and high blood pressure.
The health care community hasn’t always been attuned to smokeless tobacco. Opportunities to identify it can sometimes be missed in health screenings that ask, “Do you smoke?” rather than “Do you use tobacco products of any kind?” Because the behavior, culture and chemistry surrounding the use of smokeless tobacco isn’t exactly the same as for cigarettes, cessation techniques often need to be tailored. For instance, smokeless tobacco can contain high levels of salt, leading to salt cravings among people who are trying to quit. Products such as gum or mint snuff might also need to be employed to wean the user from the ritual of dipping and chewing.
Smokeless tobacco hasn’t always had a high profile among the general public either. If you’ve been watching the news, however, there are some signs this is changing. Some colleges are considering bans on its use – Garden City Community College in Garden City, Kan., for instance, where some students apparently are getting tired of seeing used chew and snuff left in the sinks and drinking fountains. And major-league baseball is currently under pressure to ban smokeless tobacco; chew has already been banned from the minor leagues since 1993.
Chew is “baseball’s bad habit,” declared the Chicago Tribune last week, predicting that if youths no longer have ballplayers to emulate, the number of young people using it will drop.
Photo: Wikimedia Commons