Recognizing oral carcinoma

Author: Amber Crossley, MSN, ARNP, FNP-BC

Oral carcinoma is identified as one of the top ten cancers worldwide, accounting for nearly 2% to 5% of all cancer cases.1, 2 In 2014, there were an estimated 42,440 new cases of oral and pharyngeal carcinoma.

Males have a greater risk of developing the disease compared to females.2 Black males in particular are amongst the highest at-risk group for developing oral carcinoma.2 Oral carcinoma typically develops after the age of 50, with the majority of cases occurring between the ages of 60 and 70.2 When initially diagnosed with oral carcinoma, more than 50% of people will have metastases.3

The most common causes of oral carcinoma are related to tobacco use and alcohol consumption.4 In fact, 75% of all cases of oral carcinoma may be caused by the combination of tobacco and alcohol use.4


However, it has also been extrapolated that chronic trauma to the oral mucosa, such as in the case of ill-fitting dentures or the consumption of high-temperature foods, is a leading modifiable risk factor for oral carcinoma.1,5 Dietary deficiencies of vitamins A, C, E, selenium, and folates may also contribute to the development of malignant cancerous lesions in the oral cavity.6

While cases of oral carcinoma have decreased over the last few years in the United States, oropharyngeal cancer is increasing in incidence.4 The rise in cases of oropharyngeal cancer may be related to viral and infectious diseases; however, the mechanisms are largely unclear. Some of these infections and viruses include human papilloma virus (HPV), periodontitis, candida albicans, syphilis and herpes simplex virus.7 However, for the purposes of this case presentation, only oral cavity cancer will be discussed.

A Non-Healing Oral Lesion
MC is an 82-year-old white female who visited her primary care provider’s office complaining of a mouth sore. The sore was present for approximately six months, and grew increasingly painful.

She has worn dentures for more than 10 years, and was accustomed to the typical soreness with irritation sometimes associated with everyday denture use. With this particular occurrence, the soreness lingered in the same area and lasted longer than any previous experience.

MC attempted to alleviate the soreness with an existing prescription for hydrocodone. This treatment proved unsuccessful. MC scheduled an appointment with her primary care provider, as she assumed the pain was the result of ill-fitting dentures.

At MC’s initial appointment, the provider noticed a 7mm erythematous lesion on the lower interior aspect of her right molar, and suggested it could be the result of her ill-fitting dentures. Because MC had exhausted her hydrocodone, the provider prescribed tramadol and a viscous lidocaine suspension for pain. She was told to follow-up with her dentist once the sore completely healed in order to be fitted with new dentures. She was instructed to refrain from denture use until the sore had resolved. There were no further follow-up instructions given.

One week after the initial visit, MC returned to the primary care provider’s office because of increasing pain and discomfort. During this visit, the provider noted the sore had ulcerated edges that were friable and showed little improvement. She was referred immediately to an otolaryngologist for the suspicion of carcinoma of the oral cavity.

Patient History
MC is an 82-year-old widow. She is a Medicare recipient living in government-subsidized housing for the elderly. MC smoked tobacco between the ages of 17 and 52 at a rate of 1.5 packs per day, or 53 pack years. During the same 35 year time frame, she drank 1 to 2 alcoholic beverages daily.

Over the past 10 years, she lost a total of 40 pounds without any lifestyle modifications to justify the weight loss. At the time of MC’s initial primary care visit, she weighed 91 pounds. Additional patient history included hypothyroidism, mitral stenosis, gastroesophageal reflux disease, coronary artery disease, arthritis and hypertension.

Clinical Features
Oral carcinoma is defined as cancer involving the floor of the mouth, hard palate, buccal mucosa, interior tongue, retromolar trigone, or alveolar ridge.8 Premalignant oral carcinoma may present as a painless white patch known as leukoplakia, or a painful reddened patch identified as erythroplakia.9 In addition to the aforementioned signs, the cervical lymph nodes may be enlarged.10 Any erythroplakia or leukoplakia lesions that appear to be non-healing in an older individual should be deemed suspicious.10

Differential Diagnosis

Refer to the table below to help you rule out other conditions.


Early identification of oral carcinoma offers patients the greatest chance for successful treatment and survival following diagnosis.5

An initial patient history that includes tobacco use, alcohol consumption, sexual practices, denture use, oral trauma, infections of the oral cavity and a history of present illness should be obtained.8 It is important to understand that patients complaining of ill-fitting dentures are four times more likely to develop an oral lesion that is cancerous.5

Oral lesions caused by trauma increase the likelihood of carcinogen absorption from tobacco and alcohol in the oral mucosa. This absorption may disrupt the deoxyribonucleic acid of the mucosal cells.1

Following a thorough history, the provider can perform a complete head and neck examination. During oral cavity inspection, a mirror and fiberoptic exam should also be performed.8 A combination of inspection and palpation for lumps or abnormalities within the tissue of the oral mucosa is the definitive mechanism used to screen for oral cancer as identified by the U.S. Preventive Services Task Force.4 In the presence of a potentially cancerous oral lesion, a surgical biopsy should be completed to confirm a diagnosis of oral carcinoma.9

Imaging studies can be used to detect and identify metastases of oral carcinoma. Computed tomography is the preferred imaging study performed at the site of the primary tumor.11 This study can identify the extent of the tumor, as well as lymph node involvement.10,12 Additionally, a chest x-ray is recommended in order to determine whether or not the oral carcinoma originated in the lungs or metastasized to the lungs. The lungs are the primary site for metastases of oral carcinoma.12 More than 90% of oral cavity cancers are considered to be squamous cell carcinoma.11

Laboratory studies should also be considered in addition to imaging studies. Serum ferritin, alpha anti-trypsin, and alpha-antiglycoprotein levels can be elevated in patients with advanced cancer of the head or neck region.12 Laboratory studies alone cannot determine the presence of oral carcinoma. However, they can aide in identifying the extent and progression of the cancer.12

Case Outcome
A surgical biopsy was performed in order to identify the causative organism. MC was diagnosed with stage IV malignant squamous cell carcinoma of the right retromolar trigone, as well as squamous cell carcinoma of the right middle and lower lobe of the lung. The patient had no lymph node involvement.

Because of her increased age and nutritional status, MC did not qualify for multimodal treatment. Instead, she is being treated with aggressive radiation therapy over a period of 12 weeks.

Understanding key factors related to MC’s case — increased age, history of tobacco and alcohol use, and ill-fitting dentures — is paramount when identifying the painful, non-healing, 7 mm lesion in her oral cavity as a potential diagnosis of oral carcinoma.

Implications for Practice
Due to the increase in oral health disparities, the Institute of Medicine released a report revealing a new demand for non-dental health care providers to perform screenings for oral diseases as well as offering prevention advice and referral to preventative services.13

Increasing interprofessional collaboration amongst dentists, nurse practitioners, physician assistants, physicians and medical students has shown to be effective in implementing the head, ears, eyes, nose, oral cavity, and throat (HEENOT) assessment into practice.14 While this is similar to the head, ears, eyes, nose and throat assessment, it allows for the integration of the oral cavity into the evaluation of the head and neck exam.

One study, conducted between 2008 and 2014 at New York University, revealed that the result of HEENOT implementation led to 500 patient referrals to dental clinics for suspicious oral lesions.14 Preventative measures at the primary care level should focus on the greatest risk factors (tobacco use, alcohol consumption and ill-fitting dentures).

Research has shown that due to the sometimes vague and misleading symptoms of early-onset oral carcinoma, a diagnosis may be prolonged by up to 6 months.12 Although screening for oral cancer in healthy individuals without risk factors may not be beneficial, evidence supports oral screenings by primary care providers for high-risk patients.3, 4, 15

Given the fact that only 30% of patients ages 65 years and older have dental insurance coverage, the primary care provider must screen patients who present with many risk factors for oral carcinoma.14,16 Because there are a greater number of primary care providers in comparison to dentists, they have the potential to increase awareness and detection of oral carcinoma.16

While the leading cause for oral carcinoma is tobacco use, it is recommended that the primary care provider encourage patients who use tobacco to employ smoking cessation products.4 Second, the primary care provider should educate patients on the harmful effects of daily alcohol use.12 Third, providers should stress to patients the importance of regular dental check-ups and denture fittings as an essential tool for maintaining good oral health.5

Amber Crossley practices as an advanced registered nurse practitioner in Jacksonville, Florida.

1. Piemonte ED, et al. Relationship between chronic trauma or the oral mucosa, oral potentially malignant disorders and oral cancer. J Oral Pathol Med. 2010;39(7):513-517.

2. National Cancer Institute. Stat fact sheets: oral cavity and pharynx cancer.

3. Rethman MP, et al. Evidence-based clinical recommendations regarding screening for oral squamous cell carcinoma. JADA. 2010;141(5):509-520.

4. U.S. Preventative Services Task Force. Oral cancer: screening.

5. Manoharan S, et al. Ill-fitting dentures and oral cancer: a meta-analysis. Oral Oncol. 2014;50(11):1058-1061.

6. Freedman ND, et al. Fruit and vegetable intake and head and neck cancer risk in a large United States prospective cohort study. Int J Cancer. 2008;122(1):2330-2336.

7. Meurman JH. Infectious and dietary risk factors of oral cancer. Oral Oncol. 2010;46(6):411-413.

8. National Comprehensive Cancer Network. Head and neck cancers.

9. Jefferson GD. Adult with oral cavity lesion. AAO-HNSF Patient Month Program. 2011;40(5): 1-25.

10. Arya S, et al. Head and neck symposium: imaging in oral cancers. Indian J Radiol Imaging. 2012.22(3):195-208.

11. Akram S, et al. Emerging patterns in clinico-pathological spectrum of oral cancers. Pak J Med Sci. 2013;29(3):783-787.

12. Scully C. Cancers of the oral mucosa. Medscape. 2016.

13. Institute of Medicine. Improving access to oral health care for vulnerable and underserved populations.

14. Haber JH, et al. Putting the mouth back in the head: HEENT to HEENOT. Am J Public Health. 2015;105(3):437-441.

15. American Family Physician. Screening for the early detection and prevention of oral cancer.

16. Cohon LA. Expanding the physician’s role in addressing the oral health of adults. Am J Public Health. 2013;103(3);408-412.

October, 2016|Oral Cancer News|

Rodeo Competitors Fight Smokeless Tobacco Use at Laramie Jubilee Days

Author: Nick Learned

Cody Kiser and Carly Twisselman

Two professional rodeo contestants will ride exclusively for the Oral Cancer Foundation this weekend as part of Laramie Jubilee Days with a goal of preventing young fans from using smokeless tobacco.

Cody Kiser and Carly Twisselman each aim to show rodeo fans, particularly the younger ones, chewing or using other forms of smokeless tobacco isn’t what makes them who they are. They promote the Foundation’s campaign which uses the slogan “Be Smart. Don’t Start.”

Their approach is anything but confrontational or aggressive. Rather than encouraging people to quit, they hope to encourage young fans to never pick up the habit in the first place. And where some rely on statistics to make the point, Kiser and Twisselman take a different approach. Simply giving attention to young rodeo fans is a big part of getting their message across.

“Its not the facts that they’re going to take home,” Kiser says. “Everybody knows that tobacco’s bad; you can get cancer and you can die. But the biggest impact that I see is just acknowledging those kids or acknowledging those people in the audience that want to know more, and you can show them what you can do without tobacco.”

“I’m not out there to tell anybody how to live their life or preach to them about needing to quit,” Kiser says.

“It’s not our place to do that,” Twisselman says. “People most of the time aren’t going to listen when you tell them something like that anyway.”

The pair will be wearing Oral Cancer Foundation gear and handing out buttons, wristbands and bandanas bearing campaign messaging.

As they travel the rodeo circuit, Kiser and Twisselman each say they often see other riders use various types of smokeless tobacco such as chew and snuff.

“It’s very common,” says Kiser. “You see it everywhere.”

“One of my traveling partners, he started when he was in high school. He was just around it all the time,” says Kiser. “It was just the ‘cowboy’ thing to do, I guess.”

“A lot of people are very respectful about it,” Twisselman says. “They’ll see me in my shirt and be like ‘oh yeah, you represent the Oral Cancer Foundation’ and they’ll spit their chew out. I think that in itself is a positive side effect of it.”

“I think a large part of a lot of these cowboys is, it’s the cowboy thing to do, so they start doing it,” Kiser says. “And that’s where I want to step in and show the younger generation that you don’t have to chew to be a cowboy. You can be a cowboy athlete and not chew and treat your body as best you can, because what we do is very difficult and it’s hard on the body.”

“A lot of folks started when they young,” Kiser says. “And I’ve talked to guys who started chewing later in life and they can’t quit, or it’s hard for them. It’s a vicious thing.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Rodeo outreach program fights oral cancer

Author: Stewart M. Green


Carly Twisselman, a spokesperson with the Oral Cancer Foundation’s rodeo outreach program, and her horse Chanel travel the Western rodeo circuit and talk with kids about the dangers of using spit tobacco. Photo by Stewart M. Green

Carly Twisselman brushed her horse Chanel outside a stall at the Norris-Penrose Event Center, home of the Pikes Peak or Bust Rodeo, which will roll into town July 13-16. “I’ve been rodeoing my whole life,” she said. “Now I do it at the professional level. This is my rookie year so I’m going really hard. I want to win the rookie title.”

Summer is the busiest time of the year for cowgirls and cowboys. “We call it Cowboy Christmas, the 4th of July run,” she said. Twisselman and her travel partner have recently competed in Utah, Nevada, Arizona, New Mexico, and just drove up from Pecos, Texas, to Colorado Springs for qualifiers. “It’s a crazy time,” she said. “Lots of traveling, but lots of money to be won.”

Twisselman, a 30-year-old barrel racer, grew up on a ranch near San Luis Obispo on the central California coast. “My family’s been ranching there for seven generations,” she said. “I was on the back of a horse all the time. I was riding before I could walk.”

While growing up in the Western ranching and rodeo culture, Twisselman was aware of the widespread use of spit tobacco by cowboys. “I’ve been around it my whole life and seen a lot of things that were negative and I was affected by it.”

Rodeo and tobacco have a long history together. Starting in 1986, the U.S. Smokeless Tobacco Company sponsored the Professional Rodeo Cowboys Association until the association ended its partnership with tobacco advertisers in 2009. Tobacco use, however, still thrives with cowboys and spectators at rodeos.

In 2014, the Oral Cancer Foundation, a nonprofit organization that supports prevention, education and research of oral cancer, reached out to pro rodeo athletes to spread the word about the dangers of tobacco use, with Cody Kiser, a bareback bronc rider, as their first rodeo spokesperson. This past year they added Carly Twisselman to continue creating awareness in the rodeo community.

“Honestly, it was God that they came to me,” said Twisselman. “Their goal was to reach rodeo people, people in the Western culture and people that were horse lovers because tobacco is a huge problem in rodeo.” The foundation asked Twisselman to be a spokesperson and she gladly accepted. “It’s an amazing thing to represent such a great organization. I can take this rodeo platform where I’m in front of thousands of people and use it for good.” While the Oral Cancer Foundation wants to help adults with tobacco problems, its rodeo focus is on children. According to The Centers for Disease Control and Prevention, 9.9 percent of high school-age boys use spit tobacco nationwide, while 10.5 percent of men ages 18-25 use it. Usage is higher in rural states like Wyoming, Montana and West Virginia. A can of spit tobacco packs as much nicotine as 40 cigarettes, and a 30-minute chew is like smoking three cigarettes, making addiction to spit tobacco one of the hardest to break. Spit tobacco, including smokeless tobacco, dip, snuff, chew and chewing tobacco, can cause gum disease, tooth decay and oral cancer. Almost 50,000 people will be diagnosed with oral cancer in 2016.

“We aren’t telling people they should stop,” Twisselman said, “but we show people why it’s not good to use tobacco. If someone is chewing, I’m not going to go lecture them.”

Twisselman and Kiser focus on helping kids make positive choices about tobacco use. “Kids look up to us as idols and if they see us doing good and not chewing tobacco then maybe they won’t either,” Twisselman said. “Our message is: ‘Be Smart, Don’t Start.’”

Twisselman also attends junior rodeos where she hands out wristbands, bandanas, pins, and buttons. “Kids love the freebies,” she said. She also wears Oral Cancer Foundation logos on her competition shirts.

Surprisingly, some rodeo women chew tobacco. “It’s not the problem it is with the men,” Twisselman said, “but I do see it. I find it really repulsive. Sometimes women who chew will see me and say, “Oh, you work with oral cancer” and they’ll take their chew out and throw it away because they don’t want to be disrespectful to me.”

Twisselman said she and Kiser are making a difference, noting people are becoming more educated about the dangers of throat cancer from chewing tobacco and learning that it’s not a healthy habit. “We’ve only been doing this for a year now and we’re still getting our feet wet,” she said. “It’s hard to know if fewer kids are chewing now but I’m getting the word out and interacting with them. Because we take the time to talk with kids and give them the little gifts, it has a huge impact on them.”

To learn more about oral cancer and its prevention, medical research, education and for patient support, then visit

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Rodeo rider partners with nonprofit group to fight smokeless tobacco use

Author: Rebecca Cade

SALT LAKE CITY — Oral cancer is becoming an epidemic in the U.S., and has been in the news in the last year with the loss of major league baseball hall-of-famer, Tony Gwynn, who died at 54 from smokeless tobacco use.

Rodeo has a historic tie to smokeless tobaccos, and Oral Cancer Foundation, has teamed up with Bareback Rider Cody Kiser to draw awareness to, and prevent, this growing epidemic where it thrives – the rodeo circuit.

Smokeless/spit tobacco is one of the historic causes of deadly oral cancers, and is more addictive than other forms of tobacco use.

The nonprofit is seeking to spread awareness of oral cancer and the dangers of starting terrible tobacco habits. While others are focused on getting users to quit, The Oral Cancer Foundation is reaching out to young people to not pick up the habit that they may see one of their rodeo “heroes” engage in.

Their message is simple, “Be Smart. Don’t Start.”

With the strong addictive powers of smokeless tobacco, the foundation and Kiser aim to engage fans early.

At the rodeos, Kiser will be solely wearing OCF logos and wording, while handing out buttons, wristbands and bandanas with the campaign messaging on them. The bareback rider hopes this will make him an alternative positive role-model for the adolescent age group whose minds are so easily molded.

“It’s something I’ve always been passionate about, so when I got into the partnership with OCF, it was no big deal to be able to say ‘I don’t smoke or chew, never have, and it’s easy not to,'” Kiser said.

Kiser added it all starts with kids.

“Most of these guys I ride with started smoking and chewing in sixth or seventh grade,” he said. “So, if we can get to those kids now, and tell them ‘you don’t have to do this to be cool or be a cowboy’ and show them what you can do without it.”

More information on the campaign can be found at

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Rodeo rider raising awareness of chewing tobacco and oral cancer

Author: Danielle Radin



REDDING, Calif. – The Redding Rodeo kicked off Wednesday night with events like barrel racing, cattle roping and mutton busting.

Professional barrel racer, Carly Twisselman said chewing tobacco is prominent at rodeos. She’s teamed up with the Oral Cancer Foundation to try to change that.

“We want to show children that you can follow your dreams, be who you want to be, pursue being a rodeo athlete and not chew tobacco,” said Twisselman.

Twisselman competes in rodeos across the country and sees chewing tobacco time and time again.

She’s teaching children chewing tobacco is not the ‘cool thing to do.’ She also wears letting on her sleeves every race that reads, “Be smart, don’t start.”

She also has a brother who chews and had a health scare from it.

“My brother’s had signs of cancer of the mouth from chewing,” said Twisselman. ”  “I just think that’s the wrong message we should be sending to this children.”

According to the oral cancer foundation, there will be about 48,000 new cases of oral cancer in 2016 in the United States. 75 percent of all oral cancer patients use tobacco.

They estimate nearly 10,000 people in the United States will die from oral cancer in 2016.


Troisi: Raising age on tobacco purchases would protect Texas children

Author: Catherine Troisi

Tobacco products are a known cancer-causing agent and responsible for one in three cancer deaths. Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders and suicides combined — and thousands more die from smoking-related causes such as fires caused by smoldering cigarettes. E-cigarettes, often touted as a safer alternative, have not been well-studied and may contain unknown poisons.

We are not protecting our children from this danger. Unlike alcohol sales, where you have to be 21 years to purchase legally, adolescents and young adults 18 and over can purchase tobacco products. While the Texas Legislature wisely raised the age to buy e-cigarettes from 14 to 18 years last year, it’s time to look at raising the legal age for all tobacco products to 21.

The problem is not just those age 18 and older smoking. This young legal age to purchase makes it easier for children under age 18 to get access to cigarettes and other products. Each year, 19,000 Texas children under the age of 18 start smoking. In Texas, almost one out of every six high school students smokes — and over their lifetime, half a million Texans who started smoking under age 18 will ultimately die of tobacco-related diseases.

Most of us have someone in our family or know someone who has been affected by a tobacco-related disease. A colleague lost both parents and his only sibling as a result of smoking that began when they were teens. Each relative suffered for over a decade before finally succumbing to the effects of tobacco. His brother was 46 when he was diagnosed with oral cancer. Cancer took his jaw, tongue, teeth and ability to speak clearly and swallow. He suffered for 13 years before it took his life.

There’s also an economic impact. Smoking by children under age 18 costs the state almost $9 billion dollars in direct costs and each Texan household’s federal tax is increased by $756 per year, according to reports from the Campaign for Tobacco-Free Kids. Imagine what we could do with that money both as a state and as individuals rather than use it for tobacco-related medical costs.

The tobacco industry knows that nine out of 10 smokers start before age 18 — and each day 3,200 children smoke their first cigarette. An estimated $636 million is spent on marketing to sell their harmful products just in Texas. Children are twice as sensitive to tobacco advertising as adults and more likely to be influenced to start smoking by these marketing tactics than they are by peer pressure. Tobacco companies have to get children smoking by age 18 — otherwise the odds that they will start are small.

Would raising the legal age to purchase actually stop children from getting these products? The tobacco company Phillip Morris thought so in a 1986 report: “Raising the legal minimum age for cigarette purchaser to 21 could gut our key young adult market (17-20)” The Institute of Medicine agreed in a 2015 report predicting that were the minimum age for the sale of tobacco products 21, over time, the adult smoking rate would decline by about 12 percent and smoking-related deaths would decline by ten percent. The report also states, “Although changes in the minimum age … will pertain to individuals who are 18 and older, the largest proportionate reduction …. will likely occur among adolescents of ages 15 to 17 years.” Research shows that kids often turn to older friends as sources of cigarettes. Raising the sale age to 21 would reduce the likelihood that a high school student will be able to legally purchase tobacco products for other students and underage friends.

The legal age for the purchase of tobacco products is set by states and in some cases counties. Hawaii became the first state to raise the tobacco sale age to 21 and just last week California joined them. At least 135 localities in nine states have also raised the tobacco age to 21.

The U.S. Federal Drug Administration recently announced a “deeming rule,” which extends its authority to cover all tobacco products. However, the rule does not restrict online e-cigarette sales and marketing, including flavors such as “cotton candy” and “gummy bears” designed to entice youth.

As Texans, we want to protect our children and make sure they grow up healthy and safe. Raising the legal age to buy tobacco products to 21 years is a proven strategy to do this. Let’s make it a priority to protect our families and communities — while saving money — by starting this discussion.

Note: Catherine Troisi is an epidemiologist at the UT Health School of Public Health in Houston.

California Raises Smoking Age To 21

Author: Huffington Post Staff

The law makes it the second state to raise the minimum age to 21, following Hawaii.


SAN FRANCISCO, CA - MAY 31:  Isaiah Atkinson smokes a cigarette in front of the San Francisco Centre on May 31, 2011 in San Francisco, California.  Since 1987, the World Health Organization has celebrated "World No Tobacco Day" to raise awareness to the health risks associated with smoking tobacco. Smoking is the second biggest cause of death globally and is responsible for the death of one in ten adults worldwide.  (Photo by Justin Sullivan/Getty Images)

SACRAMENTO, Calif. (Reuters) – California will raise the legal age for purchasing tobacco products to 21 from 18 under a bill signed on Wednesday by Democratic Governor Jerry Brown, part of a package of anti-smoking measures that also regulates electronic cigarettes.

Under five bills signed into law on Wednesday, California will ban the sale of vaping products or tobacco to anyone under the age of 21, imposing a fine of up to $5,000 against companies that violate the law.

“It is long past due for California to update our approach to tobacco,” said Steven Larson, president of the California Medical Association. “There has been an alarming rise in the use of e-cigarettes by teens, putting them at risk for lifelong addiction.”

Under the measures, electronic cigarettes will be regulated like traditional ones. That means that wherever cigarettes are banned, such as in restaurants, workplaces and public areas, use of e-cigarettes will also be prohibited.

The state will also expand its funding for anti-smoking programs under the bills.

Brown stopped short of allowing local counties to impose their own tobacco taxes, noting in his veto message that several proposed new taxes would be placed before voters on the November ballot.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

May, 2016|Oral Cancer News|

FDA Spends $36 Million on Anti-Chewing Tobacco Ad Campaign

Author: Elizabeth Harrington
Cans of smokeless tobacco sit in the Tampa Bay Rays dugout before a baseball game between the Rays and the Baltimore Orioles, Wednesday, April 14, 2010, in Baltimore. After hounding Major League Baseball and its players union over steroids, Congress now wants the sport to ban smokeless tobacco. (AP Photo/Rob Carr)

Cans of smokeless tobacco sit in the Tampa Bay Rays dugout before a baseball game between the Rays and the Baltimore Orioles, Wednesday, April 14, 2010, in Baltimore. After hounding Major League Baseball and its players union over steroids, Congress now wants the sport to ban smokeless tobacco. (AP Photo/Rob Carr)

The Food and Drug Administration is spending $36 million on an anti-chewing tobacco advertising campaign targeted at white male teenagers in the midwest.

The federal agency announced Tuesday it is expanding its “Real Cost” anti-tobacco campaign to “educate rural, white male teenagers” and convince them to stop dipping.

“Smokeless tobacco use is culturally ingrained in many rural communities,” the FDA said. “For many, it has become a rite of passage, with these teenagers seeing smokeless tobacco used by role models, such as fathers, grandfathers, older brothers, and community leaders.”

The campaign will run television, radio, and print advertisements, as well as put up public signs and billboards and post on social media.

An FDA spokesperson told the Washington Free Beacon that the total cost for the campaign is $36 million, which will be financed through taxes on tobacco manufacturers. Paid ads will cost $20 million, and the remaining budget will cover “research, strategic planning, creative development, and contract management.”

The agency is also partnering with two dozen minor league baseball teams in the midwest that will host anti-chewing tobacco events and feature advertisements from the campaign.

“Amplification of messaging from the campaign will take place at 25 Minor League Baseball stadiums throughout this summer using a variety of efforts, including sponsoring in-stadium events, the placement of print ads, running of television ad spots, and opportunities for fans to engage with players who support the FDA’s efforts on smokeless tobacco,” said Tara Goodin, an FDA spokesperson.

The list of minor league clubs participating in the campaign includes the Albuquerque Isotopes, the Fargo-Moorhead Redhawks, the Traverse City Beach Bums in Michigan, the Sioux Falls Canaries, and the Burlington Bees, an Iowa farm team for the Los Angeles Angels.

Chewing tobacco has been banned at ballparks in Los Angeles, San Francisco, and Boston, including Fenway Park, and major leaguers can face $250 fines and “are subject to discipline” from Major League Baseball’s Commissioner Rob Manfred if they dip during games.

ESPN reported that signs are now posted in Fenway with a phone number so individuals can call to report on other fans they see chewing tobacco to “alert security.”

The FDA provided an example of one of its new campaign ads, which features a man at a bowling alley with a can of chewing tobacco in his back pocket.


“This can can cause mouth cancer, tooth loss, brown teeth, jaw pain, white patches, gum disease,” text on the ad reads.

The campaign is targeted at white males aged 12 to 17 who are using smokeless tobacco, which the FDA estimates to be 629,000 nationwide, or 0.19 percent of the U.S. population of 318.9 million.

“Not only is the target audience using smokeless tobacco at a high rate, but many do not fully understand the negative health consequences of their actions,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “In communities where smokeless tobacco use is part of the culture, reaching at-risk teens with compelling messaging is critical to help change their understanding of the risks and harms associated with smokeless tobacco use.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

April, 2016|Oral Cancer News|

Cowboy raises awareness for oral cancer

Author: Annie Sabo
KRISTV cody interview

In an environment where smokeless and spit tobacco is prevalent, cowboy, Cody Kiser, says he feels like the luckiest guy in the world to represent the Oral Cancer Foundation.

He told us, “I just happened to be in a class with a classmate. Their sister works for the oral cancer foundation…one thing led to another and they said  we’ve been looking for a cowboy that doesn’t smoke or chew and we’d love to be able to work out some kind of deal where we help you out you help us out…now I’m here.”
Although Cody has not been personally affected by the cancer, he wears a special patch on his shirt to raise awareness for the deadly disease.

He said, “I’m very lucky that I haven’t had any family members or friends be affected by oral cancer. I’ve made friends with people that have been now and it’s a real eye opener.”

Since partnering with the oral cancer foundation, he works hard to promote this message: “Be smart don’t start…we want to get out to the kids and fans who haven’t smoking or chewing yet.”

Cody says the best part about working for the oral cancer foundation is serving as a role model for children. He told us, “You can be an elite athlete and an amazing cowboy without having to smoke or chew. That’s our goal is to get to those kids before they do that. I just want to be a good role model for these kids.”

Rodeo after Rodeo, Kiser hopes to make a difference.

10334178_GKiser wears this patch every time he competes.


View Cody Kiser’s full inter view here:

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.