• 7/6/2004
  • Bostaon, MA
  • By Stan Grossfeld, Globe Staff
  • Boston Globe

For Red Sox pitcher Curt Schilling it is harder than firing a split-fingered fastball past Alex Rodriguez. Harder than beating the Yankees. “It’s obviously the hardest thing I’ve ever tried to do. Quit,” said Schilling about his greatest opponent, smokeless tobacco. “And I still haven’t done it yet.”

It is an uncomfortable subject. Schilling has battled the demons of smokeless or spit tobacco since he was 15, when a high school classmate dared him to try it. He liked it and was hooked.

Smokeless tobacco contains 28 cancer-causing agents, according to the National Cancer Institute. It has been linked to oral cancer, tooth and gum decay, and possibly heart disease, according to the American Cancer Society. The Surgeon General has testified before Congress that “smokeless tobacco does cause cancer.” It also contains highly addictive nicotine.

In March 1998, Joe Garagiola, the former major league catcher and current chairman of Oral Health America’s National Spit Tobacco Education Program (NSTEP), brought an oral health team to the spring training site of the Phillies, for whom Schilling was plying his trade at the time. “Schilling was in a line to get checked,” said Garagiola. “I could see that he was getting very edgy because he was thinking about the exam. I practically held him by the hand making sure he wouldn’t leave. We were talking umpires and Yogi [Berra] stories, anything I could to keep him there. He comes out and he’s as white as a sheet. He said the second they looked in his mouth the dentist said, `If you were my son, I’d have this biopsied yesterday.’ ”

The results showed that Schilling had a lesion on his lower lip, a sign of abnormal cell changes, and a precursor to oral cancer. Days later, a somber Schilling appeared at a press conference in Clearwater, Fla. “It’s bad,” he began. “Basically in no uncertain terms they told me that if I were to continue I would have cancer. They were 100 percent sure of it. You wonder how the tobacco companies — the people that do this — can go to sleep at night. It’s a drug, there’s no doubt about it. It’s addictive.”

Stops and starts

There are two types of spit tobacco sold in the United States. There’s chewing tobacco, the leafy kind that comes in pouches; a “chaw” of tobacco gives you the puffed-out-cheek look of Lenny Dykstra. Then there’s moist snuff, sold in round cans, which comes cured, finely ground, and sometimes flavored. A pinch placed between the cheek and gum is called dipping. One pinch packs as much nicotine as nearly four cigarettes.

Schilling, who has used the moist snuff, went through two cans of Copenhagen a day for years. His father, a smoker, got cancer before he died in 1998 of a brain aneurysm. His wife is a skin cancer survivor. He told Garagiola he was worried for his kid. “Schilling had the courage to talk about it publicly,” said Garagiola. In 1998, Schilling told Time magazine, “It got to where my gums were bleeding and my lower lip was like raw meat. I would stop for a day or two and then dip again.”

He has tried to stop at least a dozen times. Once he tried to stop cold turkey for two weeks and became violently ill. He stopped for a year and a half.

“I saw him at the All-Star Game at Fenway Park in 1999,” said Garagiola. “He walks up to me and says to one of his kids, `Gehrig, here’s the man that saved Daddy’s life.’ I said, `No, you saved your Daddy’s life because he loves you so much.’ ”

Garagiola says he can recognize two things a mile away: A bad toupee and whether someone is dipping. When Garagiola ran into Schilling again in 2000 things were different. “He said, `I was playing golf and one of the guys said, `Aw, come on, one dip isn’t going to hurt you and I was off and running.’ I said `OK, usually you fall off the horse seven times. This is your first time. Now get back on that horse.’ ”

When John Greene, the dentist who conducted the initial oral exam, returned to the Phillies spring training camp in 2000 for a checkup, Schilling was absent. “I called him at home and he said, `Doc, I’m embarrassed.’ I told him if you can stop for a year, you can stop. I don’t want to be critical of him. I give him a lot of credit, he keeps trying. Just criticize the product and the addiction,” said Greene, dean emeritus at the University of California-San Francisco’s school of dentistry. Greene said he watched on television as co-MVP Schilling was celebrating the 2001 World Series victory against the Yankees and saw that Schilling was still dipping. Asked if Schilling will get oral cancer, Greene said, “I think he will if he continues.”

Schilling, a five-time All-Star, is known for his community service. He and his wife, Shonda, a melanoma survivor, have launched SHADE, The Curt and Shonda Schilling Melanoma Foundation of America, and have also raised more than $4 million to battle amyotrophic lateral sclerosis (Lou Gehrig’s disease). But in a recent clubhouse interview when the subject of his own struggle against spit tobacco is broached, Schilling politely says he would rather not talk. Ironically, it was “World No Tobacco Day.” “I’m not really interested in talking about it because I’m still battling it,” said Schilling. “It’s not something I want to talk about. There’s nothing to talk about. I haven’t quit.”

Nearly half of the current Red Sox use spit tobacco, higher than the 36 percent average in Major League Baseball, according to a 2003 study by the Oregon Research Institute.

Recipe for cancer

The American Cancer Society estimates that 27,260 new cases of oral cancer will be detected this year, resulting in 7,230 deaths. Among the ingredients in spit tobacco are cancer-causing substances such as nitrosamines and benzopyrene as well as toxic materials such as cadmium (found in car batteries), polonium 210 (in nuclear waste), uranium 235 (in nuclear weapons), and formaldehyde, (in embalming fluid), according to Dr. Peggy Walsh, a professor at the University of San Francisco and a NSTEP consultant. “Pair highly addictive nicotine with cancer-causing chemicals . . . that’s a recipe for disaster,” said Walsh.

Mike Bazinet, spokesman for U.S. Smokeless Tobacco Company, would not discuss the components of the company’s tobaccos. “We don’t make any health claims,” he said. “We don’t debate health issues in the media.” U.S. Smokeless expects record sales in 2004. It is the only part of the US tobacco industry still growing. Last month, legislation was introduced that would give the Food and Drug Administration new powers to regulate smokeless tobacco.

U.S. Smokeless is trying to convince the FDA that its products are a safer alternative for the nearly 50 million adults who smoke in the US. They claim “tobacco harm reduction” is an alternative to the prevalent “quit or die” philosophy. One study from the University of Alabama claims the mortality rate of smokeless tobacco is only 2 percent that of cigarettes. Dr. Greg Connolly, a scientific advisor for the Massachusetts Tobacco Control Program, says that research is funded by U.S. Smokeless and, “in my opinion, is biased by unrestricted grants.”

“I hate statistics,” said Garagiola. “Maybe because I never wanted to see my batting average flashed on the scoreboard. Hell no, it’s not a safer alternative. What they’re telling you is don’t jump out of the 50th floor, jump out of the 30th floor. You’re going to get killed either way.”

Connolly acknowledges that spit tobacco is not as great a health risk as cigarettes, which have hundreds of carcinogens in them. But spit tobacco can still be lethal. “It’s like shooting yourself in the foot instead of the head,” he said.

Last year, U.S. Smokeless spent $72.5 million on advertising. Connolly says the company is targeting young adults with starter flavored tobaccos where the user “graduates” to more addictive nicotine products. “It’s a gateway to cigarette smoking. If you use spit tobacco you are three times more likely to smoke,” said Connolly.

A baseball tradition Connolly fears a return to the 1980s when Hall of Famers Carlton Fisk and George Brett were endorsing Skoal Bandits and one in five high school athletes in Massachusetts was using spit tobacco. The Centers for Disease Control recommends Nicorette gum, the nicotine patch, and cessation counseling instead of smokeless tobacco.

In the Red Sox clubhouse, Schilling says he has used the nicotine patch, herbal blends of snuff, and underwent counseling. “I’ve tried everything,” he said. Does being around ballplayers during the season make it harder to quit? Schilling shakes his head. “No, that would be making an excuse,” he said. Asked why he uses, Schilling shrugs. “I don’t know why, I really don’t. I’ve quit for over a year and started back again so I can’t put my finger on any one thing. I don’t chew when I play or when I pitch.”

Schilling has said that dipping dehydrates him so he doesn’t do it while he’s pitching or working out. He dips more in the offseason when he has time on his hands.

According to Garagiola, Schilling met Bill Tuttle, a former major leaguer who lost part of his jaw and cheek after getting oral cancer. Tuttle toured some MLB clubhouses before his death in 1998 and Oral Health America published a before-and-after poster of the former outfielder. In the first picture he’s in his Minnesota Twins uniform with a big chunk of tobacco bulging in his cheek. That picture is titled, “Glory Days.” Next to it is a picture of a disfigured Tuttle dying, his face swollen, his eyes shut. That photo is entitled, “Gory Days.”

The image of Tuttle, who was 69 when he died, pains Schilling. “Oh, sure it does, sure it does. It’s a weakness, you gotta be set and make a commitment to quit.”