• 7/9/2006
  • Pittsburgh, PA
  • Lee Bowman
  • ScrippsNews (www.scrippsnews.com)

The Pittsburgh Pirates’ dugout at PNC Park, site of Tuesday’s All-Star game, is less likely to be tobacco-stained than was their lair in old Three Rivers Stadium when the Midsummer Classic was last played there 12 years ago.

A newly published study_ based on 10 years of surveys and looking into the mouths of professional baseball players at Pirates spring training camps _ finds that smokeless-tobacco use among members of the club’s major and minor league teams declined by more than a third between 1990 and 2000.

Dipping and chewing goes way back with baseball. Many think the urge to chew and spit is a way to expend nervous energy between the next at-bat or the next play in the field, whether the chew is sunflower seeds, bubble gum or wads of tobacco.

“A lot of players say they only use tobacco during the season or cut way down in the off-season. It’s very much part of the cultural aspect of baseball,” said Dr. Keith Sinusas, lead author of the study published in the July issue of Medicine and Science in Sports and Exercise.

The difference, says Sinusas, is that tobacco users are much more likely to have one or more lesions or patches in or around the mouth that can progress to oral cancer.

Since 1986, the U.S. Surgeon General has warned of a clear association between smokeless tobacco use and oral cancers.

Sinusas and former Pirates team physician Dr. Joseph Coroso started surveying players and managers at spring training in Bradenton, Fla., in 1991.

“It was all voluntary, but we got about 90 percent compliance with taking the survey and letting us do oral exams every year. They all have to take a physical anyway, so they’re sitting around and we gave them the forms. It gave them something to do,” said Sinusas, who practices at the Middlesex Hospital Family Medicine Residency in Middletown, Conn.

Typically, about 200 to 250 men from the Pirates farm system teams and the major league club show up at spring camps. The doctors got 190 to 259, including some coaches, to participate each year.

In their first survey, they found that 41 percent of players at all levels were using snuff or chew. They found the lesions, called oral leukoplakia, in 22.6 percent of all players in 1991 and in 9.3 percent of players examined in 2000. Throughout the decade, about a third of those who reported smokeless tobacco use were found to have the lesions.

By the time of the last survey in 2000, only 25 percent of the players at all levels said they were using smokeless tobacco. The prevalence of lesions among all players was 9.4 percent.

That’s still far above the national level of smokeless tobacco use _ about 3.4 percent _ as measured by a government survey on drug abuse done in 2000.

While several other studies have used surveys and oral exams to get snapshots of chew tobacco use among professional baseball players, and found similar levels of use, Sinusas and Coroso are the only ones to have looked at so many players _ nearly 2,700 total exams _ and over a full decade.

Of course, the study didn’t track the same players the whole time. The turnover in participants in each camp was 20 to 25 percent _ because of trades, retirements and players being released. And because they kept the surveys anonymous, the doctors had no way to track the habits of the few veterans and coachers who may have reported to camp the entire decade.

“Still, we think we captured the trend for this team and, actually because of all the turnover, for baseball in general,” Sinusas said.

While player education about the risks of smokeless tobacco clearly played a role, the biggest impact on the change appears to have come from Major League Baseball’s 1993 decision to ban the stuff from all minor league clubs.

“The ban’s only in effect at the minor level, but there was a decline in use among both majors and minors,” Sinusas said.

Use among minor players was 40 percent in the first year of the survey and just 20 percent by 2000. Among players in the majors, use fell from 55 percent to 32 percent over the decade.

“We gave a talk about the risks each year to the minor leaguers, and I want to believe that had some influence,” the researcher said. “Anyone who we found lesions in, we counseled them at the time about the hazards and quitting.”

The National Spit Tobacco Education Program, with former catcher and broadcaster Joe Garagiola as leading spokesman, also has been instrumental in getting the message about the dangers of chew and snuff to athletes at all levels, and there have been some high-profile quitters, including pitcher Curt Schilling and centerfielder Brett Butler, both of whom had cancer scares.

Still, spit tobacco is well entrenched in baseball. “We did notice that the coaches, as a group, had much less a decline in using tobacco than the players, probably because they’re older and their habits are more ingrained,” Sinusas said.

“On the plus side, the percentage of players who said they wanted to quit almost doubled, from 29 percent in 1991 to 52 percent in 2000,” Sinusas said. “As guys in the minors move up and older players retire, it’s logical that we’ll see fewer and fewer major leaguers with the habit.”