• 6/26/2007
  • Munster, IN
  • John Doherty
  • Nwi.com

Time was when smokeless tobacco was fashionable and every house had a fancy spittoon. Now it’s something that most guys would prefer the women in their lives didn’t know about.

Yes, it is primarily a male habit. According to the Oral Cancer Foundation, 92 percent of users are male. However, oral cancer won’t discriminate in favor of the 600,000 women using nationwide.

Still, when most people think chewing tobacco, they don’t think about one gender or another. They think about one sport: baseball.

A number of collegiate baseball players who chew tobacco were contacted by The Times for this story. Not one would agree to be interviewed — even anonymously.

However, a longtime youth baseball coach was more than happy to come forward. Not because he chews. He doesn’t and never did.

It’s due to what he sees during his daytime job.

Jay Platt is an oral surgeon. And about once a month, a young man who chews tobacco will come into his office. “He’s concerned that he has a white patch on his cheek or gum and he’s afraid it’s cancer,” Platt said. “We biopsy it and most times it isn’t.”

One would think that would be enough to scare someone straight. However, they invariably tell Platt, “I can’t quit,” because they’re addicted.

According to the National Cancer Institute, smokeless tobacco users absorb 2-to-3 times more addictive nicotine into their bloodstream than smokers do.

While nicotine doesn’t cause cancer, there are more than 10 other substances found in smokeless tobacco (see table) that do.

Consequently, sometimes the news from the biopsy is bad and the resulting treatment involves more than just removing the visibly affected tissue.

“The surgery is radical and disfiguring,” Platt said. “It impairs chewing and speech.”

Typical is loss of part of the tongue and mandible (jawbone). Radiation therapy and chemotherapy often follow.

The American Cancer Society estimated there were 31,000 cases of oral cancer last year. The five-year survival rate for oral cancer is slightly higher than 50 percent, which is far better than lung cancer. Consequently, some would argue that smokeless tobacco is a safe alternative to cigarettes. Similarly, one could argue that getting shot by a .22 is a safe alternative to getting shot by a .45.

So why ever start?

Younger baseball players are attracted to the habit by seeing big leaguers with that wad of tobacco in their cheek. If they spend enough years in the game, they’ll find a teammate who’s more than willing to help get them started.

This, despite the practice being banned at the high school, college and professional minor league levels.

Platt, who has a son playing collegiate baseball, isn’t convinced the ban is enforced all that well. “Yes, I see it all the time,” he said. “College kids in particular.”

And it isn’t as if those guys are pretending to chew tobacco. Even that is prohibited by the NCAA. A January 2003 memorandum from the NCAA to its umpires reads in part:

1. If a player, coach or other team personnel is using tobacco of any type, they are to be ejected immediately.

2. If a player coach or other team personnel is using something that has the appearance of tobacco, it should be removed immediately. The offending person is not to be ejected. The appearance of tobacco includes tins, pouches, mint leaves and any substance that mimics a tobacco product.

The rule for professional minor league baseball is similar. Instituted in 1992 in hopes of gradually ending the habit at the major league level, the strategy seems to be paying off in the minors. Success in the big leagues, though, has been elusive, with one study demonstrating usage remaining constant at 36 percent between 1998 and 2003.

The numbers among teenagers aren’t encouraging either with the CDC estimating that 13.6 percent of high school boys and 2.2 percent of high school girls use smokeless tobacco regularly.

How then do you get them to stop?

The National Spit Tobacco Education Program (NSTEP) offers a seven-step program on its Web site, www.nstep.org. While admitting that the process is a tough one, NSTEP advises current users that “each urge to chew lasts only 3-5 minutes — you can get through the craving with deep breathing exercises and keeping busy.”

Keeping oneself busy is better than keeping an oral surgeon busy with biopsies. “If (you) keep chewing,” Platt said, “(one of those biopsies) will eventually be positive.”

Then you will be keeping a plastic surgeon; ears nose, and throat specialist; and an oncologist busy. Ultimately, in 2004, the ACS estimated more than 7,000 oral cancer victims kept a funeral director busy.