By Richard Pieters, M.D. and Anthony Giamberardino, D.M.D.
Versions of the following joint commentary by the presidents of the Massachusetts Medical Society and the Massachusetts Dental Society, calling attention to the dangers of smokeless tobacco, were published in several newspapers across the Commonwealth during July and August.
Richard Pieters, M.D.
The headlines first came with baseball Hall of Famer Tony Gwynn. His all-too-early death at 54 was attributed to the long-term use of smokeless tobacco. Now it’s former Red Sox pitcher Curt Schilling, who revealed August 20 that he was diagnosed in February with mouth cancer. “I do believe without a doubt, unquestionably,” said Schilling when making his condition public, “that chewing [tobacco] is what gave me cancer…I did it for 30 years. It was an addictive habit.” His physician agreed.
Many of us who grew up with the game are used to seeing players chewing tobacco, but a new generation of children watching in the stands and on television may be seeing smokeless tobacco used for the first time. They are the ones most influenced by what baseball players do both on and off the field. And that behavior by professional athletes can be more powerful in shaping behavior than any advertising campaign by the tobacco industry.
Anthony Giamberardino, D.M.D.
Although cigarette smoking in the United States continues to decline, a report from the U.S. Centers for Disease Control and Prevention (CDC) indicates that the use of smokeless tobacco has held steady over the past nine years. CDC says that 14.7 percent of high-school boys, and 8.8 percent of all high-school students, reported using smokeless products in 2013.
The CDC further states that smokeless tobacco contains 28 carcinogens, which can cause gum disease, stained teeth and tongue, a dulled sense of taste and smell, slow healing after a tooth extraction, and, worst of all, oral cancer.
Smokeless tobacco is not harmless. According to the National Institute on Drug Abuse, it delivers more nicotine than cigarettes and stays in the bloodstream longer. Clearly, tobacco use is both a serious medical problem, as well as an oral health problem.
In a letter to baseball commissioner Bud Selig following the death of Tony Gwynn, nine leading health care organizations, including the American Medical Association and the American Dental Association, stated, “Use of smokeless tobacco endangers the health of major league ballplayers. It also sets a terrible example for the millions of young people who watch baseball at the ballpark or on TV and often see players and managers using tobacco.”
Oral cancer continues to be a serious problem in the U.S. More than 30,000 new cases are diagnosed each year, and the five-year survival rate is only around 50 percent. While a batting average of .500 would be considered outstanding in baseball, 50/50 odds aren’t very good in the game of life.
The connection between oral health and overall health is well documented. What happens in the mouth can affect the entire body. Physicians are now being trained to examine the mouth and to work with dentists to make patients more aware of the importance of oral health as it affects their overall health and well-being.
Programs such as the Massachusetts Dental Society’s Connect the Dots, in which physicians and dentists work together in the community, and the Massachusetts Medical Society’s establishment of a Committee on Oral Health mark the beginning of a growing relationship between physicians and dentists to promote oral health in the Commonwealth.
But oral cancer isn’t the only health risk from smokeless tobacco. Users have an increased risk of heart disease, high blood pressure, heart attacks, and strokes.
Many health issues are preventable, especially those related to tobacco use. The medical and dental professions can play a key role by providing education and screening for oral cancer.
Major league baseball players have an important opportunity to contribute to this educational process by aiding in prevention efforts, particularly aimed at impressionable young people. For the past four years, the Massachusetts Dental Society, in partnership with NESN and the Boston Red Sox, has produced TV campaigns on the dangers of smokeless tobacco.
The Massachusetts Medical Society and the Massachusetts Dental Society are committed to reducing tobacco use in all its forms and welcome the continued participation of the Red Sox and all of major league baseball. In 2014, chewing tobacco continues to be as much a symbol of baseball as the actual action on the field.
For the health of our children, shouldn’t this image of our national pastime now be considered past its time? The cases of Tony Gwynn and Curt Schilling should serve as a warning to us all.
Richard Pieters, M.D., a radiation oncologist at the University of Massachusetts Memorial Medical Center in Worcester, is president of the Massachusetts Medical Society. Anthony Giamberardino, D.M.D. practices general dentistry in Medford and is president of the Massachusetts Dental Society.