Study Cites Baseball Players’ Smokeless Tobacco Use

More than half of all professional baseball players participating in a large-scale study use or have used chewing tobacco and snuff, and more than half of those who do use it regularly have abnormalities in their mouths that could eventually lead to cancer, UC San Francisco researchers said here Monday.

The researchers surveyed and examined 1,109 major and minor league players from seven big league organizations--including the California Angels, the San Francisco Giants and the Oakland Athletics--last March during their spring training season.

Of the players examined, epidemiologist Virginia L. Ernster told a meeting of the American Assn. for the Advancement of Science, 39% had used smokeless tobacco within the previous week and 4% within the previous month. Another 13% were former users.

The smokeless tobacco of choice for 75% of those who used it was snuff, which has been closely linked to oral cancer.

The only good news in the study, Ernster said, was that few of the players smoked, and none of the lesions had yet turned cancerous.

Overall, “this terrific group of role models for young men” are setting a disappointing example and endangering their own health at the same time, she concluded.

Chewing tobacco is made up of loose leaves or a plug of tobacco that is inserted in the jaw and chewed regularly, with the released juices being spit out. Snuff is powdered or finely ground tobacco that is held between the teeth and gums and whose use is imperceptible until it is time to spit. Their use is widely considered to be a growing problem in the United States among youths who mistakenly believe that it is safer than smoking.

A 1986 study by the National Institute on Drug Abuse found that 25% of all males aged 12 to 25 had used smokeless tobacco at some time, contrasted with only 9% of males over the age of 35. An estimated 8.2% of males aged 17-19 and 5.9% of those aged 20 to 25 use smokeless tobacco regularly, contrasted with only 2% over age 40.

“It used to be that only old men used smokeless tobacco,” Ernster said. “Something has turned the demographics upside down.”

One contributor to the increased use among young people, she added, is the example set by celebrities, such as baseball players.

Less than 1% of women use smokeless tobacco, mostly American Indians and native Alaskans.

Smokeless tobacco, particularly snuff, has been associated with a variety of lesions in the mouth, including leukoplakia (white and red patches), gum irritation and recession and staining of the teeth. Long-term use has been firmly linked to development of oral cancer.

In addition, researchers suspect that smokeless tobacco may alter blood pressure, heart rate and total cholesterol levels, increasing the risk of heart disease. The key ingredient that is linked to these problems, as is the case in smoking, is nicotine.

The study was conducted in Arizona, where the seven major league teams in the spring training “Cactus League” and their 35 affiliated minor league teams practice. About 81% of the subjects were between the ages of 20 and 29 and 68% were Anglo.

In their study, Ernster and her associates administered a four-page questionnaire to each of the participants about their smoking, chewing and alcohol use; checked their overall health, and gave them each a comprehensive examination of the mouth.

They found that 87% of the players had never smoked and that only 4% now smoked. About 46% of the Anglo players were now using smokeless tobacco, more than twice the percentage among minority groups, reflecting use patterns that exist in the population as a whole. They also found that those who used smokeless tobacco most frequently were also the individuals who drank the heaviest, averaging more than two drinks a day.

Among the players who used smokeless tobacco regularly, 46% had lesions in their mouths, contrasted with 1.8% of those who never used smokeless tobacco. Most of the lesions cause pain or a burning sensation when they come in contact with food or other products, according to Sol Silverman Jr., professor of oral medicine at UC San Francisco.

Such lesions can turn cancerous among individuals who have used smokeless tobacco for decades, Silverman said. Biopsies of 91 of the lesions, however, showed that all were benign.

In a few cases where biopsies were delayed for several days, Ernster noted, the lesions had disappeared because the players had been frightened out of using snuff. Their disappearance suggested that most of the lesions were not yet serious, she said.

The UC San Francisco team will examine the same players and any newcomers at spring training this year and in 1990. They hope to continue following some of the players after that to obtain long-term information about the health risks.