Anthony Giamberardino and Richard Pieters: It’s time to change this spitting image
It’s something that’s too familiar. And, sadly, too often are the outcomes. During any major league baseball game, players can be seen with their cheeks extended and a dark fluid being spit out of their mouths. It’s a common occurrence.
While many of us who have grown up with the game are used to seeing players chewing tobacco, 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 can be more powerful in generating sales than any advertising campaign by the tobacco industry.
The recent death of major league baseball Hall of Famer Tony Gwynn, which has been attributed to his long-term use of the product, is just one more sobering reminder of a life cut short. He was only 54.
Although cigarette smoking in the United States continues to decline, a recent 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. In 2013, according to the CDC, 14.7 percent of high-school boys, and 8.8 percent of all high-school students, reported using smokeless products.
The CDC further states that smokeless tobacco contains 28 carcinogens, which, according to the American Dental Association, 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.
For some, oral cancer can result in multiple surgical procedures and disfigurement. For Tony Gwynn, it apparently cost him his life.
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.
The elimination of smokeless tobacco in the sport would be a grand slam. For the health of our children, shouldn’t this image of our national past time now be considered past its time?
Anthony Giamberardino, D.M.D. practices general dentistry in Medford and is president of the Massachusetts Dental Society. Richard Pieters, M.D., a radiation oncologist at the University of Massachusetts Memorial Medical Center in Worcester, is president of the Massachusetts Medical Society.
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