The Ohio Dental Association is launching renewed efforts this month on the facts and dangers of smokeless tobacco through Operation TACTIC, directing this information specifically to middle school students and educators across the state. Spring is an especially pertinent time to spread this message because of baseball, golf and other warm weather sports that are stereotypically linked to players using smokeless tobacco products. And middle school youth are considered to be of an age more likely to start using smokeless tobacco -- but also more able to stop or to be influenced not to start.
Usage by Ohio youth is high. The 1999 Youth Risk Behavior Survey conducted by the U.S. Centers for Disease Control indicates that 19.0 percent of Ohio high school males use smokeless tobacco in any environment, and 3.1 percent of Ohio's female teens use smokeless tobacco. It is believed girls are using it as a weight control measure and for a buzz induced from the nicotine rush, often dangerously in combination with alcohol. The 1999 Ohio Youth Tobacco Survey indicated that 13 percent of the males and two percent of the females reported using these substances before the age of 13.
Ohio ranked tenth highest among responding states in the national survey for the percentage of male teens who have used smokeless tobacco products.
As a dentist, Dr. Billie Sue Kyger of Gallipolis, ODA president-elect, knows firsthand the oral health implications of using smokeless tobacco. She also knows this personally -- a former patient and popular businessman in her community, Kevin D. Smith, died of oral cancer this past January. He was only 32 years old -- a husband and father of two young children -- who had started using smokeless tobacco at age 13.
Diagnosed with a malignant lesion of the tongue approximately 18 months before his death, Smith underwent extensive surgeries -- after radiation treatments which did not work -- one to remove his tongue and reconstruct it (a 22-hour surgery which was ultimately unsuccessful), using one of the chest muscles. Because the cancer had spread to the pharynx, another surgery, again using chest muscle, grafted tissue onto the throat; this, too was unsuccessful. In addition to surgical intervention, Smith also underwent chemotherapy because the cancer continued to spread and form more tumors.
Kyger said had he seen a dentist more frequently, the cancer could have been diagnosed much earlier because dentists can often identify early signs or oral cancer. "His prognosis may have been quite different and he could have been treated at a much earlier stage of the cancer. But his loss has already educated people in our area. I have already seen several young male patients who have stopped using all forms of smokeless tobacco as a result of this tragedy," Kyger said.
Smith's widow Tammy said her mission now is awareness about oral cancer and to tell others to not "rub," the common term of using smokeless tobacco. In fact she said many employees of the family business had also used smokeless tobacco products -- and every one of them has since quit.
To boys and girls who "rub," she says, "stop, and don't start. At the very least, you are hindering your ability to eat, to talk. Kevin lost his tongue, he was fed through a tube in his stomach. One of the hardest things for me was that his voice was taken away, that our baby never heard his father speak."
Rural and suburban communities often report higher usage of smokeless tobacco by youth than do inner city areas. For example, the 2001 Fairfield County Youth Tobacco Survey indicates 39 percent of middle and high school males have used smokeless tobacco -- and nine percent of the teen girls in this county have also.
Smokeless tobacco users are at risk for addiction, gum disease, tooth decay, bad breath, spitting, cancer -- and death. Smokeless tobacco, also called spit, snuff, chew (chaw) and/or dip, is not a safe alternative to smoking cigarettes. The American Cancer Society reports that those who use spit tobacco are 50 times more likely to get oral cancer of the cheek, gum or inner surface of the lip than those who don't chew, and more than twice as high as cigarette smokers. Smokeless tobacco users increase their risk of cancers of the oral cavity, throat, larynx and esophagus. The tobacco juice from spit tobacco can also lead to cancer of the esophagus, larynx, stomach, prostate and pancreas.
A can of smokeless tobacco -- the popular brands sell for over $4 a can -- contains as much nicotine as 60 cigarettes and 10 times the cancer-causing nitrosamines. Other ingredients found in smokeless tobacco are also found in car batteries (cadmium), nuclear weapons (uranium 235), nuclear waste (polonium), and embalming fluid (formaldehyde). There are 28 known carcinogens in smokeless tobacco, and in fact, smokeless tobacco products were classified in 2000 by the U.S. Dept. of Health and Human Services as known carcinogens in its 9th edition of the Report on Carcinogens.
Operation TACTIC tells you what the ads don't: that using smokeless tobacco is not cool, that it is addictive and that it can be downright deadly. The program module is geared to students from second through 12th grades, and is tailored to elementary, middle and high school curricula.
To learn more about the oral health dangers of using smokeless tobacco, contact your family dentist.
To learn more about Operation TACTIC, contact the dept. of communication and public service at (614) 486-2700, or on www.oda.org . The latest materials and statistics are available on the website and can be accessed by linking to www.oda.org/news/dsp_mediaandcon.cfm
