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KX News: Students Help Draft E-Cigarette Bill

By Steph Scheurer, Reporter

The CDC reports more than 16 million minors live in states where they can buy e-cigarettes legally.

The topic of age limits on e-cigarettes is one that will be brought up during the 2015 legislative session.

Braden Will and Ashti Ali are 7th graders.

But even at a young age, they’re thinking about their safety.

“It’s kind of scary that 12 year olds, even 10 year olds can buy e-cigarettes,” says Braden Will, Simle 7th Grader, SADD.

“We don’t think it’s right that kids our age and younger can buy e-cigarettes because they’re just as harmful as regular cigarettes and so if they start now, then they’ll just get addicted for their whole life and we don’t want that to happen,” says Ashti Ali, Simle 7th Grader, SADD.

So, they decided to do something about it.

“The Simle SADD chapter wrote Representative Larson and said, you know what, we want a bill to protect our youth,” says Kristie Wolff, Program Manager, American Lung Association, ND.

Representative Diane Larson went to Simle, met with the students, and got a bill drafted that would restrict the sale of e-cigarettes to minors across the state of North Dakota.

“Currently several communities across the state have already developed city ordinances that are in place but statewide we do not have an e-cigarette ordinance so it is legal for minors not only to purchase but possess e-cigarettes across much of the state,” says Wolff.

Wolff says e-cigarette use among the youth has tripled since 2011. Currently 40 states prohibit the sale of e-cigarettes to minors. North Dakota is not one of them.

“One of the reasons could be because we only have session every other year and so this is one of the first times that our legislators, you know, are going to be addressing it,” says Wolff.

As of September, 18 cities across the state have developed city ordinances that are in place, but Braden, Ashti, and the rest of their SADD chapter hopes their voice will help make this change statewide.

“I like the feeling that we actually kind of get to help with this because it just makes me feel good,” says Ali.

“I think the way the bill came about is amazing because it’s coming directly from those we want to protect,” says Wolff.

E-cigarettes are included in North Dakota’s Smoke Free Law.

Anywhere that traditional tobacco cannot be used, e-cigarettes also cannot be used.

According to a list from the American Lung Association in North Dakota, Dickinson is just one city where e-cigarettes are not restricted from being sold to minors.

http://www.kxnet.com/story/27634626/students-help-draft-e-cigarette-bill

Smoking not 'lesser evil' in mental health treatment settings

By: Maiken Scott, Newsworks
Picture an AA meeting, and a gigantic coffee urn and a cloud of smoke come to mind.
In fact, the two men who started AA, Dr. Bob and Bill W. both died from tobacco-related illnesses.
Public health experts say smoking is still pervasive among people living with addiction and mental illness, and it’s often not seen as a priority in treatment settings.
For example, smoking rates in Philadelphia have dropped significantly over 10 years, but haven’t budged among people with mental illnesses and substance-abuse issues.
Smoking is often seen as a “lesser evil” in mental health and addiction treatment settings, explained Ryan Coffman, tobacco policy manager for Philadelphia’s Department of Public Health. It’s not a priority, and some providers assume it helps their clients cope.
Research shows the opposite to be true, says Coffman. “Individuals living with mental illness and substance-abuse disorders who smoke have more severe symptoms, poorer well-being and functioning, they have more hospitalizations, and are at a greater risk for suicide,” he said.
Research also shows that people who quit smoking along with quitting other drugs have better recovery outcomes.
Philadelphia is increasing efforts to train mental health providers on tobacco-cessation programs, and to provide them with the most up-to-date resources available to their clients, Coffman said.
But for these efforts to really take root, a major cultural shift will have to occur, said University of Pennsylvania psychiatrist Robert Schnoll, who studies tobacco cessation.
“Research indicates that upwards of 25 percent of mental health care facilities still permit smoking on the grounds and on the premises,” he explained. “There’s pervasive use of cigarettes, or cigarette breaks, as a reward for pro-social behavior, so that’s certainly one of the issues we need to address going forward.”
Some providers think their clients don’t care about tobacco cessation, he said, or don’t understand the benefits. Some also simply don’t see it as their responsibility.
Research also indicates that smoking rates are high among people who work in mental health treatment settings, Schnoll said.
http://www.newsworks.org/index.php/homepage-feature/item/75483-smoking-not-lesser-evil-in-mental-health-treatment-settings?linktype=hp_impact

Ready to quit smoking? Here's what works best

Kim Painter, Special for USA TODAY
It’s always a good time to quit smoking. But if smoking cessation has a season, it’s about to begin.
Thursday is the American Cancer Society’s Great American Smokeout, a day on which all smokers will be encouraged to abstain or start making a plan to quit. In coming weeks, even more people will make resolutions to quit as New Year’s Day approaches.
Sadly – with smoking causing 480,000 deaths each year in the United States – most will not succeed, at least this time.
One reason: most people try to do it alone, and just 4% to 7% of those people manage to quit on any given attempt, according to the cancer society. Getting help can raise quitting rates to 25% or more, at least in studies, the society says.
But what kind of help?
“We have a gold standard, and it’s a combination of counseling and medication,” says Yvonne Hunt, a program director at the National Cancer Institute’s tobacco control research branch. But just 4% of potential quitters use such combinations, according to the federal Centers for Disease Control and Prevention.
There are several methods to choose among, Hunt says: “People can mix and match and find a combination that works best for them.”
Among the proven methods:
• Counseling. One way to start planning a quit attempt is to call 1-800-QUIT-NOW (1-800-784-8669) to reach counselors on your state’s quit line. In-person counseling is available through many clinics and hospitals. Increasingly, counseling also is available through text messages (such as the cancer institute’s SmokefreeTXT program). Some websites and apps offer advice too, but quality varies.
• Varenicline (Chantix). This prescription pill is the most effective smoking-cessation drug in studies. It can ease withdrawal symptoms and make smoking less satisfying by blocking the effects of nicotine. The pills carry warning labels – which a Food and Drug Administration panel recently voted to keep – saying they have been linked to mood swings, depression and suicidal thoughts. But those side effects are rare “and generally it’s accepted as a safe medication,” says Lee Westmaas, director of tobacco control research at the cancer society.
• Bupropion SR (Wellbutrin, Zyban). This is another prescription pill. It is best known as an antidepressant but it also can decrease cravings and withdrawal symptoms in those quitting smoking. Common side effects are dry mouth and difficulty sleeping.
• Nicotine-replacement therapies.
Nicotine from a patch, gum, spray, inhaler or lozenge can ease withdrawal symptoms and cravings in the first weeks and months without cigarettes. Some require a prescription and all are considered medications. They can be combined with non-nicotine medications. They have various side effects. For example, patches can cause skin irritation and nicotine gum can cause mouth sores.
Not on the list of proven methods: hypnosis, acupuncture and laser therapy. “You will certainly find people who swear by these methods, but they do not have a solid evidence base behind them,” Hunt says.
Some smokers also may be surprised that electronic cigarettes – e-cigarettes – are not listed as quit-smoking aids by groups such as the cancer society or the National Cancer Institute. The increasingly popular devices contain nicotine, but unlike nicotine-replacement therapies, they are not regulated and have not been thoroughly studied as quitting aids.
“The sale of e-cigarettes is going 100 miles an hour and the science is going five miles an hour,” says Jonathan Bricker, a psychologist specializing in smoking cessation at Fred Hutchinson Cancer Research Center, Seattle.
Bricker’s own research focuses on improving counseling methods. It is clear smokers need more and better help than is available now, he says: “We are not helping 65% to 75% who want to quit.”
But it’s also important for smokers who fail one — or many — quit attempts to keep trying, Westmaas says. “Each attempt gives them more information about what to do differently next time.”
More information on quitting is at the federal government’s smokefree.gov site and the cancer society’s cancer.org site.
Benefits of quitting:
For those who need reminders about why they should quit, here – according to the cancer society – are some benefits after:
20 minutes: heart rate and blood pressure drop
12 hours: carbon monoxide levels in blood drop to normal
2 weeks to 3 months: circulation and lung function improve
1 year: excess coronary heart disease risk cut in half
5 years: risk of mouth, throat and bladder cancer cut in half
10 years: risk of dying of lung cancer cut in half
15 years: risk of coronary heart disease same as non-smokers’
http://www.usatoday.com/story/news/nation/2014/11/16/quit-smoking-what-works/18812269/

Our View: Do more to keep e-cigs, youths apart

The Times Editorial Board, SC Times

Surveys of Minnesota and U.S. youth show alarming increase in e-cigarette use. Lawmakers can slow this increase by immediately acting to limit access.

Two surveys released the past week — one state and one national — deliver a powerful message about the most pressing issue regarding e-cigarettes:
Government needs to lead a stronger charge to keep them out of the hands — and bodies — of minors.
To this point, most of the e-cigarette debate has been about whether e-cigarettes — which electronically convert liquid nicotine into vapor to be inhaled — are as harmful as traditional tobacco and secondhand smoke.
That debate has raged for years, even decades. A resolution seems months, or more likely, years away.
What’s more pressing to resolve — as evidenced by two surveys of youths’ nicotine use — is slowing the fast-rising number of minors who are trying these devices.
How fast?
The 2014 Minnesota Youth Tobacco Survey released Monday found 28 percent of high school students have tried e-cigarettes. On Thursday, the Centers for Disease Control and Prevention reported 4.5 percent of high school students nationally used e-cigarettes regularly in 2013 — triple the percent from 2011. Equally disturbing: 12 percent of U.S. high school students and 3 percent of middle-schoolers had tried them at least once.
And remember, e-cigarettes have been widely available in America for only about seven years.
Such findings make it clear e-cigarettes hold potential for creating countless new generations with unhealthy and high rates of nicotine addiction.
Hasn’t America learned enough hard lessons from 50 years of tobacco-based nicotine addiction to know it needs to snuff out that potential now instead of waiting for more research?
Ultimately, there is no debate that nicotine is a potent, addictive drug. E-cigarettes are simply a delivery mechanism.
So lawmakers should act now to keep the drug and the delivery system out of the hands of minors.
An easy decision is to enact a federal ban on selling minors e-cigarettes, “e-juice” and related products. Minnesota is one of about 35 states with such bans. However, sales via the Internet still provide youth access.
Another important step is to apply the same rules to the marketing of e-cigarettes that are applied to traditional tobacco.
After all, even a cursory glance at products and advertising makes it clear many producers are targeting youth. Think everything from trendy-looking e-cigarettes (and accessories) to bubble-gum flavored e-juice.
Finally, there is merit in increasing the taxes paid on all e-cigarette products.
Such an approach proved successful in reducing youth use of traditional tobacco. And it might even dissuade adults from nicotine addiction.
Again, too much of the debate about whether and how to regulate e-cigarettes remains focused on comparisons to traditional tobacco.
Seeing how e-cigarettes are gaining traction among youth, the focus needs to shift to keeping these nicotine-delivery devices out of their hands — at least until they are legal adults.
http://www.sctimes.com/story/opinion/2014/11/16/view-keep-e-cigs-youths-apart/19089759/

The Taste Of Menthol Cigarettes Is Not Worth The Lung Complication Risk Compared To Regular Tobacco

By
Due to their minty taste and aroma, menthol tobacco products are often found more preferable than the bitter aftertaste and smell of regular cigarettes. Unfortunately, many smokers harbor the misconception that switching to menthol can help with smoking cessation. A recent study published in the journal Respirology has revealed that although better tasting than regular cigarettes, menthol cigarettes carry a higher risk of developing lung disease and being hospitalized as a result of complications.
Researchers recruited 1,941 regular cigarette smokers and 3,758 menthol smokers to compare each group’s overall health condition over the course of 18 months. Participants were between the ages of 45 and 80 and smoked at least 10 packs of cigarettes each year. The research team found that menthol smokers were more likely to be young, female, or black. Regular cigarette smokers were able to cover a longer distance in six minutes, while menthol smokers were more short of breath.
Although both groups had similar frequencies of chronic obstructive pulmonary disease (COPD) “exacerbations” — worsening of the condition — throughout the study, menthol smokers had a higher frequency of severe exacerbations at 0.22 per year, compared to 0.18 per year for regular cigarette smokers. Using menthol cigarettes as opposed to regular cigarettes was also associated with a 29 percent higher risk of severe lung disease exacerbations.
“We were surprised that menthol smokers, compared to non-menthol cigarette smokers, reported more severe exacerbations and had greater odds of experiencing severe exacerbations,” Dr. Marilyn Foreman of the Morehouse School of Medicine in Atlanta, Ga., told Reuters Health in an email. “Frequent exacerbations do affect quality of life and may result in greater loss of lung function over time.”
According to the Food and Drug Administration, over 40 percent of youth smokers and 30 percent of adult smokers in the United States report smoking menthol cigarettes. Following repeated attempts by anti-smoking campaigns to have the FDA ban menthol-flavored cigarettes, the administration recently began a series of studies to gauge the health-related impact of these tobacco products.
Source: Park S, Demeo D, Foreman M, et al. Menthol cigarette smoking in the COPDGene cohort: Relationship with COPD, comorbidities and CT metrics. Respirology. 2014.
Justin Caba is a reporter for Medical Daily focusing on nutrition, fitness, and all things athletic.
http://www.medicaldaily.com/taste-menthol-cigarettes-not-worth-lung-complication-risk-compared-regular-tobacco-309638

Letter: Raise state cigarette tax, protect ND kids

By Nicholas Thies, Fargo

I have a friend who started smoking in ninth grade, roughly seven years ago, and he is still addicted to this day. The tobacco companies are aware of these trends and spend millions of dollars on new products and deceptive marketing with the goal of turning children into lifelong customers, as is the case with my friend. I have talked with him, and he has told me how raising the tobacco tax would greatly encourage him to quit smoking.

One of the best ways to prevent kids from ever starting the deadly addiction is to increase the price of tobacco products so they can’t afford to purchase them. States have been successfully using this tactic over the past decade by increasing local tobacco taxes. It can also help detract adult smokers from continuing the habit. Many of my aunts and uncles have been smoking for decades, and I always wished for something that would make them quit.

I’m suggesting we raise North Dakota’s cigarette tax significantly. Of the surrounding states, North Dakota’s tobacco tax is incredibly cheaper.

This one simple act can keep nearly 7,900 North Dakota kids from ever becoming adult smokers. And, more importantly, it means that more than 4,700 caused deaths would be prevented.

North Dakota, this is a win-win idea. You can decrease long-term health care costs and protect our children. I urge you to write your legislator and ask them to consider increasing North Dakota’s tax on all tobacco products.

It’s the right choice for our kids.

http://www.inforum.com/content/letter-raise-state-cigarette-tax-protect-nd%E2%80%88kids

Raise tobacco tax to discourage kids

By KATHLEEN DONAHUE Bismarck

Almost all tobacco users became addicted before age 26. Thousands of kids try their first cigarette every day.

In recent years, declines in youth smoking rates have stalled and the use of other tobacco products by youth has actually increased.

The tobacco companies are aware of these trends and spend millions of dollars on new products and deceptive marketing with the goal of turning children into lifelong customers.

Advertising influenced my cousin to start smoking at an early age. Years later, his tobacco use cost him his life. I want to make sure no family experiences such a loss.

One of the best ways to prevent kids from ever starting the deadly addiction is to increase the price of tobacco products so they can’t afford to purchase them. States have been successfully using this tactic over the past decade by increasing local tobacco taxes.

I’m suggesting we raise North Dakota’s cigarette tax significantly. This one simple act can keep nearly 7,900 North Dakota kids from ever becoming adult smokers. And more importantly, it means that more than 4,700 tobacco-caused deaths like my cousin’s untimely passing would be prevented.

North Dakota, this is a win-win idea. You can decrease long-term health care costs and protect our children. I urge you to write your legislators and ask them to consider increasing North Dakota’s tax on all tobacco products. It’s the right choice for our kids.

http://bismarcktribune.com/news/opinion/mailbag/raise-tobacco-tax-to-discourage-kids/article_94347622-4046-11e4-a807-af727e9b9e46.html

Letter to the Editor: Stop glamorizing the role of tobacco in baseball

Chris Hansen, Washington | The Washington Post

Just weeks after the early death of beloved baseball star Tony Gwynn from cancer likely caused by chewing tobacco, and just days after World Series-winning pitcher Curt Schilling told the world he attributes his cancer to years of chewing tobacco, The Post irresponsibly leads an article about the Washington Nationals with the portrayal of chewing tobacco use as a rally-inducing, lucky superstition [“Nationals’ luck runs out against Phillies thanks to stellar performance by Burnett,” Sports, Aug. 27].

To all the young baseball fans who look to The Post each morning to see if their heroes won last night: Tobacco causes those heroes to suffer nicotine addiction, disease and death. Stephen Strasburg recently stated publicly that he is trying to quit using chewing tobacco but that it is very hard to quit. It is time for the team owners and the players association to eliminate tobacco from baseball, and it is time for the media to stop characterizing tobacco as a quaint part of baseball culture.

Instead of inducing winning rallies, tobacco in baseball induces life-shortening defeats — and that is the only coverage it deserves on the sports page of The Post.

The writer is president of the American Cancer Society Cancer Action Network .

http://www.washingtonpost.com/opinions/stop-glamorizing-the-role-of-tobacco-in-baseball/2014/08/31/cdd004dc-2e08-11e4-be9e-60cc44c01e7f_story.html

CDC: E-cigs may be tempting non-smoking youths to smoke

By Reuters Media

CHICAGO – Electronic cigarettes may be more tempting to non-smoking youths than conventional cigarettes, and once young people have tried e-cigarettes they are more inclined to give regular cigarettes a try, U.S. researchers said on Monday. A report, released by a team at the U.S. Centers for Disease Control and Prevention, lends evidence to the argument that electronic cigarettes encourage youth smoking.

The study, based on nationally representative youth surveys, found that more than a quarter-million adolescents and teens who had never smoked used an electronic cigarette in 2013, a threefold increase from 2011.

Youths who had tried e-cigarettes were nearly twice as likely to say they would try a conventional cigarette in the next year compared with those who had never tried an e-cigarette, according to the study in the journal Nicotine and Tobacco Research.

E-cigarettes are slim, reusable, metal-tube devices containing nicotine-laced liquids that come in exotic flavors. When users puff, the nicotine is heated and released as a vapor containing no tar, unlike conventional cigarette smoke.

Health experts have raised concerns that the burgeoning $2 billion e-cigarette industry, which has been virtually unregulated, would reverse gains in the decades-long effort to curb youth smoking in the United States. Just 15.7 percent of U.S. teenagers reported smoking in 2013, the lowest rate on record.

In April, the U.S. Food and Drug Administration proposed rules that would ban the sale of e-cigarettes to anyone under 18 but would not restrict flavored products, online sales or advertising, which public health advocates say attract children.

Earlier this month, attorneys general from 29 states urged the FDA to strengthen those rules to better protect young people from nicotine addiction.

“We are very concerned about nicotine use among our youth, regardless of whether it comes from conventional cigarettes, e-cigarettes or other tobacco products,” Dr. Tim McAfee, director of CDC’s Office on Smoking and Health, said in a statement.

“Not only is nicotine highly addictive, it can harm adolescent brain development.”

In the CDC study, researchers analyzed data from the 2011, 2012, and 2013 National Youth Tobacco Surveys of students in grades 6-12. They found that more than 263,000 who had never smoked a conventional cigarette used e-cigarettes in 2013, up from 79,000 in 2011.

Among non-smoking youth who had tried electronic cigarettes, 43.9 percent said they intended to smoke conventional cigarettes within the next year, compared with 21.5 percent of those who had never used e-cigarettes.

Lorillard Inc leads the U.S. e-cigarette market, while Reynolds American Inc and Altria Group Inc are rolling out their own brands nationwide this summer. A Wells Fargo analyst report in July projected that U.S. sales of e-cigarettes would outpace conventional ones by 2020.

http://www.inforum.com/content/cdc-e-cigs-may-be-tempting-non-smoking-youths-smoke

Schilling: Tobacco gave me cancer

Former Boston Red Sox pitcher Curt Schilling revealed Wednesday for the first time the type of cancer he was battling — squamous cell carcinoma, a type of mouth cancer — and detailed the painful treatment and recovery process that caused him to lose 75 pounds.

Telling his story for the WEEI/NESN Jimmy Fund Radio-Telethon on Wednesday morning, Schilling said he believes that a 30-year habit of chewing tobacco is what caused the cancer.

“I do believe, without a doubt, unquestionably that chewing was what gave me cancer,” he said. “I’m not going to sit up here from the pedestal and preach about chewing.”
The 47-year-old Schilling said he spent six months in the hospital with a feeding tube, undergoing chemotherapy and painful radiation treatment. During that time, he said, he developed a staph infection and there was a week of his life he doesn’t remember.
“I got chemo and radiation for [seven] weeks, and I came back to my room and my family was sitting there and I thought, ‘You know what, this could be so much worse. This could be one of my kids,'” Schilling said. “I’m the one guy in this family that can handle this. From that perspective, I’ve never said ‘Why me?’ and I never will.”
The most painful part of the treatment, he said, was the radiation, which he received five days per week for seven weeks. Schilling said doctors created a pliable mask to put on his face, an implement the former pitcher said was “the straitjacket for when they are giving you radiation.”
“The first day I went in, they clamped [the mask] down, they do the radiation into the tumors,” Schilling said. “The second day they did it. And about the third day I started developing almost a phobia and I literally had to be medicated for the seven weeks to go and do that. I couldn’t control myself under the mask.”
He added: “If this happened again, I’m not sure if I would go through the treatment again, it was that painful.”
Schilling said he’s lost so much weight because it is still painful to swallow — “I can’t put enough calories in my body” — and he is still shaky and weak at times.
He paused several times during the interview to take sips of water (he says he still does not have any saliva), and his voice sounded different than we’re used to hearing from Schilling. He is currently on leave from his job as an analyst on ESPN’s Sunday Night Baseball telecast.

“Recovery is a challenge,” Schilling said. “There are so many things that are damaged during the process. I don’t have any salivary glands, I can’t taste anything and I can’t smell anything right now. And there’s no guarantee they’ll come back.”

Schilling reiterated that the cancer was in remission, a statement he tweeted to the world for the first time in June, and that his follow-up care includes doctor visits every 1-2 months and scans every few months to determine if the cancer has returned.

He described how he first discovered the cancer over the winter.

“This all came about from a dog bite,” Schilling explained.

He said the dog bite damaged his finger enough to send him to the doctor. On his way to see the physician, he felt a lump on the left side of his neck and decided to get it checked out with a nearby ear, nose and throat specialist.

“He did a biopsy and two days later he diagnosed me with squamous cell carcinoma,” Schilling said.

It is the same type of cancer former Buffalo Bills quarterback Jim Kelly is suffering from.

“Commonly this is known as mouth cancer … cancer of the lining of the mouth,” said Schilling’s physician, Dr. Robert Haddad of the Dana Farber Cancer Institute. “The lump in the neck is why most patients go to the doctor first because they feel the lump in the neck, that’s the lymph node that’s enlarged.”

This was Schilling’s second public appearance since the cancer diagnosis. In May, he appeared at Fenway Park as the Red Sox celebrated the 2004 World Series-winning team.

“It was weird,” Schilling explained of the appearance. “I was in the hospital at the time. They wouldn’t let me come over [to Fenway] and go back [to the hospital]. So I had to determine if I was OK and ready to be discharged. I said ‘Yeah, yeah, OK.’ And two days later I was back in the hospital. That’s why [my son] Gehrig walked out with me, because I was afraid I was going to fall on the way in because I was so discombobulated.”

He was asked Wednesday why he has stayed out of the spotlight in recent months, choosing only now to talk about it for the first time.

“I didn’t want people feeling sorry for me,” he said. “I didn’t want the pity, I didn’t want any of that stuff.”

Schilling pitched in the majors for 20 seasons with the Baltimore Orioles, Houston Astros,Philadelphia Phillies, Arizona Diamondbacks and Red Sox. The six-time All-Star finished with a career record of 216-146 and a 3.46 ERA. His 3,116 strikeouts rank 15th all time. He won two World Series titles with the Red Sox and one with the Diamondbacks.

Red Sox manager John Farrell noted how the use of smokeless tobacco is not prohibited on the big-league level, protected by the players’ collective bargaining agreement with Major League Baseball.

“MLB has taken steps to dissuade players from using it through educational programs that are administered to every team,” Farrell said. “It’s even got to the point [in the minor leagues] now where players can be fined if smokeless tobacco is in view of the general public. There have been some of those warnings and penalties levied on some of our players.

“I think we all recognize that it’s addictive and causes cancer. That’s proven. [But] at this time, it’s upon the player to make the conscious decision for himself to use it or not. All we can do is continue educate guys what the ramifications are. … On the heels of the unfortunate passing of Tony Gwynn and what Curt is going through, you would think this would be a current beacon for guys to take note that there’s a price to be paid, if you’re one of the unfortunate ones stricken by cancer.”

http://espn.go.com/boston/mlb/story/_/id/11380584/curt-schilling-former-boston-red-sox-pitcher-says-chewing-tobacco-led-mouth-cancer