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Players find tobacco habit hard to shake

By Peter Abraham |  BOSTON GLOBE

FORT MYERS, Fla. — The sequence when Red Sox slugger David Ortiz walks to home plate has been the same for years now.
Big Papi tucks his bat under his right arm, spits into the palm of his batting glove, and slaps his hands together before staring out at the pitcher.
But there’s one aspect of the routine that Ortiz wishes he could stop: the need to have a pinch of tobacco in his right cheek.
It’s a habit he picked up in the minor leagues and can’t break.
“I use it as a stimulator when I go to hit,” Ortiz said. “But the minute I finish my at-bat I spit it out. It keeps me smooth and puts me in a good mood. I don’t do it in the offseason. I don’t really like it that much, to be honest with you.”
Smokeless tobacco use stubbornly remains a part of baseball, even though Major League Baseball has tried to discourage its use for the last few years because it is known to increase the risk of cancer. While smokeless tobacco use is not as prevalent in baseball as it was several years ago, a survey of the 58 Red Sox players invited to spring training this year found 21 who admitted to using it.
“It’s a nasty habit, but it’s one of those traditions in baseball,” said Red Sox manager John Farrell, who “dipped” smokeless tobacco when he played and admits to using it now on occasion.
Major League Baseball rules prohibit teams from providing tobacco products to players and strongly encourages clubhouse attendants not to purchase tobacco for players. Players cannot have tobacco tins in their uniform pockets or do televised interviews while using smokeless tobacco. Violators are subject to fines; no Red Sox players have been fined.
The rules were put in place in 2011 as part of the latest collective bargaining agreement with the Players Association. An initial proposal to ban tobacco use entirely was rejected by the players. The idea behind the rule change was to look out for the health of the players, present a better example to children, and clean up the image of a game long stained by disgusting brown spit.
“When I first started playing, everybody did it,” said Ortiz, the team’s most veteran player. “Now you see fewer guys because everybody knows it’s bad for you. They try to educate us about it, but some people don’t listen.”
As part of the effort to discourage use, the Red Sox provide alternatives to their players. There are five flavors of bubble gum available in the clubhouse, along with tubs of sunflower seeds. There’s even a big box of fruit chews imported from Japan.
Most players who use smokeless tobacco actually use snuff, finely ground tobacco usually placed under the lower lip. A few players chew leaf tobacco, creating telltale bulging cheeks.
In the Globe’s informal poll, the only Red Sox player who said he didn’t want to quit was outfielder Jonny Gomes. He’s also the only one interviewed who uses chewing tobacco, not snuff.
“I’d quit if my family wanted me to,” Gomes said. “The kids aren’t old enough to realize what’s going on. People are baffled I don’t do it in the offseason because I do it all the time when we’re playing. But I don’t have an addictive personality. There’s just something about it that goes with baseball. There’s something attached to hitting. I can’t describe it.
“Once I stop playing, I’ll never do it again. I know it’s a bad idea.”
For each player, the habit takes on different forms. Pitchers Jake Peavy and Felix Doubront said they use smokeless tobacco only when they’re on the mound. Fellow pitchers Andrew Miller and Clay Buchholz use it during games but not when they’re pitching.
“It’s just part of my routine when I play,” first baseman Mike Napoli said. “It would feel weird without it. I’ve gone a couple of months without it. But as soon as I step on a field, I feel like I need it.”
The dangers of smokeless tobacco are evident.
It increases the risk of various forms of oral cancer, gum disease, and lesions in the mouth that can become cancerous, according to the American Cancer Society and other medical groups. Hall of Famer Tony Gwynn was found to have mouth cancer in 2010 and required extensive surgery. He believes it was from tobacco use.
Smokeless tobacco delivers a greater dose of nicotine — the addictive ingredient in tobacco — than a cigarette, according to the National Institute on Drug Abuse. Although the nicotine is absorbed more slowly, a greater amount stays in the bloodstream.
Starting in 2012, teams were required to have dentists screen players for signs of oral cancer. The Red Sox had their exams when they reported to spring training.
“You certainly understand what MLB is trying to do,” Peavy said. “I respect that. At the same time, it’s really, really hard to tell grown men who have been in this game and done it for a long time that they can’t do something that’s legal. Old habits die hard.
“I grew up with it,” said Peavy, who grew up and still lives in Alabama. “It was big with my family. Next thing you know, you’re buying cans and you’re addicted to nicotine.”
But Peavy wants to quit because of his three young baseball-loving sons.
“I can’t stand the idea of them seeing me do it and thinking it’s OK for them,” he said.
Doubront, who has two sons, feels the same way.
“My family hates it,” he said.
Fears that players’ children, and young fans, will follow their lead are well founded. A survey done by the Centers for Disease Control and Prevention in 2009 found that 15 percent of high school boys were using smokeless tobacco, a 36 percent increase from 2003.
Third baseman Brandon Snyder quit after he found out his wife was pregnant early last season.
“One night I had a dream that I died from something having to do with dip,” he said. “When I woke up I didn’t have the slightest want or need for a tobacco product. I had been doing it since I was 13.”
Because tobacco use is prohibited in the minor leagues and most levels of amateur baseball, many younger players arrive in the majors unfamiliar with it. But two Sox prospects, outfielder Bryce Brentz and lefthander Drake Britton, said the minor league tobacco ban is only casually enforced.
“I did it in the minors,” Britton said. “The people who want to can still do it. They’ll look in your locker to see if you have it, but that’s really it.”
Britton was casually spitting into a water bottle as he spoke.
“I know I need to quit,” he said. “I don’t want to be one of those guys who never quits, dips the rest of my life, and gets cancer.”
Brentz, 25, is trying to quit now. He’s worried he’ll reach for a tin once he goes hitless in a game.
“It doesn’t take much for a baseball player to blame something,” he said. “I should feel the same chewing gum, but I don’t. It’s addicting.”
Snyder and Gomes have tried chewing a mint product manufactured in Danvers. Jake’s Mint Chew, founded in 2010, has provided a tobacco alternative to players from the Red Sox, Orioles, Dodgers, and Twins, along with a few NFL players.
Adam Benezra, who founded the company with Jake Sweeney, said sales rose by 132 percent after the first year and have climbed steadily sense. The company now has seven employees.
“We get a lot of athletes who contact us,” Benezra said.
Miller could be the next.
“I’m torn all the time, but there are dangers in everything,” he said. “I try for moderation, and I don’t do it in the offseason. It’s a habit during baseball season for me, and it always has been. I wish it wasn’t. I feel like an idiot for doing it.”
http://www.bostonglobe.com/sports/2014/03/06/tobacco-chewing-nasty-habit-still-kicking-mlb/nZDZK9LOFDlr0MFj9X1WkO/story.html

Kids who use snus before age 16 more likely to become smokers

BY SHEREEN JEGTVIG
(Reuters Health) – Norwegians who started using snus before age 16 were more likely to become cigarette smokers than those who started using snus later in life, according to a new study.
Snus is moist smokeless tobacco developed in Sweden. It’s contained in a small pouch, and unlike regular chewing tobacco, it doesn’t make the user spit.
Research suggests snus has lower levels of chemicals called nitrosamines than cigarettes and may be less harmful.
In Norway, snus has become a smoking cessation aid and most older snus users are former smokers.
But snus is also becoming increasingly popular among young Norwegian adults, many of whom have not smoked cigarettes. And although research is divided, the current thinking is that snus use reduces the likelihood of taking up smoking.
The authors of the new study wanted to know more about when people start using snus, to see if that ties into whether they also begin smoking cigarettes.
“I already knew about the research investigating associations between snus use and later smoking, but discovered that snus debut age had not been mentioned in that research,” Ingeborg Lund told Reuters Health in an email.
Lund is a researcher with the Norwegian Institute for Alcohol and Drug Research – SIRUS, in Oslo. She and her colleague Janne Scheffels published their study in Nicotine andTobacco Research.
The researchers analyzed surveys of Norwegian teenagers and adults conducted from 2005 to 2011.
Out of 8,313 people, 409 were long-term snus users who had started using snus before cigarettes or never used cigarettes. Of the snus users, 30 percent were long-term smokers.
Just over one third of the snus users started using snus before age 16. The researchers discovered those participants had two to three times the odds of becoming lifetime smokers, compared to people who began using snus after age 16.
They also found that early snus users had about the same rate of cigarette smoking as non-snus users. About 23 percent of early snus users were current smokers at the time of the survey, compared to only six percent of people who started using snus when they were older.
“Snus use seems to protect against smoking if the snus debut does not happen too early during adolescence,” Lund said.
She said it’s particularly important to keep teenagers tobacco-free until they are at least 16 years old.
“At younger ages, even if they start with a low risk product such as snus, there is a high risk that they will switch to – or add – other high-risk products, such as cigarettes,” she said. “This risk is reduced when they grow older.”
Since snus use is much less common in other countries, Lund said she doesn’t know if these results can be generalized outside of Norway and Sweden.
Lucy Popova, from the Center for Tobacco Control Research and Education at the University of California, San Francisco, told Reuters Health the new study was “interesting.” She was not involved in the research.
“Earlier initiation of snus basically makes it a gateway to tobacco use, to cigarette use in the future,” she said.
Popova explained that traditional Swedish snus is less dangerous than cigarettes.
“But it’s not harm-free, and (what) is really bad is when people start using both products because of increased rates of cardiovascular disease, pancreatic cancers and other problems,” she said.
Snus is fairly new to the U.S., and Popova said the version made in the U.S. isn’t like the traditional Swedish product.
“A research study found that it’s different from the traditional low-nitrosamine snus in Sweden – it’s not necessarily going to be as low-harm,” she said.
Popova is concerned with heavy promotion for smokeless tobacco products like snus.
“There’s been a lot of studies showing that more advertisement for tobacco products makes it more likely that children will use tobacco products,” she said, “and it’s important to keep youth tobacco-free as long as possible.”
SOURCE: bit.ly/1dP5O2Q Nicotine and Tobacco Research, online February 5, 2014.
http://www.reuters.com/article/2014/02/17/us-kids-snus-idUSBREA1G16T20140217

CHART OF THE DAY: How Cigarettes Became Bigger Than Spitting Tobacco 100 Years Ago

, Business Insider
These days, you can’t talk about tobacco without talking about the rise of e-cigarettes.
“By year-end 2013, the e-cigarette category is expected to have doubled to over $1B from $500MM in 2012, according to various industry sources,” noted RBC Capital analyst Nik Modi.
Still, e-cigarettes represent a very tiny fraction of the tobacco business.  Tobacco giant Lorillard recently said that e-cigarettes may have taken 1% of the U.S. cigarette volume.
However, there was once a time when the cigarette wasn’t the dominant product in the tobacco business.
“We point out that it took 45 years for tobacco consumers to transition from smokeless to cigarettes during the late 1800s and early 1900s,” added Modi. “The cigarette’s popularity among tobacco consumers as we know it today was helped by two key catalysts: 1) spitting tobacco was declared unsanitary and disease spreading, leading to spittoons being removed from public places in 1915; and 2) during the Second World War, soldiers were given cigarettes as part of their rations.”
The removal of spittoons a hundred years ago isn’t unlike the bans on smoking we see today.
Who knows where we’ll be 45 years from now?

cotd tobaccoRBC Capital Markets

http://www.businessinsider.com/historical-share-of-tobacco-2013-12#ixzz2nekV5FUw

Study finds cigarette alternatives may not be safer than cigarettes

UC Davis Researchers Examine E-Cigarettes, Cigars, Hookah
Written By CATHERINE MAYO

If you’ve ever been convinced to smoke hookah — or anything else for that matter  — because someone told you it was completely safe, you aren’t alone (but you’ve been lied to).

Are smoking alternatives as safe as people think? UC Davis pulmonary physicians recently published a study concluding these replacements can be addictive gateways to cigarette smoking. The assessment — which focused on cigars, hookah, e-cigarettes and a Swedish smokeless tobacco called snus — provides new insight on why people trying to quit smoking (and those who haven’t started) should avoid all types of tobacco products.

“Everything I included … in some way or another has become popular in America or worldwide… [These products] are the most commonly used, and because [of this], there is a misperception about them,” said Michael Schivo, assistant professor of internal medicine at UC Davis Health System and lead author of the study.

The research team found that because of a lack of regulation and research, e-cigarettes show unclear risks. From 2011-12, e-cigarette use among students in grades six to 12 doubled. Many people trying to quit smoking view e-cigarettes as a safe way to wean themselves off nicotine, but according to the study, Schivo recommended smokeless tobacco before e-cigarettes to better avoid lung cancer and cardiovascular disease. Moreover, for non-smokers trying something new, the nicotine can be dangerously addicting.

Smoking hookah, a technique that employs a special form of tobacco called shisha smoked out of a water pipe, is growing in popularity among college-aged adults and is commonly perceived as a harmless recreational activity, was discovered to be significantly worse than cigarettes. Waterpipe use leads to deeper and longer inhalation of tobacco smoke than other forms of smoking. In fact, the Mayo Clinic says a typical one-hour-long hookah session consists of 200 puffs compared to the cigarette’s average of 20 puffs. Nicotine levels are reduced in waterpipe smoking, but the amounts of arsenic, chromium and lead — chemicals known to be carcinogens — are all significantly higher.

While this information may come as a shock to some, many others know it and choose to ignore it as best they can.

“I’m sure that almost everyone who smokes … has been told countless times that they should stop. It’s not that they don’t know the risks, it’s just a tough habit to quit,” said Brad Howard, a second-year civil engineering major.

The study arrives in the final months of UC Davis’ tolerance for smoking. Beginning in January 2014, the UC Davis Smoke-Free policy takes full effect. The campus will no longer tolerate any forms of smoking, including e-cigarettes and hookah.

Krystal Wong, a second-year human development major and intern at the Student Health and Wellness Center, welcomes the addition of this new policy.

“Davis is trying to promote a healthier environment … Second-hand smoking can cause health hazards for many students,” Wong said.

Schivo is in support of the new rules.

“Public awareness is good however it’s employed,” he said.

Whether you are for or against the policy, we can at least now know not to believe anyone who tries to convince us smoking alternatives are safe. We only have evidence to prove the opposite. Take it as you will, live your life, be smart.

http://www.theaggie.org/2013/10/24/study-finds-cigarette-alternatives-may-not-be-safer-than-cigarettes/

Tobacco Companies Target Youth, Mislead Public About Smokeless Products In Order To Maintain Profits

By 
British American Tobacco (BAT), the maker of Lucky Strike, Dunhill, and Pall Mall cigarettes, has recently spent some time promoting its smokeless tobacco brands, saying that snus, a moist tobacco that’s typically placed under the upper lip, is “at least 90 percent less harmful than smoking cigarettes.” But new research, meant to serve as information for tobacco policy in the European Union (EU), finds that BAT and other tobacco companies aren’t really concerned about the public’s health and, rather, are more concerned about maintaining profits should cigarette sales decline.
Snus, one of the many forms of smokeless tobacco, is currently banned in every country in the EU except for Sweden. Researchers with the UK Center for Tobacco Control Studies were tasked with finding information regarding transnational tobacco companies’ interests in smokeless tobacco from the 1970s to the present, to better inform policymakers in their decision, according to a statement.

It’s All For The Profits

By comparing the tobacco industry’s internal documents to its campaigns to help reduce public harm with smokeless tobacco, the researchers found that “there is clear evidence that [British American Tobacco’s] early interest in introducing [smokeless tobacco] in Europe was based on the potential for creating an alternative form of tobacco use in light of declining cigarette sales and social restrictions on smoking, with young people a key target,” they wrote.
BAT’s internal documents note cigarettes’ declining popularity, saying, “We have no wish to aid or hasten any decline in cigarette smoking. Deeper involvement in smokeless is strategically defensible. There are fewer people in sophisticated markets starting to smoke. There are increasing numbers of people giving up. There are increasing restrictions on smoking, particularly in public, whether by law or by society.”
An estimated 10 million people currently smoke cigarettes in the UK, and 29 percent ofall citizens of the EU smoke. Numerous campaigns to help people quit — 31 percent of EU smokers have tried to quit in the last year — have been implemented, even including an iPhone app that analyzes smoking habits and provides daily, customized advice. With such campaigns, smoking rates have gone down across the continent.
Although there may be lower levels of the carcinogenic tobacco-specific nitrosamines in smokeless tobacco, the National Cancer Institute says that there are still at least 28 chemicals that have been found to cause cancer. Smokeless tobacco has been found to cause oral, esophageal, and pancreatic cancers.

Smokeless Tobacco, Cigarettes, and the Youth

BAT and other tobacco companies specifically target young people in their smokeless tobacco campaigns, the authors said. Portioning snus made it easier to use for young people, and the companies chose which markets to test throughout Europe based on youth and student populations. When certain brands of snus were launched in the UK, “students were both the target and the means of promotion.”
“The fact that smokeless tobacco investments in Europe coincided with the implementation of smoke-free policies, combined with evidence of the industry’s promotion of dual cigarette and snus use in the U.S., add weight to the concern that transnational tobacco companies may hope to exploit snus as a way to reduce the impact of regulations aimed at reducing smoking rates,” the authors wrote. Last month, a study from the Harvard School of Public Health found that rather than replacing cigarettes with smokeless tobacco, one in 20 middle and high school students were using both.
The authors concluded that the “Swedish experience” with snus could not be generalized to other countries in which snus is not as popular. They say that evidence pointed directly to the industry’s interest in snus “because it could be used in smoke-free environments and could be promoted to young, non-tobacco users to create a new form of tobacco use. This last finding lends support to concerns that smokeless tobacco may lead to, rather than from, smoking.”
Source: Peeters S, Gilmore A. Transnational Tobacco Company Interests in Smokeless Tobacco in Europe: Analysis of Internal Industry Documents and Contemporary Industry Materials. PLOS Medicine. 2013.

Most youth who use smokeless tobacco are smokers, too

By Anne Harding, Reuters
NEW YORK (Reuters Health) – Most young people in the U.S. who use newer smokeless tobacco products are smoking cigarettes too, according to new research.
“These findings are troubling, but not surprising, as tobacco companies spend huge sums to market smokeless tobacco in ways that entice kids to start and encourage dual use of cigarettes and smokeless tobacco,” Vince Willmore, vice president of communications at the Campaign for Tobacco-Free Kids, a Washington, D.C.-based advocacy organization, told Reuters Health in an email.
“From 1998 to 2011, total marketing expenditures for smokeless tobacco increased by 210 percent – from $145.5 million to $451.7 million a year, according to the Federal Trade Commission,” he added.
Swedish-style “snus,” introduced to the U.S. in 2006, and dissolvable tobacco products, introduced in 2008, are arguably less harmful than conventional chewing tobacco because they contain fewer nitrosamines, and have been promoted as safer alternatives.
But public health experts have been concerned that these products could serve as a “gateway drug” to use of conventional smokeless tobacco and to cigarette smoking.
To better understand the prevalence of smokeless tobacco use among young people, Dr. Gregory Connolly of the Harvard School of Public Health in Boston and his colleagues looked at data from the 2011 National Youth Tobacco Survey, which included nearly 19,000 sixth- to 12th-graders from across the country.
Overall, the researchers found, 5.6 percent of young people reported using any type of smokeless tobacco. Five percent used chewing tobacco, snuff or dip, just under two percent used snus and 0.3 percent used dissolvable products.
Among young people who were current smokeless tobacco users, about 72 percent reported smoking cigarettes too, while almost 81 percent of young people who used only snus or dissolvables were also smoking cigarettes.
Just 40 percent of smokeless tobacco users said they had plans to quit using tobacco, according to findings published in Pediatrics.
“We found higher current use than we expected. It’s just not experimentation, it looks like it’s taken hold among adolescents,” Connolly told Reuters Health.
“The most distressing finding was that this is not resulting in children or in young adolescents switching from smoking to these new products that may or may not be safer when used alone. They’re using both in very high numbers.”
Little information had been available on trends in the use of novel smokeless tobacco products, so studies like this one are important, Dr. Neal Benowitz, who has studied the health effects of smokeless tobacco at the University of California, San Francisco, told Reuters Health.
“To me the fact that 72 percent of users concurrently smoke cigarettes is a serious issue,” he said. “These would be safer alternatives only if people used them exclusively, and as soon as you’re talking about dual use you virtually negate any reduction of harm.”
Benowitz, who was not involved in the current research, noted that studies have shown use of smokeless tobacco among U.S. youth can indeed be a gateway to cigarette smoking.
“The most disturbing finding is that a huge percentage of youth smokeless tobacco users also smoke cigarettes,” Willmore said.
“This indicates that smokeless tobacco compounds the problem of overall tobacco use in the United States, rather than helping to solve it as some tobacco companies claim.”
RJ Reynolds, which makes Camel Snus and dissolvable tobacco products including Camel Orbs, Sticks and Strips, did not respond to a request for comment by press time.
“The tobacco industry is facing the 21st century with a whole new strategy, and that is to bring in new products that they claim to be safer,” Connolly told Reuters Health.
He pointed out that under the Family Smoking Prevention and Tobacco Control Act, passed in 2009, the U.S. Food and Drug Administration is charged with regulating tobacco products, including smokeless tobacco.
“When we look at this data I think it is very disturbing to realize that the law has not kept them out, and at least in this data set they’re gaining traction among young people,” Connolly said.
SOURCE: http://bit.ly/13INoAt Pediatrics

Letter: Harm-reduction not best public policy for tobacco

There has been a good deal of talk about “harm-reduction” strategies (promoting alternative tobacco products, such as chewing tobacco or e-cigarettes, as safer alternatives to smoking cigarettes) as being good options for tobacco users to reduce the risk of using tobacco while maintaining the addiction to nicotine.
Reducing-harm strategies can be an option for an individual who wants to try to reduce his or her own risk of harm while maintaining an addiction. However, when it comes to tobacco use, harm-reduction strategies are not the best public policy to use to address the population-based well-being that public health strategies must address.
• How would it be if the public health professionals advocated for food handlers to wash their hands most of the time after using the bathroom rather than every time? After all, it would reduce the chances of contracting disease from someone who never washed his/her hands. One could say it is better than never washing one’s hands. The public policy must continue to be the best method of preventing disease transmission, that is: wash one’s hands every time, not just sometimes.
• I hear a lot about smokeless tobacco being a good alternative for adult smokers who don’t want to quit using tobacco. Consider this: It is not just adults who use chew. The sweeteners added and new products that have come on the market make it an easy way to addict our next generation to tobacco. North Dakota’s youth consume smokeless tobacco at a rate almost twice the national average (N.D., 13.6 percent, U.S., 7.7 percent). In addition, smokeless tobacco is not without its health hazards.
• E-cigarettes are often touted as a good alternative to tobacco use. We are told by some that the vapor is harmless. This is not true. It has not been regulated or studied enough to know how dangerous it is, but it is not harmless. There is another issue to consider. Have you ever noticed how candy cigarettes and now e-cigarettes mimic the activity a smoker would do with a cigarette? It models the smoking behavior and should not be discounted as harmless.
One of the core functions of public health is to promote strategies that protect the health and safety of the community. Public health providers are accountable to the community to provide up-to-date information and advocate for tried-and-true strategies to improve or maintain a community’s health status.
As a public health nurse, I cannot support harm-reduction policies that supports maintaining one’s addiction to tobacco. Harm- reduction policy is not sound public health policy.
The rationale that was brought up recently in a letter to the editor, that the tobacco user who is not willing or able to quit should have chewing tobacco or e-cigarettes researched and funded with tobacco prevention dollars in the state of North Dakota, falls short. The evidence is readily available regarding what works and how to gain access to help. The options are available, and they are FDA-approved and researched for safety and effectiveness. They are called nicotine replacement therapy and NDQuits at (800)-QUIT-NOW.
Knox, RN, is master of public health and certified tobacco treatment specialist with the Grand Forks Public Health Department Tobacco Prevention Program.
http://www.inforum.com/event/article/id/408308/

'Cowboys get cancer, too,' says speaker at smokeless tobacco summit in Missoula

By Alice Miller
For nine months, James Capps didn’t have a bite of food. He had to pour nutrition drinks into a feeding tube to get nourishment while he underwent and recovered from treatment for oral cancer.
Smokeless tobacco is dangerous, and Capps’ story is the testament.
Capps is featured in a short video and advertising campaign in Oklahoma that shares his story. After the video’s first week on television, the number of people requesting tobacco-cessation aids jumped 300 percent.
Capps said he loves his new role as an advocate and hopes his story gives people the push they need to quit.
“You don’t need that crutch to be someone you want to be,” he said. “You should do it without tobacco.”
Capps traveled to Missoula from his hometown of Atoka, Okla., to receive the Cliff Niles Creative Media Award during the seventh National Smokeless and Spit Tobacco Summit, held at the University of Montana this week.
The summit, held every other year, focuses on prevention and research about smokeless tobacco. Hundreds of people from around the country are attending the summit, which features more than 70 presentations.
UM’s College of Health Professions and Biomedical Sciences hosted the event and received $32,250 from the National Association of Chronic Disease to plan the summit, which is the only national conference of its kind.
Smoking takes center stage when people talk about tobacco use, said Patricia Nichols, an independent consultant for Montana’s Tobacco Use Prevention Program and co-chairperson of the summit’s smokeless advisory board.
However, smokeless tobacco is just as dangerous. It causes cancer and contributes to cardiovascular disease, Nichols said.
“We want people to know that this isn’t a safe habit, even if your grandpa did it,” she said.
Smokeless tobacco use tends to be more common in rural areas because it allows manual laborers to get the kick tobacco provides without tying up their hands, she said.
And smokeless tobacco requires people to spit.
“Which is a lot easier in rural locations,” she said.
***
Tobacco companies are constantly putting new products on the market, she said, and the rise in smoke-free public spaces and businesses equates to a resurgence in use of smokeless tobacco products.
As with other tobacco products, companies are targeting the younger generation, because they need more people to replace those who have quit or died, Nichols said.
One way Montana is fighting back against tobacco company advertising to younger people is through a tobacco-free rodeo program.
In 2010, the Montana High School Rodeo Association agreed to the Montana Tobacco Use Prevention Program’s request for the organization to adopt a more stringent tobacco-free policy, said Crissie Hansen, a prevention specialist out of Dillon.
Most parents, rodeo workers and fans abide by the policy, which prohibits tobacco use by anyone during rodeo events.
“We really have not had any friction on it,” Hansen said in response to a question about community feedback on the policy during a presentation Tuesday at the summit.
In addition to the policy, about 200 rodeo athletes have taken a pledge not to use tobacco. Athletes must sign the pledge if they want to participate in the reACT rodeo series and have a chance at end-of-season prizes. reACT is a student-based program advocating against tobacco use.
The rodeo program is a way for health workers to reach kids where they play – venues where tobacco companies have traditionally excelled, said Alison Reidmohr, a health educator with the Montana Tobacco Use Prevention Program.
Changing how kids look at tobacco and its use helps alleviate peer pressure to do something that has been associated with the rodeo scene, she said, adding some athletes are sharing their personal stories through commercials.
***
Capps, the Oklahoman who’s speaking out against smokeless tobacco, said he knows well the pressure cowboys feel to use tobacco.
Capps was hooked by the time he was 15, and he began dipping because that’s what every good Oklahoma cowboy did.
“So I thought dipping snuff was the way to fit in,” he said.
Girls thought it was nasty.
“Well, we’d just get another girlfriend,” he said.
Thirty years after he began dipping snuff, Capps got oral cancer at the base of his tongue. Because doctors couldn’t get to the tumor surgically, they put a port in his neck and pumped chemotherapy drugs directly to the tumor – 24 hours a day, seven days a week for seven weeks.
He received radiation therapy five days a week over the same time. Now, he has difficultly speaking, suffers from dry mouth and must wash down every bite of food with water.
The risks of getting cancer were there for him to see.
“I believe everybody knows there’s that chance,” he said. “But the key thing is this: It will never happen to me.”
Today, Capps knows differently.
“Now I know cowboys get cancer, too,” he said.
http://missoulian.com/news/local/cowboys-get-cancer-too-says-speaker-at-smokeless-tobacco-summit/article_5445e1e2-ff04-11e2-b71d-0019bb2963f4.html

1 in 20 School-Aged Kids Use Smokeless Tobacco

Susan E. Matthews, Everyday Health Staff Writer
Approximately 1 in 20 school-aged U.S. kids use smokeless tobacco products such as dip, chewing tobacco or snuff, a new study found. While smokeless products are often promoted by tobacco companies as “healthier” options, the study also found that teens who use them are not replacing traditional tobacco with smokeless tobacco, but instead are using both.
Since young people aren’t switching products and are instead combining them, any potential health benefits associated with switching to smokeless brands are lost. In fact, by using both types of products, young adults may actually be increasing their risks for tobacco-associated illnesses.
And in a blow to the idea that transitioning to smokeless products might help teens quit tobacco, the survey showed that less than half — 40.1 percent — of smokeless tobacco users intended to quit.
Researchers from the Harvard School of Public Health used data from the 2011 National Youth Tobacco Survey, which included more than 18,000 students in grades 6 through 12 who were asked about their use of a variety of tobacco products over the previous 30 days. Of the surveyed students, 5.6 percent used smokeless tobacco products, and 72.1 percent of these students also used conventional tobacco products including cigarettes, cigars, and water pipes.
In recent years, several novel forms of smokeless tobacco have come onto the market, such as snus, which is moist snuff, and dissolvable tobacco. Of the students using smokeless tobacco, 5 percent used traditional products, while 1.9 percent used snus, and 0.3 percent used the dissolvable tobacco. Compared to traditional smokeless tobacco and cigarettes, these products contain fewer carcinogenic nitrosamines, and may pose less health risk. As a result, tobacco companies have promoted them as a better tobacco alternative.
Males in the survey more likely to use smokeless tobacco products than females (9 percent versus 2 percent), and students over 18 were also more likely to use them than students aged 9 to 11 (10.8 percent compared to 2.2 percent). Smokeless tobacco use has stayed relatively consistent, at around 5 percent, while cigarette use has declined over the past decade, the researchers noted.
“Promotion of snus or dissolvable tobacco products at a population level may not have benefits and might even cause harm from dual use with combustible and/or conventional smokeless tobacco products,” the researcher wrote in the study, published in Pediatrics. Student who reported noticing warning labels on the products were actually more likely to use tobacco, suggesting that these warning aren’t effective, according to researchers.
The American Academy of Pediatrics has called for further regulation of novel tobacco. The study authors suggested more effective warning labels on smokeless products, and that physicians take more initiative in bringing up the harms of smokeless tobacco in consultations with young adults.
Based on the survey results, the researchers concluded that peer pressure was the most likely influence on smokeless tobacco use. If a close friend used these products, an individual was almost 10 times more likely to also use them, the study found.
Another study out today in Pediatrics found that children of smokers were 3.2 times more likely to smoke than children of non-smokers, even if the smoking parent had quit before the child was born. For children over age 11, smoking prevalence ranged from 23 to 29 percent of children whose parents had once smoked, compared to 8 percent of children of parents who had never smoked. The researchers, from Purdue University and Pennsylvania State University, suggested the study supported the idea of genetic predisposition towards smoking.
http://www.everydayhealth.com/stop-smoking/1-in-20-school-aged-kids-use-smokeless-tobacco-7884.aspx

New tobacco products lure younger smokers

By Adelaide Effie Beckman
For The TimesDaily
It remains illegal to market tobacco products to teenagers, but some health experts argue it hasn’t stopped some companies from finding a way around the law.
Tobacco companies are now targeting teens with cheap nicotine products in colorful packaging, according to Melanie Dickens, tobacco prevention and control coordinator for the Lauderdale County Health Department.
Dickens said teens are more susceptible to the new flavored tobacco products such as nicotine sticks and orbs.
However data collected by the Alabama Department of Public Health shows that the number of high schools students who smoke has significantly decreased. Nearly 19 percent of high school students in Alabama smoked in 2010, compared to 30.2 percent in 2000.
Nicotine sticks look like toothpicks, but they are pure nicotine. Dickens said teenagers can easily have them in their mouths without attracting attention from their parents or their teachers. She added nicotine orbs are small dissolvable tablets of nicotine that come in different flavors, which “look like little Tic-Tacs.”
Dickens said parents don’t always know if their children are using tobacco because the new nicotine products don’t create the smoke or smell of cigarettes and cigars.
“A lot of times if the kids are not using cigarettes . . . mom and dad might not be aware,” she said.
Dickens said teens often don’t realize how much nicotine they’re using. One Black and Mild cigar has the same amount of nicotine as 10 cigarettes, and one pinch of smokeless tobacco has the same amount of nicotine as three or four cigarettes. Both products are popular with teens, she said.
“They feel invincible; that’s why they don’t want to quit,” she said. “It’s an addiction and a habit.”
Talking to children early on about the dangers of tobacco use is the best way to keep them from becoming smokers, according to Valerie Thigpen, prevention specialist for the Lauderdale County schools district.
“If you wait until they’re in the sixth grade, they’ve already been exposed,” she said.
Thigpen said children need to be taught the risks associated with tobacco and how to say no to peer pressure.
“I am a major believer in if you can prevent someone from starting, it’s a whole lot easier than getting someone to stop once they’ve started,” Thigpen said.
There are lots of reasons teens smoke or use smokeless tobacco, Dickens said. Peer pressure, boredom and marketing all play a role. Thigpen said teens often smoke because their parents do.
University of North Alabama student Jestin Coats said he only smokes when he’s stressed after a long day. He said he rarely smokes, maybe once every nine months, and he has no trouble stopping once he’s started.
Coats said he had his first cigarette when he was 19 and his parents didn’t know. “I don’t want them to.”
The Centers for Disease Control and Prevention say other factors that contribute to tobacco use in teens are low socioeconomic status, lack of parental support or involvement, low self-image or self-esteem, low levels of academic achievement and exposure to tobacco advertising.
Religious participation, racial/ethnic pride and higher academic achievement or aspirations are factors that have been found to protect teens from tobacco use.
“Tobacco is a huge issue with a lot of our high school students,” Thigpen said. “They tell me, ‘I just like it. I like the way it makes me feel. It calms me down.’ The kids seem to live by ‘if it feels good, do it,’ because if it brings them pleasure they can’t get enough of it.”
Officials with the disease control center say tobacco use in teens is associated with high-risk sexual behavior, use of alcohol and use of marijuana and other drugs.
“Tobacco is still truly the gateway drug,” Thigpen said.
“We’re not saying that everyone who uses tobacco is going to use bigger things,” Dickens said, adding it’s a risky behavior that leads to other risky behaviors.
Katelyn Cosby, 22, a resident of Rogersville, said she started smoking when she was 14 or 15.
“My mom was not happy,” Cosby said. “She used to steal my cigarettes out of my purse and put ‘how to quit smoking’ pamphlets in my purse. I usually just gave them back to her.”
Cosby said she started smoking because many of her friends were smoking. She quit smoking while she was pregnant with her children, but she said she hasn’t made the effort to quit permanently because it’s too much of a habit.
“It’s weird to try not to (smoke),” she said.
Dickens said 6.3 million children who are alive today will eventually die of tobacco related illnesses if the current rates of tobacco use do not change.
“(Not using tobacco) is the one thing you can do to reduce your risk of cancer,” said Amy Fields, a spokeswoman for the American Cancer Society. “People who quit at any age, whether they’re young or old, they’re going to live longer.”
Fields said as many as one-third of cancer deaths could be prevented if people avoided tobacco products. Lung cancer is the cancer most commonly associated with smoking, but using tobacco products increase a person’s risk of developing all types of cancer.
“Kids have no idea the damage they do to themselves (by smoking),” Thigpen said.
Dickens said teens should try to break their smoking habits as soon as possible because the longer a person smokes, the harder it is to quit.
For information on how to quit, Dickens suggested calling 1-800-QUIT-NOW or talking to a health care provider.
Fields said her advice to parents whose children smoke is to do everything possible to help their children kick the habit immediately.
http://www.timesdaily.com/news/local/article_4488ab9a-ec3a-11e2-bb9b-10604b9f6eda.html