Something Healthy to Chew On: Tips on Spit

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Dentists and Physicians Join Forces Against Smokeless Tobacco in the MLB

Together, the Massachusetts Dental Society (MDS) and the Massachusetts Medical Society (MMS) are committed to reducing tobacco use in all of its forms, especially smokeless tobacco. For that reason, the MDS has joined forces with the MMS by releasing a joint commentary to educate patients that smokeless tobacco is not harmless, and encourage Major League Baseball to ban smokeless tobacco use at games by its players. The commentary, written by MDS President Dr. Anthony Giamberardino and MMS President Dr. Richard Pieters, cites the influence that baseball players have on children and teens, and the positive impact that banning the substance would have on preventing younger generations from adopting a very unhealthy habit. To make their point, Dr. Giamberardino and Dr. Pieters point directly to the recent death of Hall of Famer Tony Gwynn, whose battle with oral cancer is attributed to his lifelong use of chewing tobacco. Read Commentary Here



Curt Schilling's Powerful Message to His Younger Self: Say NO to Smokeless Tobacco

In a personal piece published by The Players' Tribune, Curt Schilling, former pitcher for the Boston Red Sox, warns his 16-year-old self that accepting a dare of using chewing tobacco will lead to life-threatening mouth cancer and become a major regret in an otherwise idyllic life filled with family, friends, and baseball.


Red Sox Player Goes to Bat for the MDS


The MDS has launched an anti-smokeless campaign with NESN. Shane Victorino, outfielder for the 2013 World Series champions Boston Red Sox, is featured in a 30-second commercial. The player also appears on a poster the MDS has produced as part of the campaign.




With smokeless tobacco, it's not the nicotine that causes cancer; it's the other chemicals in tobacco products.

It's not surprising that the most serious effect of using smokeless tobacco—also known as spit tobacco, chewing tobacco, or dip—is an increased risk of cancer of the mouth and pharynx. Smokeless tobacco is absorbed quickly and directly through the inside of the mouth, making it very dangerous . . . and potentially deadly. Research has shown more than half of smokeless tobacco users have noncancerous or precancerous lesions in their mouth, with their chance of getting oral cancer being 400 percent greater than for nonusers. Oral cancer kills 50 percent of its victims within five years of diagnosis


A report in the Journal of the American Medical Association calculated that smokeless tobacco users who use chew or dip eight to 10 times a day could be exposed to the same amount of nicotine as people who smoke 30 to 40 cigarettes a day.

How is this possible? Because smokeless tobacco has a higher dose of nicotine than cigarettes. An average dose of nicotine in chewing tobacco is 4.6 mg compared with 1.8 mg in a cigarette. And it's the nicotine that makes you addicted.

What is smokeless tobacco?

The term "smokeless tobacco" was coined by a tobacco company to make it sound harmless to users. However, according to the MDS, there is no such thing as "harmless tobacco."

There are two forms of smokeless (or spit) tobacco: chewing tobacco and snuff tobacco.

      Chewing Tobacco

Packaged in a pouch, chewing tobacco is usually placed between the cheek and gum, with users keeping it in their mouths for several hours to get a continuous high from the nicotine in the tobacco.

        Snuff Tobacco

Usually sold in cans, snuff tobacco is placed between the lower lip and the gums. Just a pinch is needed to release the nicotine, which is then swiftly absorbed into the bloodstream, resulting in a quick high.



"If I had known then what I know now, I never would have put dip in my mouth."

Smokeless tobacco's direct and repeated contact with the gums causes them to recede, which can eventually result in tooth loss.

If you use smokeless tobacco, your risk of developing heart disease increases. The constant flow of nicotine into your body causes greater risk of heart disease, increased blood pressure, and sometimes irregular heartbeats leading to a greater risk of heart attacks and strokes.

Like many teenagers, Gruen Von Behrens first tried smokeless tobacco at age 13. By age 17, he had been diagnosed with oral cancer. Since then, he's had nearly 30 disfiguring surgeries to save his life, including one surgery that removed half of his neck muscles, lymph nodes, and half of his tongue.

If you use smokeless tobacco, check for these early warning signs:


  • A sore in your mouth that bleeds easily and doesn't heal
  • A lump or thickening anywhere  in your mouth or neck
  • Soreness or swelling that doesn't go away
  • A red or white patch that doesn't go away
  • Trouble chewing, swallowing, or moving your tongue or jaw


"If I had known then what I know now, I never would have put dip in my mouth. Spit tobacco seemed harmless, but it has ruined my life.”—Gruen Von Behrens 


Pain is rarely an early symptom of oral cancer. For this reason, all tobacco users need regular dental checkups. Even if you don't find a problem, see your dentist for a mouth check every three months. Chances for a cure are best if oral cancer is detected early.

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