Collegiate Baseball Athletes are Less Likely to Initiate Smokeless Tobacco Use with Proven Intervention Program

National Athletic Trainers’ Association (NATA) and Other Organizations Seek Methods to Decrease its Use and Reduce Adverse Heath Effects

DALLAS, July 20 – Among all college athletes, baseball players are the biggest users of smokeless tobacco (ST), according to the National Collegiate Athletic Association (NCAA). Despite a formal NCAA ban in 1994 against ST during games and practices, 40 percent of players use it on a regular basis. This high prevalence of use has alarmed the National Athletic Trainers’ Association (NATA), college teams, Major League Baseball and other organizations, which are concerned about its adverse health effects – oral cancer, oral leukoplakia (a precancerous lesion), cardiovascular disease, periodontal disease, tooth decay and nicotine addiction. Researchers have found that many college and professional baseball athletes begin using ST as early as 17 years old. In a study published in the Summer 2005 issue of the Journal of Athletic Training, a group of health care experts* from the University of California in San Francisco, Calif., West Valley College in Saratoga, Calif., Fullerton College in Fullerton, Calif., Major League Baseball and the Los Angeles Angels of Anaheim designed a one-year study to determine whether a smokeless tobacco intervention program, overseen by certified athletic trainers, could discourage initial sampling of ST, as well as motivate male collegiate baseball athletes to quit using ST. The study – “Cluster-Randomized Controlled Trial of an Athletic Trainer-Directed Spit (Smokeless) Tobacco Intervention for Collegiate Baseball Athletes: Results After 1 Year” – shows that when athletic trainers coordinated the prevention program, the participants were 42% less likely to initiate ST use than the baseball athletes in the control study. “This ‘prevention of ST use’ effect may look modest, says study researcher Margaret M. Walsh, MS, EdD, professor at the University of California, San Francisco. However, when viewed in light of the high risk of ST use among males who play college baseball and other sports, this effect could have an enormous impact on the health of student-athletes in U.S. colleges if the program was adopted nationally.” The study can be seen in its entirety at Until now, no consistent intervention program has been established to discourage the use of ST among college baseball athletes. The authors focused their efforts on baseball athletes attending California colleges and universities. During the 1999-2000 school year, 1,585 baseball players at 52 schools participated in the study – 883 players in 27 collegiate settings with an intervention program and 702 players in 25 control settings (i.e. where no intervention was made). All athletes completed baseline and follow-up questionnaires (12 months later) to determine their ST-use status. Baseball players at the intervention colleges were given an oral cancer screening by a dentist or dental hygienist, plus a counseling session; ongoing encouragement from their athletic trainers to quit using smokeless tobacco, along with group discussions about successful coping strategies; and a peer-led team meeting where players were shown two videos called Dangerous Game: The Truth About Spit Tobacco and The Tragic Choice: The Bob Leslie Story. Athletes were also shown slides featuring graphic pictures of facial disfigurement due to oral cancer. “Recognizing the general mass appeal that professional baseball players and their behaviors have on collegiate and even high school athletes, we at Major League Baseball are excited at the long-term implications of the program and its impact at all levels of the sport,” adds researcher Ned Bergert, ATC, head athletic trainer at the Los Angeles Angels of Anaheim. “To make this program truly successful, student athletes must be committed to stopping their addiction or not to start in the first place. Only then will they benefit from this type of intervention program which offers timely guidelines and the support of athletic trainers and other healthcare professionals to make it a win-win.” Although the intervention was significantly effective in preventing initial use of smokeless tobacco, it did not significantly increase the number of baseball players who stopped using ST compared to the control group, Walsh says “this finding is inconsistent with previous studies and may be explained by other anti-tobacco activity in control college settings. Future research is needed to determine the efficacy of the separate components of the intervention on ST use among collegiate athletes.” * Study researchers included: Stuart A. Gansky, DrPH, University of California, San Francisco; James A. Ellison, DDS, MPH, University of California, San Francisco; Diane Rudy, MS, ATC, West Valley College, Saratoga, Calif.; Ned Bergert, ATC, Los Angeles Angels of Anaheim, Los Angeles, Calif.; Mark A. Letendre, ATC, Major League Baseball, New York, NY; Lisa Nelson, ATC, Fullerton College, Fullerton, Calif.; Catherine Kavanagh, University of California, San Francisco; and Margaret M. Walsh, MS, EdD, University of California, San Francisco. About the NATA: Certified athletic trainers (ATCs) are unique health care providers who specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses that occur to athletes and the physically active. The National Athletic Trainers' Association represents and supports 30,000 members of the athletic training profession through education and research. NATA, 2952 Stemmons Freeway, Ste. 200, Dallas, TX 75247, 214.637.6282; 214.637.2206 (fax).

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