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Reading of Tony Gwynn’s death June 16 from oral cancer, which he blamed on his ugly chewing tobacco addiction during his baseball days, got me thinking about dangerous habits that start young.
I grew up in Montana, where the cowboy culture was strong and a plug in the mouth was commonplace. Baseball was big those days too, so seeing players, national and local, spit tobacco as they came up to the plate was as predictable as it was gross. Today, thanks to anti-tobacco campaigns and ballclub crackdowns, chew cuts a much lower profile.
So what’s filling the gap? E-cigarettes, also marketed with hipper names like “vape” pens or pipes and “e-hookahs.”
Maybe you’ve seen these devices on the news. They look like cigarettes, but are battery-powered and produce a vapor that usually contains nicotine. Unregulated and cheap at about $25, e-cigarettes first won kudos for use in cigarette cessation programs. Then shrewd marketers rebranded the devices as vape and hookah pens, available in a rainbow of colors and with enticing, sweet vapor flavors like jelly bean, vanilla cupcake, banana nut bread, chocolate candy bar, strawberry margarita and many, many more. The nicotine is still there, with levels varying from 0-24 milligrams — the amount of nicotine in a pack of 20 cigarettes.
The facts are troubling: e-cigarette sales are exploding, doubling since 2012 to $1.7 billion last year, with no age limit on sales so far. The number of stores selling them quadrupled in the last year alone. Middle-schoolers are finding them on the Internet.
Ten percent of U.S. high school students tried e-cigarettes in 2012, double the number the year before, according to a Centers for Disease Control and Prevention survey. But CDC officials concede there might have been a language barrier. Young people said they have not or will not use an e-cigarette, though they have tried hookah pens, e-hookahs or vape pens. Worse yet, some interviewed on high school and college campuses labeled the hookah pens as “less dangerous” than e-cigarettes.
“E-cigarettes are for people trying to quit smoking,” one high school student told a New York Times reporter this spring. “Hookah pens are for people doing tricks, like blowing smoke rings.”
Numbers in Illinois back up the nation’s trend. According to the Respiratory Health Association, smoking among adolescents dropped to 10.7 percent from 13.6 percent from 2011 to 2013. That’s good news, to be sure.
“Unfortunately,” said the association’s Emily Zadikoff, “the smokeless tobacco rate increased both city and statewide and cigar use rose statewide as well. In fact, there was actually a spike in smokeless tobacco use in 2009 that has yet to subside.”
She said prevention campaigns have the biggest impact if they include consequences that are relevant to a young person.
“Typically youth are not concerned about long-term health consequences of tobacco use such as cancer or death,” she said. “Youth are generally more perceptive to prevention messages that include short-term consequences, like how use affects their image, the smell, the cost of tobacco, the ‘gross-factor’ (what is in tobacco), that it’s toxic, educating them on Big Tobacco’s tactics to manipulate and target them, etc.”
Dentists have an influential role, said Ms. Zadikoff, and they can nip tobacco use early by sharing their exam findings with the patient.
“This is an important, teachable moment,” she said. “Advice to quit tobacco use by a healthcare professional increases quit rates significantly. Young people may be more receptive to the message from a trusted dentist — who sees evidence — rather than from their parents.”
Put that teachable moment to use.
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