Chewing or smokeless tobacco, even with the publicity warnings for US citizens by the Center for Disease Control (CDC), plus campaigns sponsored by organized baseball and medical societies, is still in our schools today.  Approximately 20 percent (1 out of 5) high school boys and two percent of high school girls continue to use smokeless tobacco.  There are about 14 million American users, over a third are under age 21.  Research reveals that more than half of those 14 million people developed their habit before 13 years of age.  Peer pressure is just one of the many reasons for starting the habit.  Serious users often graduate from brands that deliver mild nicotine to stronger brands.  With moderate consumption, the user needs more of the drug to get the same feeling.

Fortunately, there has been progress.  The organizer of America’s fastest growing sport, National Association for Stock Car Auto Racing (NASCAR) dropped its long-time affiliation with tobacco in 2010.  However, Pediatrician need to be aware that there have been setbacks in the fight against tobacco use.  New marketing campaigns that feature flavored smokeless products has won over new young users.  The National Cancer Institute noted that “candy flavors were added to smokeless tobacco products, cigars and cigarette rolling papers.”  So, there is no doubt who the tobacco companies are marketing their products.  Gregory Connolly, senior author of a study and a professor of The Practice of Public Health at Harvard School of Public Health noted, “Tobacco companies are using candy-like flavors and high tech delivery devices to turn a blowtorch into a flavored Popsicle; misleading millions of youngsters to try a deadly product.”

Patricia Richter, Ph.D. with CDC stated “Consumers need to know that smokeless tobacco products, including loose-leaf and moist snuff, are NOT safe alternatives to smoking.  The amount of nicotine absorbed per dose from using smokeless tobacco is greater than the amount of nicotine absorbed from smoking one cigarette.”  Study results suggest that smokeless tobacco including moist snuff may be more harmful than cigarette smoking and that smokeless products are in fact a cause of oral cancer in humans.”

The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) wants to help “finish the fight against cancer” by educating Americans about ear, nose and throat (ENT) manifestations of tobacco use, smoked, chewed or dipped – and their relation to cancer of the lips, mouth, throat and voice box (larynx); chronic rhinitis and sinusitis; chronic cough; gum disease; and precancerous lesions of the mouth and throat.

The physicians at Oklahoma Otolaryngology Associates treat their oral cancer patients with great care.  Their knowledge of and therapeutics for head and neck cancer evolves as new research is verified, treatment through chemo-radiation is carefully considered along with concern for organ preservation.  Our physicians take extra precautions when their patients are HPV positive.  In their care planning, there are always stages of de-escalation with high expectations of helping their patients eventually living happy, productive lives.  OOA physicians are experts at blending current knowledge with state-of-the-art treatments.

*American Academy of Otolaryngology-Head and Neck Surgery,