Intervention Plan Nixes Tobacco Use

By Staff

Coaching Management, 14.2, February 2006,

According to an NCAA study, 40 percent of college baseball players use smokeless tobacco on a regular basis—despite a formal ban by the association. That’s a higher percentage of athletes than in any other collegiate sport, making baseballers particularly susceptible to oral cancer, periodontal disease, tooth decay, nicotine addiction, and cardiovascular disease.

“At every level of the game, baseball athletes are at high risk for using smokeless tobacco,” says Margaret Walsh, a professor at the University of California School of Dentistry and one of the authors of “Cluster-Randomized Controlled Trial of an Athletic Trainer-Directed Spit (Smokeless) Tobacco Intervention for Collegiate Baseball Athletes,” published in the Summer 2005 issue of the Journal of Athletic Training. “This study shows that a brief intervention can help prevent smokeless tobacco use among college baseball athletes.”

Working with the National Athletic Trainers’ Association (NATA), Walsh conducted the study along with researchers from West Valley College, Fullerton College, Major League Baseball, and the Los Angeles Angels of Anaheim. The researchers circulated questionnaires on tobacco use to 1,585 volunteer varsity and junior varsity baseball players at 52 California colleges and universities. Approximately half of the baseball programs were then assigned to a control group, which received no special intervention beyond what’s normally done on their campuses and in their athletic departments.

Players at the other schools were enrolled in a specially designed intervention and prevention program. First, they were screened by volunteer dentists and hygienists who had been trained through a videoconference and printed training manual. Nonusers weren’t specifically counseled, but they did take part in an hour-long session led by team leaders they’d identified in their first questionnaire. These sessions included graphic slides of facial disfigurement caused by oral cancer, and a pair of videos, Dangerous Game: The Truth About Spit Tobacco, and Tragic Choice: The Bob Leslie Story. The latter concerns a high school coach who started chewing at age 13 and quit 14 years later, only to develop oral cancer and die at age 31. The team leaders then led a group discussion in which they emphasized that using is a personal choice, but that everyone should be informed of the potential consequences before making it.

The program helped keep nonusers from starting smokeless tobacco, with the number of new users in the intervention group (5.1 percent) significantly smaller than the number of new users in the control group (8.4 percent). However, while more than a third of the using athletes in the intervention program quit, that was no better than the rate among the control group.

The key to success was the support of coaches and athletic trainers, says Walsh, who believes that other colleges could easily recreate the study’s intervention program by working with local dental professionals. “This program works,” says Walsh. “Coaches are very potent role models for their players, and when coaches are supportive of a program like this, their athletes are less likely to initiate tobacco use.”