Standing Up to Smokeless Tobacco

The carcinogenic product’s use by college and professional athletes contributes to its use among male high school athletes.

UCSF’s Benjamin Chaffee, DDS ’08, PhD, MPH, is on a mission to make a dent in the nation’s alarming rate of smokeless-tobacco use. 

Cigarette-smoking rates among teens and young adults had declined for years before a slight uptick in 2020 because of the pandemic and negative issues surrounding vaping. However, the use of smokeless tobacco – also called “dip” or “chew” – has remained virtually unchanged among adolescent boys, even though such products are known to cause mouth cancer and dental disease. The rate is especially high in rural areas. 

Chaffee, an epidemiologist, dentist, and associate professor in the Department of Preventive and Restorative Dental Sciences, co-authored a comprehensive 2015 report on the role of sports in promoting smokeless tobacco. It revealed that high school athletes were 60 percent more likely to use smokeless tobacco than non-athletes and that nearly 15 percent of US high school-age males used smokeless tobacco. Chaffee and his colleagues also found a strong association between the use of smokeless tobacco by adolescent males’ role models – family members, friends, coaches, elite athletes – and its use by teens themselves. They identified exceptionally high usage in organized baseball, including in the pro leagues. 

Chaffee published a 2018 study measuring how baseball players at rural high schools in Northern California perceived smokeless-tobacco usage by professional baseball players, compared to the teen players’ actual use and susceptibility to usage. More recently, his 2020 study found that approximately the same percentage of male US high school students uses smokeless tobacco as smokes cigarettes, but the smokeless-tobacco users are exposed to higher levels of nicotine and a tumor-promoting tobacco carcinogen called NNK.  

Chaffee hopes his work will lead to regulatory and public-health efforts aimed at keeping young people from trying tobacco and becoming hooked. In 2015, the San Francisco Board of Supervisors passed the country’s first ordinance banning the use of any tobacco products by fans or players, including pros, at all baseball venues and athletic fields within the city. Similar rules have since been passed in other locales around the country. 

But Chaffee isn’t limiting his efforts to the US. He’s also the director of UCSF’s Global Oral Health Program, through which he’s connecting UCSF dental students with research opportunities to promote community oral health and reduce inequalities.

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