Combustible and Smokeless Tobacco Use Among High School Athletes—United States, 2001-2013

September 4, 2015 / Vol. 64 / No. 34

MMWR Introduction

During 2001-2013, current smokeless tobacco use increased significantly among high school athletes, but not among high school non-athletes. Furthermore, athletes reported higher use of smokeless tobacco, but lower use of combustible tobacco products, than non-athletes. The lower use of combustible tobacco products among athletes might reflect an awareness of the adverse consequences of smoking on athletic performance, including reduced lung and cardiovascular function, reduced overall fitness, and poor wound healing. However, the higher smokeless tobacco use among athletes compared with non-athletes suggests athletes might perceive these products as being harmless, socially acceptable, or even a way to enhance athletic performance. Using smokeless tobacco products, however, can adversely affect athletic performance and cause disease and premature death as they contain nicotine, toxins, and carcinogens. Several celebrated US athletes with a history of smokeless tobacco use have been diagnosed with—or died from—oral cancer. Hence, efforts are warranted to educate youth about the dangers of use of all forms of tobacco.

Implementing and enforcing tobacco-free policies that prohibit all tobacco use in school campuses and all public recreational facilities—including stadiums, parks, and school gymnasiums—by players, coaches, referees, and fans might help reduce use of smokeless tobacco and other forms of tobacco among student athletes. In addition, continued implementation of other evidence-based interventions outlined in the CDC Best Practices for Comprehensive Tobacco Control Programs is also critical to reducing all forms of tobacco use among youth. These include increasing tobacco prices, warning about the dangers of tobacco use, and increasing access to smoking cessation resources.