Part of what I do every day entails taking care of patients with head and neck cancer. Last week, one of my patients was a 42-year-old male who came in with a complaint of a sore on the right side of his tongue that he had had for about four months. It only took one look into his mouth and I knew without asking that he was a smokeless tobacco user. All the tell-tale signs were there: the discolored teeth, the receding gums and the ugly bleeding ulcer on his tongue. He had been dipping snuff and using chewing tobacco for the past 10-15 years on a regular basis. A biopsy revealed cancer, and he is scheduled for surgery to have about one-third of his tongue removed, as well as the lymph glands in his neck.

Is it worth the risk?

The NCAA has rules in place to prevent players and coaches from using smokeless tobacco during practice or competition, though it does not apply to the officials. Recently during a championship football game on television, the cameras caught an assistant coach spitting tobacco juice. Although rules are in place, enforcement is not always possible. If the penalty was a fine, a substantial one, users might ask themselves, "Is it worth the risk?"

Several months ago I had the opportunity to testify on behalf of one of my patients in a class action lawsuit against "big tobacco." What was most impressive was that the tobacco companies had put together a "team" of 18 lawyers to fight the case against them and to minimize the damages to be awarded. This case has been ongoing for almost a year. The amount of money spent on this trial numbers into the millions. Apparently, "big tobacco" feels "it's worth the risk."

The use of tobacco is addictive, and the addiction to using smokeless tobacco occurs even faster. Athletes and coaches are powerful role models to youngsters and young adults. A program outlining the dangers of tobacco needs to be instituted early--to first- and second-graders. We must get the message across that "it's not worth the risk."