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Game Changer? Smokeless Tobacco Knocked Out of the Park in Boston

featured / tobacco / behavioral research / health research

Nationals’ Bryce Harper drew attention earlier this year when fans saw his cheek packed with what turned out to be an herbal mixture. Despite the Major League Baseball (MLB) restrictions on using chewing tobacco during televised interviews (but notably not during the game) and on carrying tobacco packages in uniform pockets, little progress has been made to disassociate baseball and chewing tobacco.

The MLB player’s union has stood firm in its opposition to banning smokeless tobacco use despite health concerns and last summer’s passing of hall of famer Tony Gwynn, who attributed salivary gland cancer to his smokeless tobacco use. The union’s argument is a common one when it comes to tobacco control opposition – personal choice. New players off the field, however, are stepping up to the plate in an attempt to break the association of smokeless tobacco with baseball greats – citing the influence such an association has on the choices youth make.

Boston Red Sox Ban Smokeless Tobacco

On Wednesday, Boston Mayor Marty Walsh signed an ordinance banning chewing tobacco products at sports venues – including Fenway Park. The ban goes into effect on April 1, 2016 and applies to players, coaches, fans, and everyone else in attendance. Boston is the second U.S. city to enact a ban on smokeless tobacco products (San Francisco was the first). Earlier this week, Los Angeles City Council members also voted to end smokeless tobacco use at sports venues in the city (final vote expected in the next month).

Will this be a game changer, especially if other cities follow suit? Past research in several domains indicates greater restrictions are a step in the right direction:

  • Smokeless tobacco use prevalence rates are higher for high school athletes than non-athletes. In fact, just last week smokeless tobacco use among high school athletes was the focus of CDC’s Morbidity and Mortality Weekly Report. The report called attention to opportunities for “stronger tobacco control and prevention measures” that include a focus on smokeless tobacco, particularly among student athletes.
  • Indirect marketing, including use in movies and on television and celebrity use, has been shown to influence youth susceptibility to tobacco use. Legacy’s recent campaign plays up this angle – calling attention to “unpaid tobacco spokespeople.” In the case of smokeless tobacco specifically, use among professional athletes is an important consideration given young athletes are a particularly high-risk group who often consider professional athletes role models.
  • The context in which a behavior is performed (or not performed) is important – policies, norms, and individual behavior all influence each other. As such, policy interventions can support health behavior change, influencing environmental and social factors that impact behavior change. See, for example, an application of the social ecological theory.

It’s important to remember, however, that policy changes are one of many levels of influence – and they are hugely reliant on enforcement. Particularly for a substance notorious for being more discrete in nature, it’s critical to understand the benefits to use and barriers to quitting/abstaining as perceived by individuals. Smokeless tobacco is already banned in other arenas (e.g., high schools, colleges, and minor league baseball), but use is still prevalent among these athletes. Will MLB players cease use in cities that require it, or will they use more discretely?

It will be interesting to see how MLB players respond to the changing environment – and how the conversation is framed. More to come on this topic as we present on conversational shifts that may be necessary to address personal choice in the context of leveraging policy to achieve public health goals (in the context of smokeless tobacco and MLB) at APHA in a couple months.

Until then, we’ll hold out hope that’s not the only baseball we in DC will have to discuss in October.

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