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Chewing tobacco is not safe tobacco

Thursday, Dec. 27, 2012, 9:03 p.m.

Dear Drs. Donohue and Roach: I was washing the clothes of my 17-year-old son when I found a tin of chewing tobacco. Needless to say, I was upset. I confronted my son about it after school. He told me that a lot of his friends use it and that it is "no big deal - at least I'm not smoking!"

I told him it is a big deal because it is just as dangerous as cigarettes, and I reminded him of our family's history of cancer. My father, his two brothers and two of his sisters all died of cancer.

Can you please try to explain to my son the danger of chewing tobacco? Thank you.

- A.M.

Answer: As the parent of three teenagers, I empathize with your frustration. Trying to explain the increased risks of disease to someone who knows perfectly well what it means but doesn't really believe that it could ever happen to him is nearly impossible. But I will try, because there is a belief that smokeless tobacco is safe. It isn't.

The major risk of smokeless tobacco is in head and neck cancers - lip, mouth, tongue, throat. Having taken care of many of these patients, I can attest to the terrible pain and disfigurement that come from the disease and its treatment. But your best bet may be to talk about your son's family members who died from cancer. Discussing real people who have been through it might get through better than statistics about increased risks. A family member with esophageal or pancreatic cancer also would be important, since there is incontrovertible evidence that chewing tobacco causes these as well.

Is it safer than smoking? Yes. But playing Russian roulette with one bullet in the chamber is safer than playing Russian roulette with two.

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