Tobacco, oral health and military readiness: A Leadership Issue Published May 22, 2007 By Lt. Col. Greg Canney 305th Dental Squadron MCGUIRE AFB, N.J. -- "You're not healthy without good oral health," said Dr. C. Everett Koop, former U.S. Surgeon General. I'm amazed at the numbers of active-duty patients who use tobacco despite increased awareness of the risks. More than 28 percent of our McGuire personnel smoke, use smokeless tobacco or use both, a statistic that has not changed much over time. The Air Force goal is to reduce tobacco use below 12 percent by 2010, so we have much to do. Not surprisingly, the military percentage of users mirrors the civilian population. It is a national health issue and it is a readiness issue for the Air Force and for our leadership. Most people know about the risks of tobacco use on lung cancer, but not about mouth and throat cancer. Smoking can delay healing after tooth extraction and it contributes to gum disease, causes bad breath and stains your teeth and tongue. "Is smokeless tobacco safer than smoking?" Like cigars and cigarettes, smokeless tobacco contains chemicals linked to cancer. At least 28 cancer-causing chemicals are in spit tobacco. Sugar in these products can cause tooth decay, and gums can pull away from the teeth where the tobacco is held, exposing tooth roots and causing cold and heat sensitivity. The gums do not grow back. Surgery is required to recover the roots. Uneven white patches and red sores are common and can mean the very earliest stages of mouth cancer. The habit usually starts early with peer pressure and print ads. Remember the clever TV ads of old with pro sports heroes urging "just a pinch between cheek and gums"? Nearly 14 of high school males in the U.S. use spit tobacco and more than 1 million children will try it this year alone; more than 300,000 will become regular users. A few years ago, America's National Spit Tobacco Education Program (www.nstep.org) profiled a 25 year-old oral cancer survivor who said "Spit tobacco has ruined my life. Every time I turn around, they are putting me in the hospital either to have surgery or some kind of treatment. If I had known then what I know now, I never would have put dip in my mouth. Spit tobacco seems harmless, but in reality it was more than I could handle." This young man had nearly 30 disfiguring surgeries to save his life, including radical surgery to remove half of his neck muscles, lymph nodes, part of his lower jaw and half of his tongue. He started using spit tobacco at age 13 because his friends did, and he had cancer by age 17. Mouth cancer can spread quickly and is very difficult to treat; only half of those diagnosed will survive more than five years. Many of our patients at McGuire say they are thinking of quitting tobacco use. How many good reasons are there to quit? 1 - It's expensive. A can of dip costs $3, so a can a day is $1,110 per year. (A pack of cigarettes is $4). 2 - It's addictive. Nicotine is a stimulant that affects the brain and body. 3 - It's disgusting. Your breath smells, your clothes reek and your teeth are stained. A "very attractive" habit that once was "cool" with your friends is now an embarrassment and a health risk. I encourage supervisors, wingmen and commanders to encourage their Airmen to at least reduce tobacco use as a first step. Even better, contact the Health and Wellness Center at 754-2462 for information on their four-part tobacco cessation program that meets Tuesdays at 9 a.m. Good oral health is good for you and your family and ensures a fit, deployable asset for the Air Force.