The risk for oral mucosal lesions associated with use of smokeless tobacco among 1,109 professional baseball players during spring training in 1988 was investigated. Leukoplakia was very strongly associated with use of smokeless tobacco in this population of healthy young men. Of the 423 current smokeless tobacco users, 196 had leukoplakia compared to seven of the 493 nonusers (OR = 60.0, 95% CI = 40.5-88.8). The amount of smokeless tobacco used (in hours per day that smokeless tobacco was held in the mouth), recency of smokeless tobacco use (hours since last use), type (snuff versus chewing tobacco), and brand of snuff used were significantly associated with risk for leukoplakic lesions among smokeless tobacco users. Ninety-eight leukoplakic areas in 92 subjects were biopsied and examined microscopically. All lesions were benign, but one specimen had mild epithelial dysplasia. The long-term significance of leukoplakia in smokeless tobacco users and their relation to oral cancer is not clear.

This article has been cited by other articles:

				A. W Macara Should doctors advocate snus and other nicotine replacements? No BMJ, February 16, 2008; 336(7640): 359 - 359. [Full Text] [PDF]

				B. Rodu and C. Jansson SMOKELESS TOBACCO AND ORAL CANCER: A REVIEW OF THE RISKS AND DETERMINANTS Crit. Rev. Oral. Biol. Med., September 1, 2004; 15(5): 252 - 263. [Abstract] [Full Text] [PDF]

				B. W. Neville and T. A. Day Oral Cancer and Precancerous Lesions CA Cancer J Clin, July 1, 2002; 52(4): 195 - 215. [Abstract] [Full Text] [PDF]

				S. P. Schantz and G.-P. Yu Head and Neck Cancer Incidence Trends in Young Americans, 1973-1997, With a Special Analysis for Tongue Cancer Arch Otolaryngol Head Neck Surg, March 1, 2002; 128(3): 268 - 274. [Abstract] [Full Text] [PDF]

				I. Rubinstein Subtilisin Increases Macromolecular Efflux from the Oral Mucosa Clin. Vaccine Immunol., September 1, 2000; 7(5): 794 - 802. [Abstract] [Full Text] [PDF]

				M. M Walsh, J. Ellison, J. F Hilton, M. Chesney, and V. L Ernster Spit (smokeless) tobacco use by high school baseball athletes in California Tob. Control, June 1, 2000; 9(90002): ii32 - 39. [Abstract] [Full Text] [PDF]

				I. Rubinstein Smokeless tobacco potentiates VIP-induced DNA synthesis and inactivates NEP 24.11 in oral keratinocytes Am J Physiol Cell Physiol, February 1, 2000; 278(2): C391 - C396. [Abstract] [Full Text] [PDF]

				X.-P. Gao, S. R. Akhter, H. Ikezaki, D. Hong, and I. Rubinstein Dexamethasone attenuates acute macromolecular efflux increase evoked by smokeless tobacco extract J Appl Physiol, August 1, 1999; 87(2): 619 - 625. [Abstract] [Full Text] [PDF]

				I. Rubinstein, X.-P. Gao, S. Pakhlevaniants, and D. Oda Smokeless tobacco-exposed oral keratinocytes increase macromolecular efflux from the in situ oral mucosa Am J Physiol Regulatory Integrative Comp Physiol, January 1, 1998; 274(1): R104 - R111. [Abstract] [Full Text] [PDF]

				X.-P. Gao, H. Suzuki, C. O. Olopade, S. Pakhlevaniants, and I. Rubinstein Purified ACE attenuates smokeless tobacco-induced increase in macromolecular efflux from the oral mucosa J Appl Physiol, July 1, 1997; 83(1): 74 - 81. [Abstract] [Full Text] [PDF]