Marsee's horrible death is still an unusual occurrence, but his fondness for "smokeless tobacco" has become alarmingly widespread among American youth. Once associated with lumberjacks, laborers and juice-spitting hayseeds, smokeless tobacco includes both the rough-cut chewing variety (Red Man, Mail < Pouch and other brands, which are held in the cheek and occasionally munched) and finely ground moist snuff (Copenhagen, Skoal and the like, which are usually packed in between the lower lip and gum). In many states, it is illegal to sell tobacco of any sort to minors, but the laws are difficult to enforce. Teenage boys, in particular, are turning to snuff in record numbers, inspired perhaps by TV ads featuring such athletic idols as Carlton Fisk of the Chicago White Sox and former Dallas Cowboy Walt Garrison. The amount of snuff sold annually in the U.S. is up 60% since 1978. And while national figures on teenage use are not available, local surveys in Oklahoma, Oregon, Texas and Massachusetts suggest that between 20% and 40% of high school boys are chewing or dipping. No less worrisome is the finding, in Texas, that 55% of young dippers started before age 13. Says an exasperated Ann Ballard, a high school teacher in Houston: "I'm tired of finding cups filled with brown spit littered about the classroom."
Teens seem to view smokeless tobacco as a healthier alternative to smoking. "It can't hurt you athletically like cigarettes can," Al Lawrence, 18, of Taunton, Mass., reasons. "Baseball players use it all the time." But doctors say the facts are very different. Dipping causes visible damage "in as little as three to four months," says Arden Christen, chairman of the preventive-dentistry department at Indiana University. The gums may recede, the teeth loosen, biting surfaces are abraded, and tough, white patches called leukoplakia may appear on the gums and cheeks. After several years the mouth can be devastated. Pat Stallings, 22, a University of Texas senior and ex- Skoal dipper, required a gum graft from his upper to his lower jaw after his gums "had receded so far that you could see the bottom part of my teeth and the bone."
Recent studies bring more bad news for users. There is evidence that snuff raises blood pressure and, contrary to what some ballplayers might think, that it slows reaction time. It seems to be more addictive than cigarettes. "The nicotine level in the blood is higher in smokeless-tobacco users than smokers," says Researcher Elbert Glover of East Carolina University in Greenville, N.C., who has found that some would-be quitters "couldn't even stop for half a day."
The link to cancer, while less thoroughly documented than for cigarettes, is increasingly clear. Doctors estimate that between 3% and 6% of the callus-like | leukoplakia ultimately become malignant. A major study jointly conducted by the National Cancer Institute and the University of North Carolina found that women who used snuff for several decades have nearly 50 times the normal risk of developing oral cancer. Declares Gregory Connolly, director of the dental division of the Massachusetts department of public health: "There is a chemical time bomb ticking in the mouths of hundreds of thousands of boys in this country."
Connolly has led an antisnuff crusade that will culminate this week in an executive order requiring a label ("Warning: Use of snuff can be addictive and can cause mouth cancer and other mouth disorders") on every package of moist snuff sold in Massachusetts after Dec. 1. Legislatures in about a dozen other states are considering similar warnings as well as restrictions on advertising. Last month U.S. Surgeon General C. Everett Koop appointed a panel of medical experts to assess the risks of smokeless tobacco. A battery of major medical organizations has already called for federally required warning labels and a ban on television commercials.
Lobbying on the other side, the tobacco industry argues, as it has done in the past, that the case is unproven. "I don't question the motives of the experts," says Michael Kerrigan, president of the Smokeless Tobacco Council in Washington, "but they make great leaps in saying our product causes cancer." Even if the industry manages to stave off tighter regulation, it faces another battle, this one in court. A $147 million product-liability suit brought by the Marsee family against the U.S. Tobacco Co., producer of 90% of the snuff sold in the U.S., may be the first of several snuff-related lawsuits. Betty Ann Marsee, Sean's mother and a nurse by profession, hopes the November trial will help raise popular awareness of the dangers of snuff. Mothers in Ada, she notes, have already started to tack pictures of Sean on their refrigerators "in the hope that their kids are reminded of what can happen."