Implications of Smokeless Tobacco Use Among Athletes

Nicotine supplementation enhances simulated game performance of archery athletes

Background

Nicotine is beneficial to mood, arousal and cognition in humans. Due to the importance of cognitive functioning for archery athletes, we investigated the effects of nicotine supplementation on the cognitive abilities, heart rate variability (HRV), and sport performance of professional archers.

Methods

Eleven college archers were recruited and given 2 mg of nicotine supplementation (NIC group) and placebo (PLA group) in a crossover design.

Results

The results showed that at 30 min after the intake of nicotine gum, the “correct rejection” time in the NIC group was significantly lower than that of the PLA group (7.29 ± 0.87 vs. 8.23 ± 0.98 msec, p < 0.05). In addition, the NIC group completed the grooved pegboard test in a shorter time than the PLA group (48.76 ± 3.18 vs. 53.41 ± 4.05 s, p < 0.05), whereas motor reaction times were not different between the two groups. Saliva α-amylase activity was significantly lower after nicotine supplementation (p < 0.01) but increased immediately after the archery test in the NIC group (p < 0.05). In addition, nicotine supplementation significantly decreased HRV and increased the archery score (290.58 ± 10.09 vs. 298.05 ± 8.56, p < 0.01).

Conclusions

Nicotine enhances the performance of archery athletes by increasing cognitive function and stimulating the sympathetic adrenergic system.

Nicotine: Sporting Friend or Foe? A Review of Athlete Use, Performance Consequences and Other Considerations

Nicotine use amongst athletes is high and increasing, especially in team sports. This narrative review examines the rationale behind its use and evidence of its effect on physical performance, and considers important factors that should determine future research efforts. To date, ten studies have assessed muscular strength and power, sub- or maximal endurance and high-intensity exercise when nicotine (medication) or smokeless tobacco was used as an intervention. Two studies observed an ergogenic effect, one an ergolytic with the remaining seven reporting no change. These studies have notable limitations and confounding factors that include participant tolerance to nicotine, interindividual responses, the nicotine delivery system used and failure to adhere to rigorous experimental/scientific design. Further research is encouraged to address these limitations and determine the extent to which anti-doping and governing bodies should consider promoting, coordinating and monitoring any effort against nicotine and nicotine-containing substances in sports.

A Randomised, Placebo-Controlled, Crossover Study Investigating the Effects of Nicotine Gum on Strength, Power and Anaerobic Performance in Nicotine-Naïve, Active Males

Background

Nicotine use amongst athletes is high and increasing, especially team sports, yet the limited previous studies investigating the performance consequences of this behaviour have not examined the effects of the principal active ingredient, nicotine, per se. Therefore, we determined whether nicotine gum affected muscular and anaerobic performance.

Methods

Nine active males (24 ± 3 years) completed three trials in a random order in which 20 min prior to testing they chewed 2 mg (NIC-2), 4 mg (NIC-4) nicotine or flavour-matched placebo (PLA) gum. Peak and average peak isometric, concentric and eccentric leg extensor torque was measured followed by vertical counter-movement jump height and a 30-s Wingate test. Heart rate was measured whilst capillary blood samples determined pH, HCO₃⁻ and venous blood confirmed the presence of nicotine.

Results

Nicotine was confirmed by the presence of its major metabolite, cotinine and participants reported no side effects with nicotine. Peak and average peak isometric and eccentric torque was significantly affected (NIC-2 > PLA; p < 0.05) whilst peak (NIC-2 > PLA; p < 0.05) but not average peak (p > 0.05) concentric torque was different between trials. Counter-movement jump height was similar across trials (p > 0.05). Anaerobic capacity during the Wingate remained similar across trials (p > 0.05); however, pacing strategy (peak power and rate of fatigue) was different during NIC-2 than PLA. pH was affected by nicotine (NIC-2 > PLA; p < 0.05) and was reduced following the Wingate in all trials. HCO₃⁻ showed similar responses across trials (p > 0.05) although it was also reduced following the Wingate (p < 0.05), whilst heart rate was significantly affected (NIC-2/NIC-4 > PLA; p < 0.05).

Conclusions

Chewing low-dose (2 mg) nicotine gum 20 min prior to exercise significantly improved leg extensor torque but did not affect counter-movement jump height or Wingate performance compared to a placebo, whilst there were minimal effects of the 4 mg nicotine gum on the performance parameters measured.

ESC Study Group of Sports Cardiology Position Paper on adverse cardiovascular effects of doping in athletes

The use of doping substances and methods is extensive not only among elite athletes, but also among amateur and recreational athletes. Many types of drugs are used by athletes to enhance performance, to reduce anxiety, to increase muscle mass, to reduce weight or to mask the use of other drugs during testing. However, the abuse of doping substances and methods has been associated with the occurrence of numerous health side-effects. The adverse effects depend on the type of the consumed drug, as well as the amount and duration of intake and the sensitivity of the body, since there is a large inter-individual variability in responses to a drug. Usually the doses used in sports are much higher than those used for therapeutic purposes and the use of several drugs in combination is frequent, leading to higher risk of side-effects. Among biomedical side-effects of doping, the cardiovascular ones are the most deleterious. Myocardial infarction, hyperlipidemia, hypertension, thrombosis, arrythmogenesis, heart failure and sudden cardiac death have been noted following drug abuse. This paper reviews the literature on the adverse cardiovascular effects after abuse of prohibited substances and methods in athletes, aiming to inform physicians, trainers and athletes and to discourage individuals from using drugs during sports.

Smokeless tobacco, reaction time, and strength in athletes

PURPOSE

This study investigated the effects of smokeless tobacco on reaction time and strength in a group of Division III athletes.

METHODS

Athletes were tested for simple and choice reaction time, maximum voluntary force, and maximum rate of force generation of the knee extensors on a KinCom dynamometer at 250 degrees.s-1. Smokeless tobacco-using athletes (N = 20) were tested while both using and after abstaining from smokeless tobacco. Another group of athletes (N = 20) who did not use smokeless tobacco served as a control group.

RESULTS

Simple and complex reaction times were not affected by smokeless tobacco use or abstention. In the simple reaction time test, maximum voluntary knee extensor force was higher in the smokeless tobacco-using group while abstaining (P < 0.05). Maximum rate of force generation in the simple reaction time test was not statistically different between the conditions. In the choice reaction test, both strength parameters (maximum force and maximum rate of force generation) were higher in the user group while abstaining (P < 0.05) compared with the using condition. The strength parameter measurements in the control group were not statistically different from the tobacco-using group, while either using or abstaining.

CONCLUSIONS

We conclude that smokeless tobacco use has no effect on reaction time but may detrimentally influence maximum voluntary force and maximum rate of force generation.

Smokeless tobacco use among big ten wrestlers and selected associated factors

The use of smokeless tobacco (ST) by 234 Big Ten intercollegiate wrestlers was surveyed, with a special interest in determining their beliefs about ST health consequences and discriminators of ST use. Self-reported ST use was validated by sputum analysis of a selected team. Twenty-eight percent of the wrestlers were current, regular ST users. This is well above the national norm. Over 42% of the wrestlers had used some form of ST in the past year. Evidence indicates that three variables (prior cigarette smoking, receiving a free ST sample, and alcohol consumption) were strong discriminators of ST use.

Ergolytic drugs in medicine and sports

Just as drugs that enhance exercise capacity and/or athletic performance are often called "ergogenic," drugs that impair these functions can be termed "ergolytic." Today's athletes hear too much about the former and too little about the latter. Ergolytic drugs used today by certain athletes include alcohol, marijuana, smokeless tobacco, cocaine, antihypertensives, eye drops, and diuretics. Some antidepressants, too, can be ergolytic, as well as some antihistamines and other common drugs--even caffeine--in some settings, for some people. Internists can help their fitness-minded patients by educating them about ergolytic drugs and by tailoring their management to foster peak performance at work and play.

The prevalence of oral lesions in smokeless tobacco users and an evaluation of risk factors

BACKGROUND

The widespread use of smokeless tobacco (ST) has prompted concern in regard to the development of oral lesions in long-term users.

METHODS

For inclusion in the current study, a subject must have used an ST product, either snuff or chewing tobacco, for at least 6 months. The subjects were recruited by advertising, and none was referred for the evaluation of an oral lesion. The following were performed on all subjects: assessment of exposure to ST, cigarettes, and alcohol; examination of the oral cavity; a biopsy, if an oral lesion was found; and analysis of a blood sample for beta-carotene. The dietary intake of most of the subjects was analyzed.

RESULTS

Of the 347 ST users, all of whom were white male subjects, 45 (13.0%) had an oral lesion. Thirty-five of the lesions were hyperkeratosis and 10 were epithelial dysplasia.

CONCLUSIONS

Snuff exposure was associated significantly with the presence of an oral lesion (P < 0.0001). A decreased vitamin C intake also was found among the ST users with oral lesions (P < 0.01). The ST users with epithelial dysplasia, as compared with those with hyperkeratotic lesions, were slightly older, had a lower intake of vitamin C (P < 0.05), and were more likely to have used chewing tobacco than snuff.

Attitudes and behaviors of dental hygienists concerning tobacco use

This study surveyed a proportionate random sample of licensed dental hygienists in five states and the District of Columbia, to assess their antitobacco use behaviors and attitudes. The response rate was 79.4 percent. Descriptive data as well as chi-square, analysis of variance (ANOVA), and Duncan's multiple range test statistical results were reported. Only 6.9 percent of the hygienists sampled currently smoked. These hygienists appeared to exhibit significantly different aggregate attitudes and select clinical practice behaviors than their nonsmoking counterparts. Years of employment and geographic location showed no significant relationship to aggregate clinical practice behaviors or attitudes, although each was related to individual behaviors and attitudes. Overall, dental hygienists appeared committed to involvement in both individualized and community-based antitobacco-use efforts. Measures to coordinate hygienists' involvement at both of these levels need to be enhanced.

P.L. 99-252--implications for dentists and their clinical practice

This paper is one of a series attempting to determine the impact of Public Law 99-252, the Comprehensive Smokeless Tobacco Health Education Act of 1986, on decreasing smokeless tobacco use. Potential indicators are discussed that could be used by the dental profession to determine the efficacy of the profession's involvement in existing and future prevention and cessation efforts relative to this law. In this review, six major areas are considered for measuring declines in smokeless tobacco use relative to the role of the dental health practitioner. These areas encompass the following: (1) the dental profession's knowledge of smokeless tobacco health hazards, (2) dental practitioners' involvement in measuring changes in use patterns, (3) the influence dentists have with their patients and community in decreasing smokeless tobacco use, (4) the general attitude and intention to quit on the part of dental patients, (5) active governmental involvement efforts, and (6) health effects of smokeless tobacco that might be used for identifying decreasing smokeless tobacco use. Within each of these six broad categories, more specific indicators for measuring the impact of P.L. 99-252 relative to the dental profession were considered.

Comparative patterns of smokeless tobacco usage among major league baseball personnel

The purpose of this study was to survey major league baseball personnel in order to determine the prevalence, cultural distribution and factors influential in, and the level of knowledge of individuals regarding the harmful effects of smokeless tobacco usage. During the 1987 preseason/season, 25 of 26 baseball teams in the American and National Leagues participated in the survey. The players (46%) "dipped" or "chewed" more than the managers/coaches (35%) followed by the trainers (30%). Current usage of smokeless tobacco was highest among Caucasian athletes (50%) followed by Hispanic athletes (33%) and then Black athletes (30%). Among the baseball players surveyed who currently use smokeless tobacco, 58% started during the ages 18 to 22. This study indicates that although baseball personnel are fully aware of the harmful effects of smokeless tobacco usage, current use of smokeless tobacco in major league baseball is high. Additionally, baseball personnel start "dipping" or "chewing" smokeless tobacco at an early age and continue this practice for long periods.

Effect of ingestion of smokeless tobacco on motor distal latency of the median nerve

Subjects were 17 men between the ages of 18 and 32 yr. and regular users of smokeless tobacco. Each subject received three treatments consisting of one pouch of Skoal Bandits, one pinch of their regular brand, and a nonnicotine piece of chewing gum. The nervous transmission at the neuromuscular junction in the right thumb was compared before treatment and once every minute for 15 min. after treatment. Repeated-measures analysis of variance indicated a significant increase in the distal latencies for both the brand-name grouping and in the regularly used brand. No such difference was found in a control group when compared to the pretest results. It was concluded that smokeless tobacco ingestion resulted in a delay in the nervous transmission across the neuromuscular junction. This delay was hypothesized to be caused by the enduring binding action of nicotine to the acetylcholine receptor sites, thereby blocking the impulse in some of the faster conducting nerve fibers.

An interpretative review of smokeless tobacco research in the United States: Part I

The first part of a two-part series reviewing the published literature of smokeless tobacco in the United States and concomitant health effects associated with its use. This article delineates the current status of its prevalence, behavioral psychosocial factors associated with use, and review of the negative health effects associated with regular use.

Screening for smokeless tobacco-associated lesions: recommendations for the dental practitioner

The increasing use of smokeless tobacco and the accumulating list of associated health hazards including cancer and cardiovascular effects should be of concern to the dentist. This study documents both concern from patients' perceptions and clinical examinations of their smokeless tobacco-associated lesions. Implications for the dentists' practice among adolescents and young adults are discussed.

Prevalence and patterns of smokeless tobacco use in a southeastern university

The purpose of this study was to determine prevalence and patterns of use for tobacco products, especially, the use of smokeless tobacco among students at a university in the Southeastern United States. Six-hundred and thirty-two students, representing both sexes, participated in the survey, which elicited information regarding current and former use of tobacco products. Smokeless tobacco use was considerably more prevalent among male students than among female students; the reverse was true for cigarette smoking. Overall, the prevalence of tobacco use in this study indicates a need to begin health education programs regarding the adverse health effects of smokeless tobacco use with males and to revise smoking education programs to place more emphasis on female usage.