Many student athletes, particularly football and baseball players, in Mississippi’s junior and senior high schools, use tobacco - as do their coaches - according to the results of two new studies.

Further, an oral screening conducted among student athletes in a third study, revealed that many students with a history of tobacco use had an oral lesion, which can be an early warning sign of mouth cancer.

These studies, conducted by former athletes who are researchers at the University of Mississippi School of Dentistry, were presented on Thursday in Baltimore, Maryland during the 83rd General Session of the International Association for Dental Research.

Based on the findings, “early intervention” by dentists and other healthcare providers is needed, to decrease the risk of oral cancer among athletes who use tobacco, Dr. Kyle Hunt, who was involved in all three studies, told AMN Health.

He warned that if signs of oral cancer are not detected early, the risk of death increases.

Among the 698 seventh through twelfth graders surveyed in the first study, nearly 23 percent of boys said they had ever used tobacco in comparison to about 3 percent of girls, according to Hunt and his team. White athletes were more likely to report a history of tobacco use and were more likely to have used smokeless tobacco than were their black peers.

Further, a history of tobacco use was especially common among football and baseball players, who were more likely to say they had used tobacco than to say they had not. Football and baseball players have more “down time” to use tobacco, in comparison to athletes who participate in basketball or track, Hunt said, adding that “you can’t spit” (smokeless tobacco) on the basketball court or track field.

In other findings, 37 percent of athletes in private school and 22 percent of athletes in public school said their coach used tobacco at sports events as well, the investigators report.

“Students attitudes toward tobacco use may be affected by perception of their coaches’ use and attitudes, suggesting a target for education and intervention,” Hunt and his colleagues conclude.

To confirm this conclusion, Hunt joined Dr. Brock Martin and his team in their study of junior and senior high school coaches’ attitudes about tobacco use.

They sent a 40-question anonymous survey to 1,600 coaches of various sports in public and private schools in Mississippi. Eighty-one percent of the more than 800 respondents were white, and 84 percent were male.

Based on the responses given, the researchers concluded “tobacco use rates among athletes may be in part related to coach attitudes, beliefs and practices.”

Twenty-six percent of coaches said they currently used cigarettes or had done so in the past and nearly a third (32.9 percent) reported current or former use of smokeless tobacco, study findings show. What’s more, approximately 16 percent of coaches said they had smoked cigarettes or used smokeless tobacco in the presence of their student athletes.

“You can’t really tell someone not to do something when you’re doing it in front of them,” Martin told AMN Health.

Still, most (91 percent) of the coaches said they were willing to advise their athletes against smoking and about 78 percent said they tell their athletes not to use smokeless tobacco. Further, more than three-quarters of the coaches said they would “definitely or probably” be willing to undergo training to learn how to counsel their athletes against using tobacco products.

“They have a vested interest in the health of their athletes,” Martin said, adding that he and his colleagues plan to use their study findings to “plan intervention training for coaches” so that they can counsel their athletes about their tobacco use, rather than simply punishing them.

In the third study, Dr. Charles Belknap and his colleagues looked at the prevalence of oral lesions among student athletes. A total of 709 students underwent an oral screening for precancerous lesions after completing questionnaires about their tobacco use.

Based on their findings, “oral health care providers should routinely perform oral screenings particularly on young males who are at higher risk to use tobacco,” according to the researchers.

Oral lesions were found among 10 percent of athletes who had no history of tobacco use and about 30 percent of athletes who did have a history of tobacco use. This suggests an “almost three to one likelihood” that a young athlete who had ever used tobacco would have a lesion, Belknap told AMN Health.

Smokeless tobacco use, in particular, seemed to put athletes at risk for oral lesions. Over a third (37.6 percent) of athletes who said they had ever used smokeless tobacco had an oral lesion, in comparison to less than a quarter (23.5 percent) of those with a history of cigarette use, study findings indicate.

Smokeless tobacco can cause lesions that can become cancerous, Belknap told AMN Health. Some people who are aware of the health effects of smoking may consider smokeless tobacco to be a safe alternative, but Belknap says that’s not so. “Smokeless tobacco is not a safe form of tobacco, (or a) safe alternative to cigarettes,” he said.