Rick Bender was your typical kid growing up in the 1970s. He loved baseball and wanted to fit in with his peers. He didn’t like cigarettes, so at age 12 took his first dip of chewing tobacco. He hated the taste like any first-time user but kept it up. Sure, it was a nasty habit. But professional baseball players were doing it, and the tobacco industry was portraying it as a safe alternative to smoking, luring young people to “take a pinch instead of a puff.”
If he had only known then what he knows now – spit tobacco is dangerous. It’s tobacco, and tobacco can kill. In fact, Bender was given only 18 months to live when he was first diagnosed with an aggressive form of oral cancer at age 26. Four surgeries and 20 years later, Bender is alive and well but missing half his jaw, a third of his tongue and some use of his right arm.
He is away from his wife and kids around 100 days a year to tell his story to young people across the country. His goal isn’t to punish the tobacco industry. He just wants young people to see what could happen to them if they start using tobacco like he did.
Bender’s physical features tell only part of the story. In fact, he accurately categorizes himself as just one example of what can happen to someone who uses tobacco, and in many ways he’s the lucky one. Yes, his face is disfigured, but he is alive and healthy. He points out that tobacco use also can cause other types of cancer, and it can lead to a life of heart disease and high blood pressure.
Then there’s the worst-case scenario – the one Bender describes by introducing the name Sean Marsee. Marsee was a high school track star who during his senior year was diagnosed with the same type of oral cancer that Bender suffered. Unlike Bender, Marsee didn’t live to tell his own story. He was dead 10 months later at age 19.
Unfortunately, Marsee’s outcome is more common for that type of cancer because it is so aggressive and typically caught too late. Bender, the survivor, is the exception.
“I’m not trying to tell kids what to do,” Bender said. “I just want them to make an educated choice.” He’s the perfect counter to the argument that cancer is something that old people get. “The big message I want to get across to them is regardless of how old you are, the day you start using tobacco of any kind, you put things in your body that cause cancer. The day you start. A lot of young people think, ‘oh, I’ll be 50 or 60 when it gets me.’ Well, I was 26.”
His matter-of-fact message hit Central Louisiana schools in October, when The Rapides Foundation invited him to share his story. During a two-week visit facilitated by the Central Louisiana Area Health Education Center, Bender spoke at 16 schools and made several public appearances across the region. In all, Bender’s words reached some 7,000 Central Louisiana residents. The hope is that people young and old take his message to heart.
Alyssa Briggs, 16, of Marksville High got the point that tobacco is tobacco, regardless of how it’s packaged. “It doesn’t matter if it’s smokeless or not, it’s still going to have the same harmful effects and you can get cancer either way. It’s not safer than smoking cigarettes. It’s the same thing.”
Marksville High junior Kai Burks, 16, said, “You may think that chewing tobacco is a little bit safer because you are not inhaling it and you’re spitting it right back out, but at the same time it’s eating away your gums and it’s really damaging you more than you think.”
Asked what she’d say to a friend or loved one who used spit tobacco, Caitlyn Ponthier, 12, of Marksville High said, “I would ask them to stop because they are too young and because it could kill them.”
Central Louisiana’s spit-tobacco rate is more than double that of the rest of the nation, according to the Foundation’s 2005 Community Health Assessment. In some parishes, such as Catahoula, nearly 20 percent of adults use spit tobacco.
“Too many of our residents are suffering devastating effects on their lives and their health because of common misconceptions about spit tobacco being a safe alternative to cigarettes,” said Joe Rosier, CEO/President of The Rapides Foundation. “We want everyone to be aware that it is not safe or even a safe alternative to other forms of tobacco.”
Bender said he would love to prevent young people ever from starting to use tobacco. But for those who are already addicted, he offers these words of advice: “If somebody for some reason can’t quit and they get a sore in their mouth and it doesn’t go away in 10 days, they need to get down to a professional -- a dentist or a doctor or an ear nose and throat guy. Get it looked at, before it’s too late.”
During his school presentations, Rick Bender asks audience members if they know anyone who uses spit tobacco on a daily basis. Without fail, hands shoot up and the point is made that spit-tobacco use is prevalent.
But at several rural schools, an alarming number of students raised their hands when asked if they personally use spit tobacco. It was alarming, but not all too surprising. In eight out of nine Central Louisiana parishes, the spit-tobacco rate among adults is higher than the national average of 4.5 percent. The rate is the highest is Catahoula Parish, where nearly 20 percent of adults are spit tobacco users. Central Louisiana also saw an increase in spit-tobacco use from 2002 to 2005, when the Foundation conducted community health assessments for the region.
One fear is that the downward trend in cigarette smoking is resulting in more smokers switching to spit tobacco. Some of the parishes with the highest spit-tobacco rates have the lowest cigarette smoking rates.
Bender said the tobacco industry knows this, and is jumping on the opportunity to lure young people to spit tobacco. Tobacco cans have cute designs to appeal to the younger crowd. Also, additives gives spit tobacco pleasant tastes, such as candy.
Then there was the unintended problem that arose when groups successfully pushed for clean indoor air laws in public areas, Bender said. The laws prohibit smoking in public places in order to protect people from secondhand smoke. “But when we passed those clean indoor air acts we gave the spit tobacco industry their next advertising campaign on a silver platter. You can’t smoke. Here’s a solution: Skoal.”
However, the evidence is clear that spit tobacco in various forms poses significant health risks and is not safe. Spit tobacco products still contain varying levels and types of carcinogens, and the use of these tobacco products still heightens a user’s risk for many of the same health problem as smoking.
People who are addicted to spit tobacco and would like to quit are urged to call their doctor or the Louisiana quitline at 1-800-Quit-Now. Companies interested in learning more about the benefits of becoming a tobacco-free workplace can call the Foundation at 1-800-994-3394.
Bringing Rick Bender to Central Louisiana to share his story is one part of The Rapides Foundation’s Tobacco Prevention and Control Initiative. In its third year, the initiative is designed to reduce the region’s tobacco rate of 24.9 percent.
It consists of three components that, when used simultaneously, have been proven to reduce tobacco rates by persuading users to quit and preventing young people from ever starting. They are a community component, a counter-marketing campaign and a cessation interventions component.
The community component focuses on awarding grants to schools and organizations, so that they can implement evidence-based tobacco control interventions. In the third-year grant cycle which began in 2010, the Foundation awarded $414,000 in grants throughout Central Louisiana. The money funds a variety of interventions, including a “Tar Wars” curriculum for fourth- and fifth-graders, a “Throw Out Big Tobacco” football event, Bender’s speaking engagements and “Kick Butts Day” activities in the spring, to name a few.
Another component funds a counter-marketing campaign designed to support the local tobacco prevention and control efforts. The Foundation’s “Faces of Tobacco” campaign was launched in February and highlights real people, including Bender, who have been affected by tobacco use. A second counter-marketing campaign titled “Dear Me” began airing in August. It features real tobacco users who read letters they have written to themselves. The ads end with the message: “no one can make me quit but me.”
The third component, cessation interventions, is a tobacco use reminder-and-referral system that doctors can use with their patients who are tobacco-users. So far, 167 Central Louisiana physicians are participating in this system, themed “It’s Quitting Time.” Doctors provide patient education information about the dangers of tobacco use, prescribe medications to help them quit and refer them to the state’s quitline at 1-800-Quit-Now for further support.