Apr 17, 2012

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

When I was in University, I had a summer job with the LGD of Pinawa. Paul Westdal, Sean Corman and I drove around town in a dark green LGD pick-up. We weed whacked playgrounds, mowed grass down by the river and raked the beach in Pinawa. It was nice to be outside for the summer and the work wasnt very difficult. One day our LGD pick-up was running very rough so we took it in to the yard mechanic. The mechanic then did an amazing thing. He was showing us the clogged fuel filter between the thumb and forefinger of his left hand. Fuel was dripping down all the way from his hand to his elbow. I was trans-fixed by the lit cigarette between his first and second finger of the gas covered hand. I couldnt believe what a dumb thing I was looking at. Why would anyone have a lit cigarette in a gas covered hand? When was this guy going to go up in flames? Maybe there is some secret mechanic skill to holding a lit cigarette in a gas covered hand safely, but I remember how incredibly dumb and surprising it seemed at the time.


As pharmacists, we go to a number of talks to keep our education up to date. I went to a very interesting talk the other week. It was given by Dr. Dean Kriellaars from the University of Manitoba. Dr. Kriellaars works with the Faculty of Medicine, the Department of Physical Therapy, the Department of Physiology, the Department of Anatomy, and the Department of Surgery. Dr Kriellaars is also with the Manitoba Institute of Child Health and the Sport Medicine and Science Council of Manitoba. His talk was about Drug Abuse in Sport.


It was a very wide ranging and interesting talk. Dr. Kriellaars spent twenty minutes telling us pharmacists how fat and lazy we were. You know, we eat too much, and exercise too little. This is an important message, but not exactly Earth shaking. Dr. Kriellaars did have some interesting stats about how we are going down the wrong path, though. About half of boys and a third of girls age 6-11 get enough exercise. That number drops to 10% of boys and 5% of girls getting enough exercise by age 16. And only about 3% of us adults exercise enough.


Another interesting fact is we have eliminated a daily source of exercise for children. Dr. Kriellaars pointed out over the course of one generation, we have virtually eliminated kids walking to school. That is about 2000 steps eliminated per day from a childs daily exercise. This is probably not the best thing to be doing to what Dr. Kriellaars calls the Facebook generation. He is one of many experts claiming the children of today wont live as long as their parents because they exercise so little. As a parent, that worries me.


Dr. Kriellaars finished the section on exercise and health by pointing out that although 65% of us are overweight or obese and our lack of exercise causes or contributes to many diseases like osteoporosis, cancer, diabetes, depression and osteoarthritis, there is a little good news out there. The leading causes of death for all ages, including heart disease is actually going down. Why are we dying less if we are getting fatter and less active? Dr. Kriellaars postulates it is drugs. He thinks the heart, blood pressure and cholesterol drugs that pharmacists have been dispensing for the last 20 years have been winning the battle versus our increasingly sedentary life style for now.


Dr. Kriellaars talked about athletes that get caught for using banned substances in sport. In Canada in 2011 there were 30 infractions. Twenty-one of them (or 70%) were football players and 100% of them were male. Those stats didnt surprise me. The number one banned substance they were caught using did, though. 13 out of the 30 (or 43%) were caught with cannabis or marijuana in their systems. Now lets just ignore the fact that marijuana is illegal, or how bad it is for the body right now. In the vast majority of sports, it doesnt help performance! Why are all these athletes taking something that could get them banned from competition and doesnt help them win? The obvious answer is the athletes werent trying gain any competitive advantage, and they didnt know it was a banned substance. They were probably using the marijuana recreationally. Marijuana metabolites can be detected for 2-3 months after the marijuana is used. So again, ignoring that marijuana is illegal and could harm them, competitive athletes should avoid marijuana because it can get them kicked out of their sport for up to four years.


The part of the Kriellaars talk I found the most surprising was part on chewing tobacco. He quoted research showing 14.5% of athletes at a recent Canada Games used chewing tobacco, and that was across all 25 sports. All the users were 14-20 years old and all were male. It was even more surprising when they looked at hockey. In 2010/2011 MJHL season, 50% of the players used chewing tobacco. Again these are young athletes. So they asked these Junior hockey players where they started using chewing tobacco. Over half the Junior hockey players had started using chewing tobacco in minor hockey.


When chew tobacco use was looked at in 14-20 year old athletes it was found males in baseball (54%), hockey (52%), rugby (38%) and football (23%) demonstrated the highest smokeless tobacco use. Among smokeless tobacco consumers 45.9% used it daily, 18% weekly and 36% monthly. The majority of smokeless tobacco users reported starting using smokeless tobacco at or prior to 15 years of age. The majority of smokeless tobacco users reported adopting smokeless tobacco in a sport setting (71%). I guess the good part of the survey said those who didnt use chewing tobacco didnt use it because they thought it was disgusting and expensive. I guess Im in that half. I have tried chewing tobacco once, and disgusting is large understatement.


As quitting chewing tobacco is at least as difficult as quitting cigarettes, Dr. Kriellaars recommends that you send your tobacco chewing young hockey player to the dentist at least yearly to check for pre-cancerous lesion in the mouth. While your tobacco chewing hockey player is at the dentist, have the dentist show your hockey player how to pull out their bottom lip and look for pre-cancerous lesions themselves. That way your tobacco chewing hockey player can do a monthly self check for the early signs of mouth cancer.


The rates chewing tobacco use among hockey players and other young athletes really surprised me. Whether the chewing tobacco rates in Dauphin Minor Hockey really is 50% or more like 20-30%, that strikes me as way too many teenaged boys at risk of mouth cancer. Like watching the gas covered mechanic with his lit cigarette, these high rates of chewing tobacco use among teenage male athletes just seems dumb.


As always if you have any questions or concerns about these products, ask your pharmacist.


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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.


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