Tony Gwynn Died - June 16, 2014
By: Fred Fischer, Benefits Director, CFP, Inc.
Anthony Keith "Tony" Gwynn, Sr. (May 9, 1960 – June 16, 2014) nicknamed Mr. Padre, played 20 seasons (1982–2001) for the San Diego Padres major league baseball team. Tony, a left handed batter, was considered one of the best and most consistent hitters in baseball history with eight batting titles, seven Silver Slugger Awards, five Gold Glove Awards and was 15-time major league baseball All-Star. He was inducted into the Baseball Hall of Fame in 2007, his first year of eligibility.
On June 16th, 2014, Tony Gwynn died from complications related to salivary cancer. Tony was fifty-four years old, survived by two children (Tony Gwynn Jr., Anisha Nicole), his wife Alicia and two brothers. Tony believed his cancer was caused by chewing tobacco. For decades, he put pinches and handfuls of tobacco in his mouth day after day. He started every baseball game of his career by putting a wad of tobacco in his mouth.
According to the National Institute on Drug Abuse, chewing tobacco and snuff contain 28 carcinogens (cancer– causing agents). Smokeless tobacco increases the risk for cancer of the oral cavity, which can include cancer of the lip, tongue, cheeks, gums, and the floor and roof of the mouth. Other effects include oral leukoplakia (white mouth lesions that can become cancerous), gum disease, and gum recession (when the gum pulls away from the teeth). Possible increased risks for heart disease, diabetes, and reproductive problems are being studied.
Sweat and Snoose By Don Beck, from the Album “Craig and Terry”, “the original soundtrack for the Logging Industry”, February 2009.
One morning I was standing cross the canyon from the landing, When this greenhorn asked if he could try a chew, Said “That’s a big mistake you’re making” big a chew as you are taking, chewing snoose won’t make a logger out of you. Well he went cross-eyed then he staggered, sat down on his choker jagger, he turned green, his eyes were filling full of tears, he was gagging and a spitting rubbing hard where he’d been sitting said “I can feel that Copenhagen clear down here!”
Follow the Money- Who Profits from Tobacco Use
In Oregon, annual tobacco generated revenue (fy2014) was estimated at $336 Million dollars. The tobacco industry spent $108 million on marketing, and opponents spent $9.9 million. Annual health costs in Oregon caused directly by smoking are $1.54 Billion dollars. Altria Group and Reynolds American supply nearly 90% of the U.S. smokeless tobacco market which has been growing 5% per year from 2011 to 2013. The growth is partially attributable to the clampdown on cigarettes, which is pushing more smokers into smokeless products as it becomes increasingly difficult to light up in public and more expensive to buy cigarettes. Smokeless products also generate higher profit margins than cigarettes. Altria owns six of the ten best-selling smokeless tobacco products including Copenhagen and Skoal, the No. 1 and No. 2 premium moist snuff brands. Reynolds American's value-priced snuff, GRIZZLY, is the best-selling moist snuff brand in America. A lack of research on the effects of smokeless tobacco, combined with fewer public health initiatives geared towards this form of tobacco use, may be contributing to the steady use of these products in the U.S. Smoke-free policies for combustible tobacco have proliferated, but all forms of smokeless tobacco use are really permitted in a lot of areas. Loopholes in laws regulating cigarette use allow smokeless tobacco to be more accessible – and cheaper. Cigarettes are taxed pretty uniformly in every state, but commonly smokeless tobacco is taxed considerably lower than cigarettes. Increasing price is the single most effective way to reduce consumption. Being cheaper obviously increases the potential for people to use them.
The Numbers
A recent report from the U.S. Centers for Disease Control and Prevention (CDC) revealed that the use of smokeless tobacco among workers in the U.S. has held steady since 2005 - with rates of smokeless tobacco use being highest among males ages 25 - 44. In recent years there have been declines in cigarette smoking, but there’s really other tobacco products making up a large proportion of tobacco use in certain populations. According to the CDC, more than 30,000 people in the U.S are diagnosed with oral cancer every year. And every year, over 8,000 die of the disease, which has only a 50 percent five-year survival rate. A 2008 study from the World Health Organization indicated that smokeless tobacco users have an 80 percent greater chance of developing oral cancer than a non-user.
Prevention
There isn’t any lack of information regarding the ill effects of tobacco use, smoking or smokeless, and its relationship to cancer. For those that want to be pro-active to the effects of tobacco use, there are preventative measures and resources available to them. A few things, besides educating yourself, which you can do:
1) See your dentist and get regular checkups (Yes, your dentist!). Many dentists conduct oral cancer screening exams, and can check for sores and discolored tissue or other symptoms.
2) See your family doctor for regular checkups. Preventative medical services are covered 100% by your health policy now under the Affordable Care Act.
3) Quit the habit. For a good starting point, The National Institute of Dental and Craniofacial (NIDCR) provides a free guide called: “Smokeless Tobacco: A Guide for Quitting” on their website at: http://www.nidcr.nih.gov/OralHealth/Topics/SmokelessTobacco/SmokelessTobaccoAGuideforQuitting.htm
4) Take advantage of free and low cost cessation tools. If you have an employer provided or an individual health Insurance plan, it should provide free and low cost smoking cessation tools to assist you or your employees. The Affordable Care Act (ACA) preventative mandate requires first dollar coverage for tobacco counseling and intervention, but it’s not consistent among carriers. Some include meds, some don’t. A short summary of some of Oregon’s medical carriers tobacco cessation services:
a) Pacific Source: Quit for Life Program. 6 month program with telephonic coaching, Web Coach for online support, 8 week supply of nicotine replacement (gum, patches or bupropion the generic of Zyban) Unlimited quit attempts.
b) UHC: Quit Power – interactive program with telephonic coaching. If the member goes through the program they have access to nicotine products free of charge, if they don’t it would be subject to their Rx copays.
c) MODA: free quit hotline, online counseling. Within the tobacco cessation program free nicotine replacement, consultation. Per MODA, the individual must be enrolled in an approved cessation PROGRAM and then the consultation and supplies/drugs are at no cost share to the member.
d) Regence: Generic cessation medications considered ‘preventive’ and covered in full. Online coaching website available.
e) Providence: In Network counseling covered in full. Free prescription drugs AND OTC with a note or prescription from provider. May have to submit claim for OTC reimbursement. Classes through Providence facilities covered in full. Quit for life telephonic program, also includes free patches and gum.
f) TPM: Community Wellness benefit covers cessation classes at In-Network facilities/hospitals. Some drugs by prescription (Bupropion, Chantix, NRT nasal spray or inhaler) are covered in full as preventive. Nicotine Dependency Programs are covered in full with In-network providers.
g) LifeWise: tobacco screening and programs covered in full with in-network providers. May be covered under community wellness - $250 max benefit per year, must be at in-network facilities.
h) College Assistance Programs: Your College bound dependent may also have tobacco cessation resources at their college. Oregon State University and The University of Oregon, both sponsor tobacco cessation policies available to students and worth checking into if you have a college bound dependent.
Summary All of us have had plenty of exposure to the ill effects of tobacco use. If you, an employee or a family member are considering “quitting the habit”, there are resources to help get through what is very difficult process. We can help direct your employees to those resources provided by their health insurance carriers. If you are interested in getting provider provided educational supplies for your employees please contact us and we will help get them to you.
Our office would like to help you navigate the complex world of Health Care Reform. If you have questions about this article, health reform, or any other benefit related question, please contact us by phone at: 866-532-0417 or by email to: [email protected]. CFP has been working with OCAPA for several years and appreciates the opportunity to help with your benefit planning.