Smokeless tobacco (ST) use is common in some sports. Nicotine is a psychomotor stimulant and this raises the issue of whether such use constitutes that of a performance-enhancing drug.

Most of the data come from baseball players. Both adolescent and adult baseball players use ST [1]. Among major league players, 45% have been reported to use ST [2]. The amount of nicotine extracted from ST ranges between 20 and 45% and bioavailability is 40–60% of the extracted amount. Plasma levels peak after 30 minutes, with values which could reach an average of 20–30 ng/ml at the end of the day (similar to moderate-to-heavy smoking) [3]. ST users are thus exposed to a large amount of nicotine over a longer period than from smoking [4,5].

Nicotine has been found in some studies to enhance information processing and attentional processes in humans [6]. The robustness of this effect and whether in smokers it represents more than normalization of impairment experienced as a result of nicotine withdrawal has been debated [7,8]. In baseball ST users there are only limited data. Escher et al. [9] assessed muscular force, reaction time and choice reaction time in athlete ST users (under abstinence) versus non-users. ST users showed a stronger force, a slower choice reaction time but no difference in simple reaction time. A study by Robertson et al. [10], compared field performance between ST users versus non-users by using common baseball statistics parameters. Although the authors concluded that there were no substantial differences between the two groups, we contacted baseball experts from the Italian Federation of Baseball and Softball in order to understand the relevance of these parameters to field performance (for a comprehensive list, see the Major League website: For instance, experts highlighted that a difference of score equal to 1 in the parameter ‘stolen bases’ (which requires a fast synchronization of vigilance and motor action) between ST users (average score 5.2, from [10]) and non-users (average score 4.2 [10]) may be relevant during a match (Paolo Castagnini, Board member of Italian Federation of Baseball and Softball, personal communication). Moreover, there are statistical parameters called ‘clutch’, which measure field performance during critical moments of the match. Indeed, higher values for these parameters are an expression of a better integration between cognitive and motor processes, such as perception, vigilance, divided attention, decision-making and executive outcome, in order to meet demanding game situations. These key moments of the match are also characterized by high alertness and arousal states, as well as by a higher stress condition. Slight changes in ‘clutch’ statistic values may have a significant impact on the competition. In these cases, the modest enhancement induced by ST use may make a difference in performance that could affect the outcome of a highly competitive baseball match, where teams and players appear to be well balanced.

Thus, while the limited set of available data suggest that some psychometric values are not changed in baseball ST users under abstinence, no data are available from the field, or even from the laboratory, under actual ST exposure. The question still remains: are those subjects who are taking ST benefiting from legal doping? We suggest that ST effects should be tested on field parameters which are relevant to the specific desired effect in sports such as baseball, rather than the ‘traditional’ psychometric measures. At present, there is limited translation or modelling of complex psychomotor performance - as in sports - into the laboratory. Although specific models have been developed to study sport performance in the laboratory, valid experimental paradigms are still lacking for investigations on the effects of addictive substances on complex psychomotor performance. A possible experimental approach is to begin by correlating the statistical data available on baseball performances in the United States with information on ST use of leading players. The results of such correlations may support experimental placebo-controlled studies on any enhancing effects of low- or high-nicotine ST. We believe that if ST is shown to enhance performance, then there may be a case for banning its use in baseball and possibly other sports. Of course, if ST were to be banned, the fact that it is addictive would mean that users would need to be offered help with achieving and sustaining abstinence. It would also raise issues concerning whether smoking tobacco and even the use of pure nicotine delivery systems should also be banned. This is a difficult area, but it makes sense to begin the debate now and start collecting relevant data.


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  2. References
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