(36.9%), golf (28.3%), and football (23.8%). In the same study, use of smokeless tobacco by Division I fe- male student-athletes ranged from 0.0% (crew, gymnastics, swimming) to between 2.0% and 2.4% for soccer, soſtball, lacrosse, and track. Spit tobacco can lead to periodontal disease, loss of tooth structure, tooth staining, bad breath, and gum disease, as well an increased risk of oral cancer and leukoplakia.35