As Monte Lee grew up in the dusty mill town of Lugoff, chewing tobacco was expected from men in the Lee household.

Lee, the College of Charleston's baseball coach, had plenty of role models when it came to using tobacco. Both of Lee's grandfathers and his father chewed or dipped.

Lee was only 13 when he started. It was a habit that he didn't finally kick until two years ago.

"It's what every man in our house did," said Lee, who is 37. "It was natural. It's part of the culture of where I grew up and it's definitely part of the culture of baseball. Just about everyone I knew or hung around with used some kind of smokeless tobacco."

The ageless mix of tobacco and baseball is back in the news again after the recent death of Hall of Famer Tony Gwynn, who died of oral cancer believed to be connected to his longtime use of chewing tobacco.

Baseball organizations have taken steps to discourage tobacco use among players. Though Major League Baseball players still are allowed to use it, the NCAA banned the substance in college baseball 20 years ago, and smokeless tobacco was banned in the minor leagues in 1993. Use of any form of tobacco is not allowed in the S.C. High School League by players, coaches and officials at league sponsored activities.

On Friday, nine major medical and public health organizations released a letter to Major League Baseball, urging MLB to enact a complete ban on tobacco use at ballparks and on camera.

"Use of smokeless tobacco endangers the health of major league ballplayers," the letter said. "It also sets a terrible example for the millions of young people who watch baseball at the ballpark or on TV and often see players and managers using tobacco."

Despite the rules and sad stories such as Gwynn's, tobacco use persists in baseball. A 2009 NCAA survey indicated that 52.3 percent of college baseball players acknowledged using tobacco in the previous month, up from 42.5 percent in 2005.

Anecdotally, local coaches say tobacco use is on the rise among young players.

"It's 10 times worse now than when I was in high school," said former major league pitcher Bryce Florie, who played with Gwynn and now coaches at Northwood Academy in North Charleston. "To me, it is mind-boggling how many kids do it. I think it's a much bigger problem for young guys now than when I was in high school."

Florie himself began dipping when he was 15, and said he was introduced to smokeless tobacco on the baseball field. He quit a few years ago, saying "it got to the point where I just didn't like it anymore," and tries to discourage his players at Northwood Academy from using tobacco.

"I don't allow it in front of me, but I know it happens," Florie said. "I'm not their parent, but I put my foot down when it comes to baseball."

Like many players, Lee had a more difficult time ending his habit. He was a junior at College of Charleston when he developed a sore in his mouth and decided to stop. He went more than a year without tobacco, but returned to the ugly habit in the minor leagues during batting practice one afternoon.

"I was out in the outfield shagging fly balls and I turned to my roommate and asked him if he had any dip," Lee said. "As soon as I put it in my mouth I knew I was hooked again."

Lee said he tried to stop a couple of times when he was coaching at South Carolina and later at his alma mater, but it never took. The addiction was too strong.

"It's like smoking cigarettes," Lee said. "Just ask any smoker how hard it is to quit. I know guys who have actually gotten sick from trying to stop. The headaches and nausea can be powerful."

He finally stopped for good during his honeymoon in 2011. But that was as much out of necessity as will power. Lee didn't bring any tobacco with him and there was none to be found in Mexico.

"For me it was all mental," Lee said. "Once I got past a week without it, I knew I was going to be OK. I knew I had to stop."

Former major league pitcher Britt Reames also has found it difficult to stop. The former Citadel star, who played in more than 100 major league games, has been trying to quit for the last few years, but has been unsuccessful.

Reames, who is an assistant coach at The Citadel, said he started chewing tobacco when he was a freshman with the Bulldogs.

"It's such a disgusting habit and I know it," Reames said. "I never wanted to do it, but once I started it's been almost impossible to stop."

Reames said the vast majority of major league players chewed tobacco constantly when he played. There was almost a stigma on players that didn't use it.

"It's definitely ingrained in the culture of baseball," Reames said. "If you didn't chew, you were in the minority."

Reames, 40, has two young sons and hopes they never start chewing tobacco. "They won't do it in my house," he said.

Getting the message through to young players is difficult, especially with the way smokeless tobacco is marketed now, said West Ashley High School coach Mitch Miggenburg.

"Tobacco companies come out with all these flavors, like berry and fruit-flavored tobacco, to make it more appealing to young people," Miggenburg said. "In the mid-1990s, you had straight and wintergreen. Now, there are a lot more flavors they are marketing."

In the wake of Gwynn's death, Washington Nationals star Stephen Strasburg said he is trying to give up his habit, and ex-Braves great Chipper Jones has tweeted about his effort to stop dipping.

"If that's not an incentive, I don't know what is," Reames said of Gwynn's death. "It can kill you. It's that simple. You are risking your life doing it."