Cancer Institute A national cancer institute
designated cancer center

Oral Cancer and Tobacco

What is the link between tobacco and oral cancer?

Tobacco use is a known as a major risk factor for oral and other cancers. All tobacco products, including cigarettes, cigars, pipe tobacco, chewing tobacco, and snuff, contain toxins (poisonous substances), carcinogens (cancer-causing agents), and nicotine (an addictive substance). Each tobacco product is linked to an increased risk for specific cancers:

Cigarettes Cigarettes, the most common form of tobacco used, causes 87 percent of all lung cancer cases, according to the American Lung Association. In addition, smokers are six times more likely than nonsmokers to develop some form of oral cancer in the oral cavity. Cigarettes contain more than 43 cancer-causing agents.
Cigars and pipes Cigars and pipes are often perceived as the less harmful way to smoke tobacco. However, even when not inhaling, cigar and pipe smokers are at increased risk for cancer of the oral cavity and lungs. Pipe smokers also are at increased risk for lip cancers in areas where the pipestem rests. In addition, cigars take longer to burn and contain more tobacco than cigarettes, increasing the amount of secondhand smoke exposure.

Cigar smoking can lead to tooth loss, jaw bone loss, and other periodontal diseases.

Chewing tobacco and snuff Spit tobacco, also known as chewing tobacco and snuff, are forms of tobacco that are put between the cheek and gum. Chewing tobacco can be in the form of leaf tobacco (which is packaged in pouches), or plug tobacco (which are packaged in "brick" form). Snuff is a powdered form of tobacco, usually sold in cans. The nicotine is released from the tobacco as the user "chews."

Although chewing tobacco and snuff are considered "smokeless" tobacco products, harmful chemicals including nicotine are ingested. Other chemicals in chewing tobacco and snuff include:

  • nuclear waste

  • cancer-causing agents (carcinogens)

  • formaldehyde (normally used to embalm corpses)

  • car battery chemicals

  • cyanide (a type of poison)

  • arsenic

  • benzine

  • lead

Chewing tobacco and snuff can cause cancer in the cheek, gums, and lips. Like a pipe, cancer often occurs where the tobacco is held in the mouth. Cancer caused by "smokeless" tobacco often begins as leukoplakia (a condition characterized by a whitish patch that develops inside the mouth or throat) or erythroplakia (a condition characterized by a red, raised patch that develops inside the mouth). Other problems associated with chewing tobacco and snuff include periodontal disease, tooth discoloration, and bad breath, among others.

How do cigarettes and cigars compare?

Cigars became a trend in the 1990s, attracting the young and the old. Although perceived as less detrimental to one's health, cigars actually pose the same risk as cigarettes for oral cancer. Although many cigar smokers do not inhale, the risk for oral, throat, and esophageal cancers is the same as for cigarette smokers. Consider these facts:

Quitting tips for persons who use tobacco products:

The American Academy of Otolaryngology and the American Lung Association offer the following tips to persons who use tobacco products and are trying to quit:

Stanford Medicine Resources:

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