Tobacco and oral cancer

The use of tobacco products are a major cause of oral cancer.Footnote 1

Key facts about tobacco use and oral cancer

  • If someone smokes, their risk of oral cancer is about 5 to 10 times greater than someone who has never smoked.Footnote 1Footnote 2 This risk is multiplied if they also drink alcohol.Footnote 2Footnote 3Footnote 4
  • Oral cancer is 2 to 3 times more common in men than women.Footnote 5
  • People who smoke have a higher risk of mortality from oral cancer than those who have never smoked. This risk increases with the amount smoked per day.Footnote 1
  • In 2019, it was estimated there would be 5,300 new cases of oral cancer in Canada (excluding Quebec) and 1,450 deaths from oral cancer.Footnote 6
  • In Canada (excluding Quebec), 36% of people diagnosed with oral cancer are predicted to die within 5 years, according to 2015-2017 data.Footnote 6
  • Approximately 40% of new oral cancer cases were due to smoking in 2015.Footnote 7

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What is oral cancer?

Oral cancer is the uncontrolled growth of cells in the mouth leading to the formation of a tumour. Oral cancer can occur on the tongue, lips, cheeks, gums and the roof, floor and back of the mouth.

In men, most oral cancers occur on the floor of the mouth and tongue; in women, the most common sites are the tongue and gums.Footnote 8 Common symptoms of oral cancer include white and/or red lesions, patches or plaques, bony tumors, and open sores.Footnote 9

Treatment for oral cancer often involves surgery and radiation therapy. Surgery involves removal of the affected tissue and may also require removal of part of the jawbone or tongue.Footnote 10Footnote 11 This could change the appearance of the face and the ability to chew, swallow, and speak.Footnote 10

How does tobacco use increase the risk of oral cancer?

Some of the chemicals contained in tobacco smoke and chewing tobacco are carcinogenic, meaning they can cause genetic changes in cells of the mouth cavity, leading to the development of oral cancer.Footnote 1Footnote 12

Tobacco use increases the risk of oral cancer by exposing the mouth to these carcinogenic chemicals, either during inhalation while smoking or through direct contact while chewing tobacco products.Footnote 1Footnote 12

How does quitting reduce the risk of oral cancer?

Quitting tobacco use can reduce the size of pre-cancerous lesions, patches, or plaques in the mouth.Footnote 1 The risk of oral cancer starts to decrease within the first five years of quitting. If someone who smoked has quit for 20 or more years, their risk is the same as someone who has never smoked.Footnote 13

Quitting is one of the best ways to avoid the development of oral cancer and other smoking-related diseases.Footnote 14

If someone who smokes has oral cancer, quitting can still benefit them. Quitting can improve recovery for cancer patients.Footnote 15 Quitting can also decrease the risk of developing a new oral cancer of someone who had one previously treated.Footnote 16

Continuing to smoke after a cancer diagnosis can lower the chances of survival and increase the risk for other cancers caused by smoking, such as lung cancer.Footnote 15

Health benefits of quitting tobacco use at any age

Quitting tobacco use reduces the risk of premature death, improves health, and enhances quality of life.Footnote 14 Quitting at any age is beneficial to health.Footnote 14 Even people who have smoked or used tobacco heavily for many years will benefit from it.Footnote 1Footnote 14 Quitting is the most important thing someone who smokes can do to improve their health.

Read more about the benefits of quitting smoking.

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Footnotes

Footnote 1

U.S. Department of Health and Human Services. The Health Consequences of Smoking. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.

Return to footnote 1 referrer

Footnote 2

International Agency for Research on Cancer. World Health Organization. IARC Monographs on the Evaluation of Carcinogens Risks to Humans: Alcohol Drinking. Vol. 44. Summary of Data Reported and Evaluation. Lyon (France): International Agency for Research on Cancer; 1988.

Return to footnote 2 referrer

Footnote 3

Talamini R, Bosetti C, La Vecchia C, Dal Maso L, Levi F, Bidoli E, Negri E, Pasche C, Vaccarella S, Barzan L, Franceschi S. Combined effect of tobacco and alcohol on laryngeal cancer risk: a case-control study. Cancer Causes & Control. 2002;13(10):957-64. doi: 10.1023/a:1021944123914.

Return to footnote 3 referrer

Footnote 4

Menvielle G, Luce D, Goldberg P, Bugel I, Leclerc A. Smoking, alcohol drinking and cancer risk for various sites of the larynx and hypopharynx. A case-control study in France. European Journal of Cancer Prevention 2004;13(3):165-72. doi: 10.1097/01.cej.0000130017.93310.76.

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Footnote 5

Rivera, C. Essentials of oral cancer. International Journal of Clinical and Experimental Pathology. 2015;8(9):11884-94. PMID: 26617944.

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Footnote 6

Canadian Cancer Statistics Advisory Committee. Canadian Cancer Statistics 2019. Toronto, ON: Canadian Cancer Society; 2019. https://cdn.cancer.ca/-/media/files/research/cancer-statistics/2019-statistics/canadian-cancer-statistics-2019-en.pdf

Return to footnote 6 referrer

Footnote 7

Poirier AE, Ruan Y, Volesky KD, King WD, O'Sullivan DE, Gogna P, Walter SD, Villeneuve PJ, Friedenreich CM, Brenner DR. The current and future burden of cancer attributable to modifiable risk factors in Canada: Summary of results. Prev Med. 2019;122:140-147. doi: 10.1016/j.ypmed.2019.04.007.

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Footnote 8

Barasch A, Morse DE, Krutchkoff DJ and Eisenberg E. Smoking, gender, and age as risk factors for sitespecific intraoral squamous cell carcinoma. A case series analysis. Cancer. 1994;73(3):509-13. https://doi.org/10.1002/1097-0142(19940201)73:3<509::AID-CNCR2820730303>3.0.CO;2-X

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Footnote 9

Montero PH, Patel SG. Cancer of the oral cavity. Surgical oncology clinics of North America. 2015;24(3): 491-508. Doi:10.1016/j.soc.2015.03.006.

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Footnote 10

Kolokythas A. Long-term surgical complications in the oral cancer patient: a

Comprehensive review. Part I. J Oral Maxillofac Res. 2010;1(3):e1. doi: 10.5037/jomr.2010.1301.

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Footnote 11

American Cancer Society. Treating oral cavity and oropharyngeal cancer. American Cancer Society; 2021. https://www.cancer.org/content/dam/CRC/PDF/Public/8766.00.pdf

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Footnote 12

U.S. Department of Health and Human Services. The Health Consequences of Using Smokeless Tobacco: A report of the Advisory Committee to the Surgeon General. Bethesda, MD: U.S. Department of Health and Human Services, 1986.

Return to footnote 12 referrer

Footnote 13

Marron M, Boffetta P, Zhang Z, Zaridze D, Wunsch-Filho V, Winn DM, et al. Cessation of alcohol drinking, tobacco smoking and the reversal of head and neck cancer risk. International Journal of Epidemiology. 2010;39:182-96. doi: 10.1093/ije/dyp291.

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Footnote 14

U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2020.

Return to footnote 14 referrer

Footnote 15

U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.

Return to footnote 15 referrer

Footnote 16

Moore C. Smoking and cancer of the mouth, pharynx, and larynx. The Journal of the American Medical Association. 1965;191(4):283-286. doi:10.1001/jama.1965.03080040025005.

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