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When you stop using tobacco products, your oral cancer risk drops significantly.

Reviewed by Dietitian Casey Wing, RD, CD

Key Points

• Tobacco use is a leading risk factor for oral cancer due to its inflammatory effects.
• Quitting smoking significantly reduces cancer risk, with risks halving after five years of cessation.
• Using tobacco and alcohol multiplies oral cancer risk; reducing both can lower your chances.

If you want to lower your risk of developing oral cancer, it’s time to put down your cigarettes and tobacco products. That’s because smoking is a leading risk factor for oral cancers, which occur throughout the mouth and in the back of the throat, including on the tongue, gums, under the tongue and in the tissue that lines the mouth. These make up about 3% of all cancer cases diagnosed in the United States each year and are more common in people who are older than 40.

There are many different risk factors for oral cancer, including age, sun exposure, infection with the human papillomavirus virus (HPV), genetics, poor nutrition and alcohol consumption. But tobacco use is a major risk factor to keep in mind. “Tobacco use is probably the most well-established risk factor for oral cancer,” says Yev Davydov, DDS. “Any type of smoking byproduct creates a toxic environment for oral tissues, and frequent and longer-duration exposure is closely linked with increased oral cancer risk.”

Here’s why using tobacco products can increase your risk of oral cancer, according to dental experts.

How Tobacco Products Affect Your Risk for Oral Cancer

Tobacco Smoke Contains Carcinogenic Chemicals

Tobacco smoke contains more than 70 different chemicals deemed carcinogenic, which means they’re known to cause cancer. “When you smoke, those chemicals coat the tongue, cheeks, gums and floor of the mouth, damaging the DNA in those cells over years,” says Pia Lieb, DDS. “Cells with damaged DNA start dividing abnormally, and that’s where cancer begins.”

But there’s good news too. When you stop smoking, your risk for oral cancer drops significantly. Five years after someone stops smoking or using tobacco products, their risk of developing mouth, throat and esophageal cancers is cut in half.

“Within 10 to 20 years, a former smoker’s risk approaches that of someone who never smoked,” Lieb says. “The mouth has a remarkable capacity to heal once the assault stops.”

Smoking Increases Inflammation

Smoking contributes to chronic inflammation, which can promote the growth of cancer. It can also inhibit normal cell functioning, which can make cell mutations and cancer more likely to develop.

“Tobacco smoke is highly inflammatory,” Davydov says. “Add the frequency and duration that most people expose themselves to these compounds and cellular damage is inevitable.”

Smokeless Tobacco Products Also Pose a Risk

Even though smokeless tobacco products aren’t burned like cigarettes, they still contain lots of the harmful chemicals that are known to cause cancer. Among the more harmful types of chemicals in smokeless tobacco products are tobacco-specific nitrosamines (TSNAs), which are primarily formed when tobacco is processed or cured. TSNAs have been linked with many different types of cancer, including oral cancers and esophageal cancer.

“It’s worse in some ways, because the carcinogens sit in direct contact with one spot for hours at a time,” Lieb says. “I can usually tell which side of a patient’s mouth they favor just by where the white patch has formed.”

Some of the newer types of smokeless tobacco products or even e-cigarettes may not pose as much of a risk, especially if they contain fewer harmful chemicals than products like snuff and chewing tobacco. But more high-quality research is needed to better understand the long-term health impact.

Using Tobacco Products & Alcohol Further Increases Risk

Separately, tobacco and alcohol use both increase the risk of oral cancer. But when people use both tobacco products and alcohol, the risk of oral cancer is substantially higher. This is because alcohol acts as a solvent, allowing the carcinogens in tobacco smoke to more easily penetrate into the tissues in the mouth and throat.

“Tobacco and alcohol together don’t add up, they multiply,” Lieb says, adding that each one makes the other more dangerous. Not using tobacco products or alcohol is the best way to reduce your risk, but cutting back can also be helpful, she says. Roumiana Tzvetkova, DDS, agrees: “There really isn’t a safe level of tobacco use when it comes to cancer risk, so complete cessation provides the greatest benefit. That said, any reduction in use is a step in the right direction, especially if it leads toward quitting.”

Other Tips to Support Oral Health

• Brush your teeth twice each day and floss daily. This helps remove dental plaque and is key to good oral hygiene, which supports overall health.
• See your dentist regularly. “Routine scheduled examinations by health professionals, especially your dentist, are recommended to detect and screen for potentially dangerous lesions of the oral cavity,” says Sung Hee Cho, D.D.S. Lieb encourages patients to “ask specifically for an oral cancer screening—it takes 90 seconds.”
• If something feels off, schedule an appointment with your dentist or doctor. “Pay close attention to any persistent changes in the mouth, such as sores that don’t heal, lumps or unusual patches,” says Tzvetkova.
• Use lip balm with SPF. Sun exposure can cause cancer of the lip. Using SPF can help reduce the risk.
• Get the HPV vaccine. Infection with the human papillomavirus (HPV) can cause oral cancer. “HPV is now driving a growing share of oropharyngeal cancers in younger nonsmokers,” Lieb says.

Our Expert Take

Using tobacco products is a leading risk factor for oral cancer. Tobacco products contain carcinogenic chemicals that can damage cells throughout the mouth, increasing cancer risk. When those cells begin to divide abnormally, cancer can occur. Smoking also increases inflammation, which can promote cancer growth. People who drink alcohol and use tobacco products are at an even higher risk for oral cancer. The best way to reduce your risk is to stop using tobacco products, but cutting back can also make a meaningful difference.