Smoking and Oral Cancer

Smoking and chewing tobacco are a major cause of oral cancer.Footnote 1 

Read more about oral cancer...


The risk of oral cancer is about 5 to 10 times greater among smokers compared to people who never smoked.Footnote 2  This risk is further multiplied among smokers who also drink alcohol.Footnote 2, Footnote 3, Footnote 4 

Smokers are at higher risk of dying from oral cancer than those who have never smoked. The risk of dying from oral cancer increases with the amount smoked per day.Footnote 1 

Thirty-seven percent (37%) of people diagnosed with oral cancer are expected to die within 5 years after diagnosis.Footnote 5 There were 1,108 deaths from oral cancer in Canada in 2007.Footnote 6 

Research has shown that in 2002, about half of oral cancer deaths were due to smoking.Footnote 7 

This health warning message addresses oral cancer for cigarettes and little cigars:

Cancerous tongue

What is oral cancer?

Oral cancer is uncontrolled growth of abnormal cells starting in the mouth cavity leading to the formation of a tumour. Development of oral cancer occurs predominantly on the tongue, lower lip and floor of the mouth.

Squamous cell carcinoma is the most common cancer of the oral cavity. In men, most oral cancers are found on the floor of the mouth and tongue; in women, the most common sites are the tongue and gums.Footnote 8 

Symptoms of oral cancer include red or white spots in the mouth, which may become open sores.

Treatment for oral cancer often involves surgery and radiation therapy. Surgery involves removal of the affected tissue and if the cancer has spread to the jaw, part of the jawbone may also be removed. This may change how the face looks and the ability to chew, swallow, or talk.

How does smoking increase the risk of oral cancer?

Some of the chemicals contained in tobacco smoke cause, initiate or promote cancer.Footnote 9 Footnote 10  These chemicals cause genetic changes in cells of the mouth cavity which can lead to the development of oral cancer.

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.

The benefits of quitting

When people quit smoking, the risk of oral cancer starts to decrease rapidly.Footnote 1  After 10 to 20 years of quitting, the risk decreases to almost the same level as that of someone who has never smoked.Footnote 11 

Quitting can also decrease the risk of developing a new, second oral cancer in smokers with a previously treated oral cancer.Footnote 12 

Quitting is more effective than other measures to avoid the development of oral cancer and other smoking-related diseases.

Need help to quit? Call the pan-Canadian quitline toll-free at 1-866-366-3667.


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. P.63-67

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. P.1-8.

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.

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.

5. Canadian Cancer Society's Steering Committee: Canadian Cancer Statistics 2011. Toronto: Canadian Cancer Society, 2009.

6. Statistics Canada. Table 102-0552 - Deaths and mortality rate, by selected grouped causes and sex, Canada, provinces and territories, annual (2007), CANSIM (database). 2011 [updated 2010 Nov 15; cited 2011 Mar 15]. Available from:

7. Rehm J, Baliunas D, Brochu S, Fischer B, Gnam W, Patra J, et al. The costs of substance abuse in Canada 2002. Ottawa: Canadian Centre on Substance Abuse; 2006.

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.

9. Rodgman, A., Perfetti, T.A. The chemical components of tobacco and tobacco smoke. (2009). CRC press, Florida, USA. ISBN 978-1-4200-7883-1.

10. Hecht SS. Research Opportunities Related to Establishing Standards for Tobacco Products Under the Family Smoking Prevention and Tobacco Control Act. Nicotine & Tobacco Research [] Commentary [accepted November 25, 2010]. Web Published 2011 January;10.1093/ntr/ntq216. Available from:

11. 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.

12. Moore C. Smoking and Cancer of the Mouth, Pharynx, and Larynx. The Journal of the American Medical Association. 1965 Jan 26;191(4):107-10.

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