Tobacco Use and Oral Cancer: Potential Dangers, Initial Symptoms, and Cessation Strategies
Oral cancer, also known as mouth cancer, affects around 4 per 100,000 males and 1 in 141 females. While most people receive a diagnosis after the age of 55, it can occur in younger individuals as well.
The use of various tobacco products significantly increases the risk of oral cancer. Both direct tobacco exposure and secondhand smoke contribute to this risk.
Smoking tobacco releases carcinogens that damage the cells in the mouth, lips, throat, gums, tongue, and other oral tissues, leading to cancerous changes. Similarly, smokeless tobacco (chewing and dipping tobacco) exposes oral mucosa to carcinogenic chemicals, which can cause premalignant lesions and malignant transformations.
Secondhand smoke exposure raises oral cancer risk by over 50%, with long-term exposure potentially doubling the risk compared to non-exposed individuals.
Tobacco use disrupts the oral microbiome, creating a pro-inflammatory environment that favors chronic inflammation and carcinogenesis in the oral cavity. Changes in bacterial and fungal communities caused by tobacco contribute to cancer progression.
Alcohol and other combined risk factors, such as betel quid chewing, often interact with tobacco use to further elevate oral cancer risk. In addition, co-use of tobacco with substances like cannabis may further exacerbate risk. For example, tobacco smokers with cannabis use disorder have a notably higher risk of oral cancer, potentially due to combined carcinogenic effects and immune suppression caused by cannabis.
People experiencing symptoms such as jaw pain or swelling, mouth or lip sores that do not go away, lumps around the cheeks, mouth, or lips, red or white patches in the mouth, sore throat, lingering mouth pain, difficulty swallowing or chewing, numbness in or around the mouth, loss of tongue or jaw mobility, ear pain or interfering with speech, should visit a doctor for a full evaluation. This may include a physical exam, imaging tests, and a biopsy.
Quitting tobacco can improve heart health, increase lifespan, and reduce the risk of many chronic diseases. Medications such as nicotine patches or varenicline can help reduce cravings for tobacco. Keeping reasons for quitting in mind and seeking support from friends, family, medical professionals, and support groups can make quitting tobacco easier.
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