Chewing Tobacco and Oral Cancer: Clarifying the Risk

Chewing tobacco (smokeless tobacco) is a well-established cause of oral cancer. It contains tobacco-specific nitrosamines (TSNAs) and other carcinogens that directly contact oral mucosa. Long-term use significantly increases risk of squamous cell carcinoma of the lip, tongue, floor of mouth, and buccal mucosa, as well as leukoplakia, periodontal disease, and tooth loss. The statement that it is “not a common cause” is incorrect; it is a major preventable risk factor.