Tobacco and cancer risk

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science.

This page was updated on June 13, 2022.

One of the most important ways to prevent cancer is to avoid tobacco products of any kind. Tobacco use is one of the top causes of cancer and of cancer death, according to the National Cancer Institute (NCI). Both tobacco and smokeless tobacco may cause cancer. Quitting smoking and use of other tobacco products may reduce the overall cancer risk.

What are tobacco products?

Tobacco products include cigarettes, cigars, pipe tobacco, chewing tobacco, snuff, snus, hookah tobacco and more. In 2019, almost 14 percent of U.S. adults smoked cigarettes. Electronic cigarettes (e-cigs) and vape products are also classified as tobacco products by the U.S. Food and Drug Administration (FDA).

The health effects of tobacco products on the world population are enormous. Globally, tobacco use causes about 7 million deaths per year. In the United States, smoking is the leading cause of preventable death, according to the Centers for Disease Control and Prevention.

Smoking may lead to the following health conditions:

  • Cancer
  • Heart disease
  • Stroke
  • Chronic obstructive pulmonary disease (COPD)
  • Emphysema
  • Chronic bronchitis
  • Other lung diseases and infections, such as tuberculosis and pneumonia
  • Diabetes
  • Osteoporosis
  • Rheumatoid arthritis
  • Macular degeneration
  • Cataracts
  • Erectile dysfunction
  • Fertility issues

In addition, smoking during pregnancy may lead to complications for both the woman and baby. It also may worsen symptoms for asthma patients.

What about vaping?

The harmful health effects are more well-known for smoking tobacco than for products such as e-cigarettes and vape devices. Smoking has been around for much longer, and there are still many unknowns about the ingredients used in these newer products.

Still, research suggests that the aerosols created by e-cigarettes and vape products may contain harmful chemicals, such as diacetyl, formaldehyde and other volatile organic compounds (VOCs). These are the same cancer-causing chemicals found in cigarette smoke, but they’re present in lower amounts.

Public health authorities recommend avoiding e-cigarettes and vape products. They contain varying amounts of nicotine and may cause physical dependence. There are no testing requirements, which means there’s no way to know how safe every product is and what chemicals may be lurking inside.

How does tobacco cause cancer?

Cigarette smoke contains at least 69 different carcinogens (substances known to cause cancer), according to the NCI. These chemicals, which include hazardous gases and metals, arsenic and more, cause changes in the cells that may lead to cancer. The carcinogens in tobacco smoke may also pose a risk to others who are exposed to it through secondhand smoke.

Learn more about how smoking causes cancer.

Smokeless tobacco, like chewing tobacco, snuff, snus and other dissolvable products, also contain carcinogens that may be absorbed through the tissue of the mouth. While they’re associated with fewer deaths than smoking tobacco, these addictive products may still lead to cancer.

Tobacco use may lead to cancer in these parts of the body:

It also contributes to acute myeloid leukemia, a condition in which too many immature white blood cells are found in the bone marrow and blood.

Remember, there’s no “safe” level of tobacco use. Even one cigarette per day may affect health. While it may be tough to quit tobacco products, doing so may greatly reduce the risk of cancer, cancer death, and other severe diseases.

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