Epidemiology of Cancer by Tobacco Products and the Significance of TSNA
This chapter reviews the etiological role of tobacco in cancer using oral cancer as a model for evaluating a variety of data. A link between the use of smokeless tobacco and cancer was suspected as early as 1761 in the united states and a case report implicating snuff dipping with oral cancer appeared in 1915. While epidemiological data identify tobacco as the most important etiological factor for oral cancer, several experimental approaches identify tobacco-specific N-nitrosamines as the main cancer-causing constituents in tobacco. Reverse chutta smoking causes squamous cell carcinoma of the palate, which otherwise is a rare location for cancer. In India tobacco is smoked in many ways; the most common is bidi, others being chutta, including reverse smoking, hooka, and clay pipe. The most common, in fact, often the only form of tobacco use in most parts of the world, is cigarette smoking.