Tobacco use includes smoking cigarettes, cigars, or pipes; chewing tobacco; and using snuff. It is the single largest risk factor for head and neck cancer. The amount of tobacco use may affect the chance of recovery.

If a person smokes or has smoked in the past they have a higher risk of getting Head and Neck cancer than someone who has never smoked.​ Prolonged exposure to second hand smoke may also increase a person’s risk of developing head and neck cancer.