Researchers Find Possible Link Between Tobacco and Oral HPV

Oral HPV rate higher in tobacco users in new study of human papillomavirus type 16

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Smoking has been tied to health issues of all types. Now, smokers might have another reason to kick the habit — oral human papillomavirus (HPV).

A new study found that tobacco users were more likely to test positive for oral HPV, which can in some cases lead to certain types of head and neck cancers.

According to the authors of this new study, which was led by Carole Fakhry, MD, MPH, of the Johns Hopkins University School of Medicine in Baltimore, oral human papillomavirus type 16 (HPV-16) is a sexually transmitted infection that has been tied to an increase of oropharyngeal squamous cell cancers.

To explore the possible relationship between oral HPV and tobacco use, Dr. Fakhry and team used data from the 2009 to 2012 National Health and Nutrition Examination Survey (NHANES).

The current study included 6,887 survey participants between the ages of 18 and 59. Participants received oral HPV DNA testing and completed a computer survey measuring tobacco use and sexual behaviors.

The researchers found that, overall, 28.6 percent of the participants were current tobacco users and 1.0 percent tested positive for oral HPV-16 DNA.

Among those who were current tobacco users, 2.0 percent were found to have oral HPV DNA — a higher rate than both never and former tobacco users.

According to Steven Davis, MD, an infectious disease specialist at Baylor Medical Center at Irving, "The group of smokers in the survery also were more likely to be male, less educated and have higher numbers of reported oral sexual contacts.

"So, the risk for smokers may be influenced in this study by an increased propensity for these individuals to participate in other risky activities such as oral sex with multiple partners," he said. "However it is possible that injury or inflammation associated with smoking could increase the susceptibility to initial HPV infection."

Dr. Fakhry and team wrote that further research is needed to explore how tobacco might effect both rates of oral HPV-16 infection and progression to cancer.

"Most people are familiar with human papilloma viruses for their role in genital wart infections and later cervical cancers," said Dr. Davis. "Interestingly, HPV-16 has been associated with mouth and throat cancers usually later in life. Vaccines are available and recommended for young men and women to reduce their risk of ... HPV."

Although this study found an association between the presence of oral HPV DNA and tobacco use, it did not establish a relationship of cause and effect.

"It is clear that use of cigarettes or chewing tobacco increase the risk for oral cancers," Dr. Davis told dailyRx News. "Certainly, the interaction of oncogenic virus with other carcinogens will be a subject for ongoing study. Moreover, strategies to reduce risk for cancers will focus on vaccines as well as harm reduction through safer sex and smoking cessation campaigns."

This study was published October 7 in JAMA.

Two of the study authors reported receiving previous research support from pharmaceutical company Merck Inc., which also provided funding for this study. Additional funding sources included the the National Institute of Dental and Craniofacial Research and the Milton J. Dance Head and Neck Center.

Review Date: 
October 5, 2014
Last Updated:
October 13, 2014