The risk for laryngeal cancer is 20 to 30 times greater in smokers. About 70% of oral and 85% of laryngeal cancer deaths are directly attributable to smoking. The risks of cancer of the oral cavity, pharynx, and larynx drop sharply during the first 10 years after smoking cessation. There appears to be a syn-ergistic, multiplicative effect between smoking and drinking, such that the risk for development of cancer of the larynx is as much as 75% higher in people who use tobacco and alcohol versus those exposed to either substance alone (US Surgeon General, 1990, 2004).

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