In man, nicotine is commonly consumed via smoking cigarettes, cigars or pipes. The addictive liability and pharmacological effects of smoking are primarily mediated by the major tobacco alkaloid nicotine. There are elevated serum cadmium and lead levels in smokers resulting in glomerular dysfunction. There is a constant and direct attack of various cigarette smoke reagents on the oral epithelial cells, which gradually accumulate and may cause a stepwise malignant transformation. The association between cigarettes and lung cancer has been proven by large cohort studies. Tobacco use has been reported to be the main cause of 90% of male and 79% of female lung cancers. Ninety percent of deaths from lung cancer are estimated to be due to smoking. This review describes the implication of nicotine, smoking, smoke extracts and other tobacco constituents on oral cancers, lung cancer and cancers of the urinary tract.

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