Cancer rates for both the salivary gland and nasopharynx are
10-25 times higher among the Inuit than among the general Canadian
population; these cancers are associated with Epstein-Barr virus
infection as well as genetic, environmental and immunologic factors.
Alcohol and tobacco are major risk factors for tumours of the mouth,
tongue and pharynx with a diet high in fresh fruits and vegetables
acting as a protective factor. Smokeless tobacco use, including snuff
and chewing tobacco is important (long-term users 50 times more
likely to develop cancer of the cheek and gum than non-users)
although vitamin deficiencies and occupational exposures are also
implicated. Smokeless tobacco has other negative health effects
and in the United States use has increased over the last two decades
largely due to increased consumption by young males. While
smokeless tobacco use is rare in Canada (overall prevalence of use
under 1% in 1986), prevalences of use of 6-30% among native children
(depending on age and study population) and 1-4% among non-native
adolescents have been reported