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Smoking increases the risk of developing oral human papillomavirus type 16 (HPV-16), according to a new study.

Participants who reported tobacco use had significantly higher levels of biomarkers of tobacco exposure. This is worrying because oral HPV-16 increases the risk of developing oropharyngeal squamous cell cancers.

Furthermore, HPV rates got higher the more cigarettes a person smokes.  

The latest study, which involved data from 6,887 participants of the National Health and Nutrition Examination Survey (NHANES), analyzed links between objective biomarkers reflective of all current tobacco exposures (environmental, smoking, and use of smoke­less tobacco) and oral HPV-16 prevalence.

Participants between the ages of 14 and 69 underwent oral HPV DNA testing, Participants were also asked to fill out questionnaires about their tobacco use and sexual behaviors. Tobacco use was defined as using a nicotine-containing product for the past five days.

The tobacco biomarkers included serum cotinine, a major nicotine metabolite, and urinary 4- (methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a tobacco­specific, carcinogenic metabolite.

The study also revealed that tobacco users were more likely to be male, younger, less educated and have had a higher number of lifetime oral sexual partners.

"These findings highlight the need to evaluate the role of tobacco in the natural history of oral HPV-16 infection and progression to malignancy," researchers wrote in the study.

The findings were published Oct. 8 in The Journal of the American Medical Association.