Which activity warrants the highest priority for education to prevent head and neck cancer?

• A. Chews tobacco
• B. Multiple sex partners
• C. History of alcohol abuse for 5 years
• D. Brushes with a soft-bristle toothbrush

Answer: (A)

The main idea is identifying which behavior most strongly increases the risk of head and neck cancer and, therefore, should be the top focus of prevention education. Smokeless tobacco use delivers carcinogens directly to the oral mucosa, including nitrosamines, leading to a higher risk of cancers in the oral cavity and nearby structures. This makes it a highly impactful and modifiable target for education: stopping or avoiding chewing tobacco can substantially reduce cancer risk.

In contrast, while alcohol use and its combination with tobacco also raise risk, and HPV infection is linked to some head and neck cancers, the most direct and preventable single behavior among the options is using smokeless tobacco. Brushing with a soft-bristle toothbrush is a protective habit and does not pose a cancer risk; it’s something to encourage, not the focus of risk education.