I agree with Christine, that the doctor could have been way more tactful. And there are people with no known etiology that get oral cancer, and we don't know why ( about 5%). But the truth is that tobacco brings more people to it than any other cause, and it is possible to chase her cause definitively, if someone wanted to by looking at the cellular dna. The are well documented markers in tobacco carcinogenesis of cells. So he likely is right, but he is equally wrong.

There would be, and is, a softer way to suggest what happened. Unfortunately, and I do not mean to sound callous here so don't shoot me, in many things in life we are the architects of our own situation - cancer or other things. But if a patient asks you outright, and many of you here are ardent pursuers of an absolute answer, what is he supposed to say - that tobacco was not part of the equation? Most of the good doctors that I have listened to explain things, soften things, even when they know that a decade or two of tobacco use is the most likely culprit. They choose not to say anything definitive to the patient because of this very issue. It serves no good for a patient to beat themselves up emotionally after the fact, they have enough on their plate with a cancer diagnosis.