Hi. I am a caregiver to my mother. As you can see from my signature, she is 60 years old and NEVER smoked a cigarette - not even to try, and in all honesty may have had 6 drinks per YEAR. The only alcoholic drink she ever really liked was her own homemade eggnog (which is amazing). Last summer (2006) my mother started having trouble opening her jaw. The oral surgeon decided by November that he was going to try a surgery to stretch the muscle in her jaw. It was a painful surgery and did not help one bit. She started losing weight when she could not open her jaw and wound up losing a total of 95 lbs. from last summer until May 22 of this year, when she was finally hospitalized. Throughout this ordeal her general practioner was actually happy that she was losing so much weight (she started out a bit over 200 lbs) and told her that nothing was wrong, keep up the good work, etc. Can you believe that!?!? Anyway, the story continues... my mom kept going to doctors - her normal doctors and new doctors - just trying to get someone to listen. Finally, in early May a new ENT ordered an MRI. Guess what - her insurance did not want to cover it. The final straw was when I took her in May for a tooth extraction and cried in the oral surgeon's office. He sent her to the ER later that day. It is all so insane. One of the first symptoms listed on the Johns Hopkins website for this type of cancer is the stiffening or inability to open the jaw. How any doctor - let alone at least 6 of them - let this happen is beyond me. So, no, you do not need to smoke, drink or do anything else to have this happen to you. It is just awful. My mother was the hardest worker I have ever known and just wanted to spend her free time gardening. Right now she is basically bedridden and I just hope and pray every day that her treatments worked.