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The American Academy of Pediatrics concluded in a 2015 policy statement that tobacco dependence is a pediatric disease

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Stage Four: Pre-Cancerous Lesions DNA mutations result in the appearance of visible lesions in the mouth's lining: Leukoplakia: White spots that cannot be removed Erythroplakia: Red patches (high risk for developing cancer) Oral Submucous Fibrosis (OSMF): Increasing stiffness of the mouth with difficulty opening Step 5: Cancerous Change After years of repeated exposure, genetic changes result in cancer that will then grow and spread into adjacent tissues until ultimately reaching the lymph nodes in the neck and even other organs

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This means that smokers often experience prolonged pain compared to non-smokers