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Data for oropharyngeal and hypopharyngeal cancers did not support risk reduction with alcohol cessation.[1] Vaccination Against Human Papillomavirus (HPV) Type 16 (HPV-16) and Other High-Risk Subtypes Vaccination against HPV-16 and type 18 (HPV-18) has been shown to prevent approximately 90% of oral HPV-16/HPV-18 infections within 4 years of vaccination.[2 ,3] Given the relatively recent adoption of vaccination and the age at which individuals are vaccinated, there is not yet evidence that vaccination at a young age will lead to a substantially reduced risk of HPV-associated oropharyngeal cancer later in life

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59 However, the possibility of differences in metabolism of NNK to NNAL in children as compared to adults is a factor that cannot be ruled out