Head and neck cancer is the sixth most common cancer in the world. The vast majority of cases are head and neck squamous cell carcinoma (HNSCC), a type of cancer that arises in the outer layer of the skin and mucous membranes of the mouth, nose and throat. Cigarette smoking is a major risk factor for developing the disease and reduces treatment effectiveness. Now Thomas Jefferson University researchers studying the effects of cigarette smoke on tumor progression show that cigarette smoke reprograms the cells surrounding the cancer cells, and helps drive HNSCC aggressiveness. The results were published online in the journal Molecular Cancer Research.