Nobody truly knows: but the chronic irritation of certain aromatic hydrocarbons in the smoke ("tars") progressively irritates cells, increases the number that die, with new ones taking their place that over many years become more and more abnormal (metaplasia), finally becoming very abnormal (dysplasia) and ultimately becoming cancer (neoplasia). I do not know the exact cellular mechanisms, but some scientists do.
Answered 5/27/2014
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