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According to your 1990 abstract, people who don't use smokeless tobacco are extremely unlikely to get those white patches: "Of the 423 current smokeless tobacco users, 196 had leukoplakia compared to seven of the 493 nonusers (OR = 60.0, 95% CI = 40.5-88.8)." More recent work shows that smoking is not as much a concern as you claim

One of the many dangers of smoking is an increased risk of diabetes, because nicotine uptake leads to altered glucose metabolism and increased blood sugar levels 1 4
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Tobacco in History and Culture: An Encyclopedia (2 vol Thomason-Gale, 2005) Hahn, Barbara

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