Smoking is a well-established risk factor for cervical cancer because it introduces carcinogens that can cause DNA damage in cervical epithelial cells. These harmful substances impair local immune response, reducing the body's ability to clear human papillomavirus (HPV) infections, which are the primary cause of cervical cancer. Persistent HPV infection combined with smoking significantly increases the risk of cervical intraepithelial neoplasia and invasive cancer. This synergistic effect makes smoking a critical modifiable risk factor in cervical carcinogenesis.

Reference: Robbins Basic Pathology, Kumar, Abbas, Aster, 10th Edition.