A rather amazing new study is claiming that smoking combined with oral sex may prove to be a very risky combination, raising a man’s risk for cancer down the road. Mainly, scientists say that transmission of oral strains of the human papillomavirus, which has been known to cause cancer, is to blame for the increased risk.

Men who smoke and have five or more partners that they’ve had oral sex with have the most risk of developing oropharyngeal cancer, which affects the head and neck. The rate of HPV infection orally has been rising among white men, particularly in the 50s and 60s.

However, the risk of oral HPV causing cancer is pretty low among most groups, but it does appear to raise your risk. A study found that 11 million American men have been infected with oral HP, or about one in nine men between 18 and 69 years of age. A lot of that has to do with the loosening of sex attitudes in the 1960s and 70s.

“Men who smoke and have five or more partners with whom they perform oral sex have the highest risk of developing a type of head and neck cancer that is triggered by exposure to the human papilloma virus – known as HPV-related oropharyngeal cancer – according to research published in the leading cancer journal Annals of Oncology [1] today (Friday),” reads the statement from the European Society for Medical Oncology. “However, the study found that only 0.7% of men will ever develop oropharyngeal cancer in their lifetimes. The risk was much lower among women, anyone who did not smoke, and people who had less than five oral sex partners in their lifetimes.”