How do nicotine and tobacco cause cancer?

by decreasing blood-sugar levels
by damaging or changing a cell's DNA
by increasing heart rate
by increasing phlegm and mucous production

Nicotine and tobacco cause cancer primarily by damaging or changing a cell's DNA. This can lead to mutations in the cells that can eventually result in the development of cancer. Additionally, tobacco smoke contains various harmful chemicals that can also contribute to DNA damage and increase the risk of cancer development. The other listed effects such as decreasing blood-sugar levels, increasing heart rate, and increasing phlegm and mucous production are all associated with nicotine and tobacco use but are not directly linked to the development of cancer.