A sharp increase in the use of moist snuff tobacco may lead in a few decades to an epidemic of oral cancer, a group of doctors says.

The physicians, from the American Academy of Otolaryngology, Head and Neck Surgery, say that the use of moist snuff, a flavored tobacco that is placed between the cheek and gum, has risen 50 percent since 1981 and that users are starting as early as the fifth grade.The increased use will lead within a few decades to a sharp rise in the number of cancers of the mouth, gum, tongue and throat, Jerome C. Goldstein, executive vice president of the academy, said at a news conference.

Mike Kerrigan, president of the Smokeless Tobacco Council, an industry group, said sales of moist snuff have increased 3 percent to 4 percent annually for the last two to three years. But he maintained it is "an unresolved controversy" as to whether the product causes oral cancer.

A surgeon general's warning about the hazard of oral cancer is printed on snuff packages.

At a news conference, Dr. Roy B. Sessions of Georgetown University Medical Center said oral cancers are directly associated with the use of smokeless tobacco.

Sessions said the increased use may be a result of the growing disapproval of smoking. People use snuff as a substitute for cigarettes or pipes, he said.

"The tobacco industry has succeeded in selling this product as a safe alternative to smoking," he said. "This will absolutely will never be a safe alternative. You're trading one cancer for another."