Tobacco and alcohol are the predominant etiologic factors for oral cancer. Studies show an association between disease severity and tobacco cessation. Relationship between oral biopsy diagnosis and risk factor cessation is unknown. Patients diagnosed with hyperkeratosis, dysplasia or carcinoma were sent questionnaires addressing demographics and risk factor use. Statistical analyses assessed whether behavior change was associated with the biopsy procedure and whether that change was related to diagnostic or demographic categories. Response rate was 37.4% (605/1619). Higher percentages of subjects with more severe diagnoses quit cigarettes and alcohol following biopsy. Younger respondents were less likely to quit smoking prior to biopsy and more likely to be still smoking (p<0.01). For patients with suspicious oral lesions, clinicians should be aware that oral biopsy diagnosis is an important tool against risk factor addiction. Younger patients are more likely to continue to be cigarette users even after controlling for severity of diagnosis.