Recently, one of the head and neck tumours located at the nasopharynx epithelium known as nasopharyngeal carci- noma (NPC) have been associated with few cancer-promoting compounds that derived from alcohol, salt preserved foods consumptions and tobacco smoking such as acetaldehyde, nitrosamine, nicotine. These cancer-promoting compounds present the ability to damage the genome and disrupt cellular metabolic processes. This review will discuss further on the molecular mechanism of acetaldehyde, nitrosamine, nicotine and NPC risk. Acetaldehyde can exert influence as carcinogen macromolecular adducts to cellular proteins and DNAs whilst nitrosamines that commonly found in preserved salted foods/diets can contribute as a powerful carcinogen via endogenous nitrosation and reactives molecules by CYP2E1. Nicotine present in tobacco could reacts with nitrosamine to form NNN and NNK known as carcinogenic agent. NNK mediates unstable reactive oxygen species that can induce DNA lesion (α-hydroxylation of NNN at positions 2’and 5’) and microenvironment alteration for tumorigenesis. In conclusion, this study suggests acetaldehydes, nitrosamine and nicotine may contribute to NPC tumourigenesis.