The idea that only heavy drinking causes cancer is being challenged by new evidence. Researchers studying Indian men found that even low alcohol intake can raise the risk of buccal mucosa cancer, a common and deadly form of mouth cancer. The findings matter now because alcohol use remains widespread while oral cancer rates continue to rise.
Fast Facts
What was found: A large Indian study shows even very small amounts of alcohol increase buccal mucosa cancer risk.
Why it matters: Risk rises below one standard drink per day and becomes much higher when alcohol combines with chewing tobacco.
Who is affected: Indian men, especially in rural areas where locally brewed alcohol is common.
The takeaway: Researchers found no safe level of alcohol for this cancer, highlighting urgent prevention and policy needs.
The study focused on buccal mucosa cancer, which affects the inner lining of the cheek. This cancer is one of the most common oral cancers in India and often strikes people in their working years. Researchers discovered that men who drank alcohol had a significantly higher cancer risk than those who did not drink at all. The risk increased even when alcohol intake stayed below one standard drink per day.
To reach these conclusions, scientists analyzed data from a large multicentre case control study across India. They compared 1,803 men diagnosed with buccal mucosa cancer to 1,903 healthy men. Trained interviewers collected detailed drinking histories, including how often participants drank, how much they consumed, and the type of alcohol. The team converted this information into grams of alcohol per day to allow fair comparisons. This careful approach helped separate alcohol’s effects from other factors like tobacco use .
The results showed a clear pattern. Men who had ever consumed alcohol had about a 68 percent higher risk of buccal mucosa cancer compared to non drinkers. Drinking less than nine grams of alcohol per day, which is less than one typical drink, still raised risk by more than 50 percent. Locally brewed liquors showed even stronger associations, with some types linked to more than double the risk.
This matters because buccal mucosa cancer has a low survival rate and often requires disfiguring treatment. Alcohol appears to make the mouth lining more vulnerable to cancer causing substances. When alcohol and chewing tobacco were used together, the danger rose sharply. Researchers estimated that more than 60 percent of cases in the study could be linked to the combined use of alcohol and tobacco.
The research team explained that alcohol itself is classified as a cancer causing substance. When the body breaks it down, it forms acetaldehyde, a toxic compound that can damage cells. Alcohol also makes the mouth’s protective lining more permeable, allowing tobacco chemicals to penetrate deeper. This interaction helps explain why the combined effect was much stronger than either habit alone.
Beyond health, the findings connect to wider social and policy issues. Many locally brewed liquors in India come from informal markets with little regulation. Some may contain higher alcohol levels or harmful contaminants. This study suggests that unregulated alcohol production could be adding to the cancer burden, especially in rural areas where these drinks are common.
Researchers say the next step is prevention. They call for stronger public health campaigns that address alcohol and tobacco together, not as separate risks. They also highlight the need for better regulation of locally brewed alcohol and clearer public messaging that no level of alcohol use is safe for oral cancer risk.
The takeaway is simple but powerful. This study shows that even small amounts of alcohol can increase mouth cancer risk, especially when combined with tobacco. Reducing alcohol and tobacco use together could prevent thousands of cases and save lives.
Story Source:
Materials provided by Tata Memorial Centre and collaborating institutions. Content may be edited for style and length.
Journal Reference:
George GS, Patil A, Moirangthem R, Doibale PN, Manjrekar A, Golapkar SV, Panse N, Krishnatreya M, Mishra A, Singh A, Rumgay H, Hosseini B, Chaturvedi A, Rajaraman P, Olsson A, Soerjomataram I, Chaturvedi P, Dikshit R, Mhatre S. Association of alcohol and different types of alcoholic beverages on the risk of buccal mucosa cancer in Indian men: a multicentre case control study. BMJ Global Health, 2025. 10(12). DOI: 10.1136/bmjgh-2024-017392.