Smoking and drinking each raise your risk of mouth cancer. Together, they do more harm than the two added up.
We've written about smoking and alcohol separately. This post is about what happens when the two go together, which is why we ask about both at every check-up.
What the Numbers Say
Cancer Research UK estimates that smoking causes around 17 in 100 cases of oral cavity cancer in the UK, and alcohol around 34 in 100. For cancers of the mouth and throat, it reports that people who drink and currently smoke have almost triple the risk of people who have never drunk, while drinkers who don't smoke have about a third higher risk (32%) than never-drinkers. Those figures compare people with different habits, and the exact risk for any one person depends on much more than that. But the direction is clear.
Why the Risks Compound
Drinkaware's guidance on mouth, throat and voice box cancers says that combining the two significantly increases the risk, and that the combined effect is greater than the two effects added separately. One proposed explanation is that alcohol may make the lining of the mouth more absorbent and its cells more sensitive to the chemicals in tobacco smoke. That's a suggested mechanism rather than a settled one, but the pattern is well documented.
What Helps
Cutting down on either one lowers your risk, and the risk tends to fall the longer you stay off tobacco. You don't have to tackle both at once, and you don't have to be perfect. If you drink, staying within the guideline of 14 units a week, spread over three or more days, is a sensible target. If you smoke, stopping is the single most useful thing you can do for your mouth and the rest of you.
Keep Checking
Whatever you decide, keep up your regular check-ups. We examine your lips, tongue, cheeks, floor of mouth and throat at every recall, and early changes are often painless. Between visits, look out for an ulcer that hasn't healed in three weeks, a red or white patch, or a lump. If you spot any of those, don't wait for your next appointment. Our post on oral cancer covers what to look for.
Support If You Want It
Help Me Quit Wales, the NHS stop smoking service, is free on 0800 085 2219 (helpmequit.wales). DAN 24/7, the free Wales drug and alcohol helpline, is on 0808 808 2234, day or night. And if you'd rather start by talking to us, that's what we're here for.
Sources: Cancer Research UK, Head and neck cancers: risk factors. Drinkaware, Alcohol and mouth, throat and voice box cancers.