A large-scale study conducted by researchers from the Centre for Cancer Epidemiology and the Homi Bhabha National Institute has now drawn a stark connection between alcohol consumption, smokeless tobacco use, and the country's escalating burden of oral cancers. A dangerous combination: Alcohol and tobacco According to the study, more than six out of every 10 cases of buccal mucosa cancer in India are linked to alcohol consumption, especially when combined with the chewing of smokeless tobacco products such as gutkha, khaini, and paan. Together, alcohol and chewing tobacco are estimated to account for nearly 62 per cent of all such cancer cases nationwide. What is particularly concerning is that even minimal alcohol intake significantly raises cancer risk. Researchers found that consuming less than 2 grams of alcohol a day-an amount lower than a typical serving of beer-was associated with an increased risk. At around 9 grams per day, equivalent to one standard drink, the risk of mouth cancer rose by nearly 50 per cent. Locally brewed alcohol under the scanner The study highlights locally brewed alcoholic beverages as posing the greatest danger. While internationally recognised alcohols such as beer, whiskey, vodka, rum, and breezers increased cancer risk by about 72 per cent, locally brewed drinks pushed the risk up to 87 per cent. These include regionally popular beverages such as apong, bangla, chulli, desi daru, and mahua. Researchers suggest that unregulated production methods may be a key factor. "Possible contamination with toxins like methanol and acetaldehyde in locally brewed alcohol could help explain the higher cancer risk," the study noted, pointing out that these substances are known carcinogens. How alcohol amplifies cancer risk The research team, led by Grace Sarah George, explained that alcohol increases mouth cancer risk regardless of how long tobacco has been used. Ethanol, they said, may alter the fat composition of the inner lining of the mouth, making it more permeable and vulnerable to carcinogens present in chewing tobacco. In simple terms, alcohol weakens the mouth's natural protective barrier, allowing harmful substances from tobacco products to penetrate more easily and damage cells-creating a fertile ground for cancer to develop. A disease affecting younger Indians Mouth cancer is currently the second most common malignancy in India, with an estimated 1.43 lakh new cases and nearly 80,000 deaths reported every year. Alarmingly, the disease is no longer limited to older populations. Nearly half of the patients studied were between 25 and 45 years of age, with most participants falling in the 35-54 age group. Survival rates remain low. Less than half-around 43 per cent-of those diagnosed with buccal mucosa cancer survive beyond five years, underscoring the aggressive nature of the disease and the urgent need for prevention. Regional hotspots and rising numbers The study estimates that alcohol alone contributes to nearly 11.5 per cent of all buccal mucosa cancer cases across India. In states with a higher prevalence of the disease, such as Meghalaya, Assam, and Madhya Pradesh, this figure rises to 14 per cent. Overall incidence rates have steadily climbed and currently stand at nearly 15 cases per 100,000 Indian men, a trend researchers describe as deeply worrying. No safe limit, clear prevention One of the study's most striking conclusions is that there is no safe level of alcohol consumption when it comes to buccal mucosa cancer. "Our findings suggest that public health action toward preventing alcohol and tobacco use could largely eliminate this cancer from India," the researchers stated. The message is clear: reducing alcohol intake, eliminating smokeless tobacco use, and regulating locally brewed alcohol could dramatically cut down the incidence of mouth cancer. As the study makes evident, prevention-through awareness, regulation, and lifestyle change-may be the most powerful weapon India has against this largely avoidable disease.