The Cancer Risk of Alcohol Consumption in Cigarette Equivalents

Alcohol is a carcinogen, but its risks have not been well-quantified and communicated. Researchers used existing data sources on alcohol and tobacco attributable fractions and UK cancer registry data to determine the absolute increase in lifetime risk of cancer from alcohol consumption (aerodigestive, breast, and liver) and tobacco smoking (bladder, aerodigestive, breast, cervical, blood, liver, lung, and pancreas).

  • Among men who do not smoke, 0.8 drinks/day increased the lifetime risk of cancer by 1 percent; for women, the same amount of consumption increased the risk by 1.4 percent.
  • The corresponding risks for 1.4 cigarettes/day were 2.1 percent for men and 1.5 percent for women.
  • The authors calculated that 1 bottle of wine/week was roughly equivalent to 5 cigarettes/week for men and 10 for women.
  • The main reason for sex differences is that breast cancer is attributable to alcohol but not smoking.

Comments: The fact that alcohol is a carcinogen even at low consumption levels is not news. But the general public, the media, public health organizations, and the alcohol industry do not usually discuss and address alcohol as a carcinogen despite it causing 4 percent or more of cancer deaths. These investigators used existing data to present the alcohol risks alongside a more familiar, commonly addressed carcinogen that will hopefully lead to greater awareness and appropriate public health actions.

Richard Saitz, MD, MPH

Reference: Hydes TJ, Burton R, Inskip H, et al. A comparison of gender-linked population cancer risks between alcohol and tobacco: how many cigarettes are there in a bottle of wine? BMC Public Health. 2019;19:316.

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