Even low daily alcohol intake—about 9g or roughly one standard drink—has been linked to a significantly increased risk of mouth (buccal mucosa) cancer in India, with the highest risk associated with locally brewed alcohol, according to a major new study.

Published online in the open-access journal BMJ Global Health, the research also found that when alcohol use is combined with chewing tobacco, the interaction may account for as much as 62 per cent of all buccal mucosa cancer cases in the country.

Mouth cancer is the second most common malignancy in India, with an estimated 143,759 new cases and nearly 80,000 deaths recorded annually. Rates have risen steadily, reaching almost 15 cases per 100,000 Indian men.

The most common form affects the soft pink lining of the cheeks and lips, known as the buccal mucosa, and fewer than half (43 per cent) of patients survive for five years or more.

Researchers note that alcohol consumption and tobacco use frequently occur together, making it difficult to determine their individual contributions to cancer risk—particularly in India, where smokeless tobacco use is widespread.

In addition, the health effects of locally brewed alcohol, popular in many rural communities, have not been well studied.