THE ROLE OF ALCOHOL IN NONSMOKERS AND TOBACCO IN NONDRINKERS IN THE ETIOLOGY OF ORAL EPITHELIAL DYSPLASIA

Oral epithelial dysplasia (OED) is an important risk factor in predict ing subsequent development of invasive carcinoma. Despite the malignan t potential of OED, the current state of knowledge regarding aetiologi cal risk factors associated with OED is limited. The aim of our study was to evaluate the aetiological role of alcohol consumption in non-to bacco smokers and smoking behaviour in non-drinkers, in patients prese nting with OED. Data from a hospital-based case control study of OED w ere used to analyse the risk associated with alcohol in non smokers an d with tobacco in non-drinkers. A total of 140 cases and 236 controls were included. In the non drinkers, the risks of OED increased with to bacco smoking of more than 20 cigarettes per day, particularly non-fil ter cigarettes. The risk of OED declined following smoking cessation, with ex-smokers of IO or more years demonstrating no excess risk relat ive to non-smokers. In the nonsmokers, consumption of alcohol was not a significant predictor of OED. However, there was a synergistic effec t of alcohol when combined with some aspects of tobacco smoking. Our r esults confirm that tobacco has an independent role in the aetiology o f OED. The role of alcohol, however, is principally only important in conjunction with tobacco use. (C) 1998 Wiley-Liss, Inc.