title: Alcohol and tobacco misuse: Reducing aerodigestive cancer risk.
abstract: Significant concerns over the health, social and economic burdens of the two most common, and frequently co-misused drugs of abuse, alcohol and tobacco, has encouraged focused but separate health promotion and disease prevention policies. However, this separation of focus means that while individuals who present with alcohol-related problems are increasingly supported to attain and maintain abstinence from alcohol they are not routinely assisted to refrain from smoking. This is tragically inopportune as alcohol and tobacco have an established "synergistic" effect on aerodigestive cancer risk. Moreover, even when patients successfully tackle their alcohol problems they remain at increased risk for developing these cancers, especially if they continue to smoke. A case series is presented together with a discussion on how service provision for co-misuse could be improved to obviate aerodigestive cancer risk. Given the prevalence of alcohol and tobacco use in the United Kingdom, these observations may have far reaching implications for the individual, health provider(s) and wider society.
authors.affiliation: Gavin Wright, Marsha Y Morgan, UCL Institute for Liver and Digestive Health, Royal Free Campus, University College London Medical School, University College, London NW3 2PF, United Kingdom.
authors.forename: Gavin
authors.initials: G
authors.lastname: Wright
authors.forename: Marsha Y
authors.initials: MY
authors.lastname: Morgan
keywords: Aerodigestive cancer; Alcohol; Behavioural control; Co-dependence; Early intervention; Mortality; Preventive therapy; Substance misuse; Tobacco
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