Identifying the Temporal Causal Relationship Between Alcohol and Tobacco Consumption with Aggregate Cancer Mortality over Alternative Time Horizons

Zahra N Masih

doi:10.30560/ijas.v4n1p24

Abstract

Identifying the causal role of tobacco and alcohol has long been acknowledged as a critical area for developing preventative strategies in particular and public policy in general. This study utilizes a unique time series method in an effort to determine the strength of causal relationships between tobacco consumption, alcohol consumption and cancer mortality. By analysing tobacco expenditure, alcohol expenditure, while controlling for health expenditures and aggregate cancer data observed annually over an 80-year period fin the US population, we consider the relevant factors explaining and potentially guiding public health concerns going forward. Our results found that while tobacco and alcohol consumption (individually) causally impact cancer mortality, alcohol consumption maintains a stronger, bidirectional impact in comparison to tobacco consumption. From this, we consider explanations from an economic, biological and epidemiological front, gauging the strength of alcohol consumption on societal wellbeing. We find alcohol consumption to be a notable causal factor in cancer mortality that has been neglected from a public policy perspective in comparison to its more mediated tobacco counterpart.

Highlights

Alcohol and tobacco significantly contribute to increased cancer risk
Stemming from the corelated associations identified in Jiang et al, this study aims to distinguish a causative relationship, if any, between alcohol/tobacco and cancer mortality, and if so identify which of the substances have a stronger effect on general cancer risk within the population
The contributions of this paper are as follows: (i) To the author’s knowledge, this paper provides a seminal attempt at understanding the dynamic causal relationships that co-exist between cancer mortality and its determinants over time; (ii) The methods we apply unveils more than just simple correlations; (iii) we examine the relationships over alternative time periods that is imperative for policy making both from an epidemiological and public health standpoint

Summary

Introduction

Alcohol and tobacco significantly contribute to increased cancer risk. As of 2018, the World Health Organization identified tobacco and alcohol as a part of the top behavioural contributors to cancer risk, a cohort responsible for approximately one-third of all cancer deaths (WHO, 2018).The National Cancer Institute classifies alcohol as a carcinogen capable of detrimental, if not fatal, health consequences including immune susceptibility or death. Alcohol and tobacco significantly contribute to increased cancer risk. As of 2018, the World Health Organization identified tobacco and alcohol as a part of the top behavioural contributors to cancer risk, a cohort responsible for approximately one-third of all cancer deaths (WHO, 2018). Studies indicate alcohol maintains a dose-response relationship with cancer, where higher volumes of alcohol consumed potentially increase cancer risk (Kirpalani, 2017; de Menezes et al, 2013). Meta-analyses on alcohol intake and cancer data indicate that alcohol promotes immunosurpressive processes in the body contributing to a higher probability in increased risk (Bagnardi, et al, 2001). Alcohol consumption is a potential threat to cancer risk, where the impact of its consumption on an aggregate scale is yet to be discovered

Objectives

Methods

Conclusion