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In a prospective epidemiological study, the relative risk of incurring a single primary carcinoma of the oral cavity, pharynx, larynx and oesophagus in any one of these sites was increased independently by the duration and intensity of exposure to tobacco or alcohol and sustained exposure enhanced the risk in a multiplicative or synergistic fashion (Schottenfeld et al., 1974) The relative risk of multiple primary cancers in the sub-group with combined exposures to high levels of tobacco and alcohol was 3.9 times that of patients exposed previously to low levels of alcohol and tobacco

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Although the episode received generally favorable reviews, [58] it finished third in its time slot