To the Editor.
—I am writing in response to the recent letter by Drs Thomas and Cantwell1 entitled "Tobacco, Alcohol, and Cancer." These authors recount the life and death of Babe Ruth, with emphasis on his tobacco and alcohol consumption and his lethal nasopharyngeal carcinoma. It is stated that Ruth "died apparently without knowing he had cancer, nor that chronic abuse of smokeless tobacco, cigars, and alcohol probably teamed up to play a role in its origin."Our current knowledge of nasopharyngeal carcinoma as reported in the literature does not support this association. The risk factors thought to be of significance in this affliction are geographic location, genetic inheritance, exposure to the Epstein-Barr virus, and certain environmental carcinogens.2 Tobacco and alcohol use have not been found to be risk factors for nasopharyngeal carcinoma. An excellent review by Henderson et al3 specifically states that "none of these variables
Garner SL. Babe Ruth, Tobacco, Alcohol, and Cancer. JAMA. 1988;259(6):840. doi:10.1001/jama.1988.03720060012013