AbstractIn a house‐to‐house survey in Ernakulam district, Kerala State, 10914 individuals were interviewed for their tobacco and alcohol habits and examined for the presence of oral leukoplakia. Very few females (1.6%) were found to be alcohol users and they were excluded from further analysis. Among 7604 males, 30.4% used alcohol regularly, 25.4% occasionally and 44.2% were non‐users. The prevalence of leukoplakia was significantly higher among regular (5.7%) and occasional (3.9%) users than among non‐users (2.9%) of alcohol. Alcohol usage was found to be related to age as well as tobacco habits. The prevalence of leukoplakia was higher among alcohol users in each age‐group as well as in each tobacco habit category. After age‐adjustment the difference between alcohol users and non‐users, although reduced, remained significant. For most tobacco habit categories the trend remained similar after age‐adjustment except for the mixed habits group, for which there was a reversal of the trend. The alcohol habit may, perhaps, produce discernible effects only in association with other ‘weak’ etiological risk factors, such as a single tobacco habit of smoking or chewing rather than a ‘strong’ etiologic factor such as the mixed habits