Worldwide, almost 600 000 new cases of head and neck cancer are reported each year.1 Alcohol drinking is an established risk factor for head and neck squamous cell carcinoma (HNSCC).2,3 In general, ethanol is oxidized by alcohol dehydrogenase (ADH) enzymes to acetaldehyde, which is then further oxidized to acetate by aldehyde-dehydrogenase (ALDH) enzymes. The gene discussed is AKR1A1; the disease is head and neck squamous cell carcinoma.