Cigarette smoking and heavy alcohol drinking are both related to an increased risk of death. A study from Scotland found that smokers who drank 15 or more units of alcohol per week were at highest risk of death, particularly because these heaviest drinkers were more likely to smoke more than people who drank less.
Smoking had stronger effects than alcohol for most of the causes of early death investigated, including coronary heart disease, stroke and cancer. Blood pressure and body mass index (BMI) generally increased with alcohol consumption, but decreased with smoking, with those who had never smoked but who drank 15 or more units per week having the highest blood pressures and BMIs.
A person’s socioeconomic position and level of education were strongly related to both alcohol consumption and smoking. For example, 30 percent of men who worked in manual jobs were both smokers and heavy drinkers compared with only 13 percent of men in other jobs. “Given the increased mortality rates associated with both smoking and heavy drinking, this will inevitably contribute to socioeconomic health inequalities,” researchers said.
These findings reinforce the importance of continuing to prioritize smoking cessation. “Given the strong links between smoking and heavy drinking, it may also be helpful to devise policies aimed at reducing both smoking and alcohol consumption in population groups where this is common,” the study concluded.
1. Hart CL, Smith GD, Gruer L, Watt GCM. The combined effect of smoking tobacco and drinking alcohol on cause-specific mortality: a 30-year cohort study. BMC Public Health 2010; 10: 789. (open access)