For many people, drinking alcohol and smoking go hand in hand. While smoking can increase the pleasurable effects of alcohol (and vice versa), it also increases the health risks associated with heavy drinking.

In this post, we’ll look at why the link between drinking and smoking exists, as well as the damage using both substances can cause. Finally, we’ll talk about how to quit or cut back: Is it easier to start with one substance at a time, or tackle both together?

The Connection Between Smoking and Drinking

cigar and sake
Photo by Julian Lozano on Unsplash

Research shows a clear link between smoking and drinking. Smokers are more likely to drink, and people who drink are more likely to consume tobacco1. Heavier drinkers also tend to be heavier smokers2. In fact, more than 85 percent of individuals with a history of alcohol abuse smoke3. These individuals are likely to be more dependent on nicotine than smokers with no history of drinking.

But why is there a connection between alcoholism and smoking? Experts have suggested several possible causes4:

  • Genetic and psychosocial factors: Many of the genetic and environmental risk factors for alcohol abuse are also risk factors for smoking. These include heredity, family modeling, peer influence, mental health disorders, life stressors, and traits like impulsivity and sensation seeking.
  • Cross-tolerance: The use of one of these substances appears to increase tolerance for the other, which can lead to higher consumption. This can happen both in general and in the moment. For example, while alcohol can slow reaction times and other cognitive functions, nicotine can counteract this. For this reason, smokers may be able to drink more alcohol than non-smokers.
  • Cross-reinforcement: In addition to balancing some of the undesirable effects of alcohol, nicotine may increase the positive effects. Both substances, for example, cause a rush of dopamine in the brain, creating a pleasurable feeling. This can increase the likelihood of sensitization to either substance, and thereby increase the chances of addiction.
  • Situational use: Smoking and drinking often occur in similar settings, such as clubs, bars, and parties. Because the two substances are frequently used together, a phenomenon called “cue conditioning” may occur. Triggers related to alcohol may also trigger cravings for nicotine, and vice versa. On top of this, people who frequent clubs, bars, and parties are simply more likely to encounter both smoking and drinking, which can make them more likely to engage in both.

Health Effects of Smoking and Alcohol

Separately, alcohol and smoking pose health risks, and these risks become more severe when the two substances are used together. Here’s why should you avoid smoking and drinking alcoholic beverages.

Health Risks of Smoking

older man smoking in a dark bar
Photo by Alex Knight on Unsplash

Smoking is the leading cause of preventable death5. Cigarettes contain over 4,000 different chemical compounds, including cancer-causing carcinogens. While lung cancer is the biggest threat, smoking is also linked to cancer of the mouth, throat, bladder, kidney, larynx, and stomach, as well as cervical and pancreatic cancer.

The toxins from tobacco and the other chemicals in cigarettes can also thicken, harden, or narrow blood vessels over time, and increase the likelihood of blood clots. This can lead to heart disease, heart attacks, and stroke.

Other health effects related to smoking include:

  • High blood pressure
  • Chronic obstructive pulmonary disease (COPD)
  • Increased risk of infertility or complications during pregnancy
  • Buerger’s disease
  • Gum disease and tooth loss

Health Risks of Drinking

Over the long-term, alcohol can have devastating effects on the body and overall health6. These include:

Health Risks of Smoking and Alcohol Abuse Together

Since alcohol abuse weakens and damages many systems in the body, people who drink are more vulnerable to the health effects of smoking.

For example, alcohol slows the body’s ability to metabolize or process harmful chemicals. More alcoholics die of tobacco-related illness than problems related to alcohol use7. In addition, both substances increase the risk for numerous types of cancer, and in some cases actually multiply the risk when used in combination.

This is particularly true for cancers of the mouth and throat: Alcohol makes it easier for toxic chemicals in tobacco to enter the cells lining these areas, and also limits the cells’ ability to repair the damage8. In fact, according to the American Cancer Society, the risk of oral cavity and oropharyngeal cancers are up to 30 times higher in people who drink and smoke heavily, versus those who don’t smoke and drink at all9.

Research also shows that cigarette smoking can worsen some of the cognitive damage linked to alcoholism, including issues with planning and memory10.

How to Give Up Drinking and Smoking

If you smoke and drink, you may wonder about the best approach to quitting or limiting both. Does quitting one make it easier or harder to quit the other? Can you quit both at the same time?

Of course, quitting two highly addictive substances at once is a challenge. Some people theorize that it’s better to focus your efforts on one at a time. But because the two are so closely linked, it’s often beneficial to tackle both together.

Quitting Smoking and Drinking at the Same Time

smoke cloud passing over a woman's face
Photo by Abdiel Ibarra on Unsplash

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that quitting smoking may actually decrease the risk of alcohol relapse11. If you frequently smoke and drink at the same time, for instance, smoking may trigger alcohol cravings. You may also find that when you quit one substance, you begin using the other more than usual. For some, making a complete lifestyle change gets the best results.

However, studies show that many people aren’t ready or willing to give up smoking in the early stages of alcohol recovery12. For some, it may take a longer period of abstinence to feel motivated to make an additional change.

Ultimately, it’s up to you. Think about your triggers—does smoking make you want to drink, or vice versa? Or will you find it more effective to focus your willpower on stopping one substance at a time? Whatever you choose, be proud of the positive step you’re making!

Quitting one substance is healthier than continuing to use both, and having success with one might make you feel more confident about quitting the other in the future. And even if you don’t quit entirely, learning to control and moderate your use significantly benefits your health. With determination and support, you can make healthy and lasting changes.

Finding Help

Of course, quitting either substance can be notoriously difficult, and there’s no shame in looking for support. Ria Health offers help to quit or cut back on alcohol, 100 percent online. We even customize plans to each member’s unique needs. So although we don’t treat tobacco use, our expert medical team will tailor treatment to give you the best shot at reaching both goals. Get in touch to learn more today.


Ashley Cullins
Written By:
Freelance writer with contributions to numerous addiction blogs and a passion for relatable content.
Reviewed By:
Content Writer/Editor
Writer specializing in targeted, informative content. Dedicated to making the abstract accessible.

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