Alcohol vs Cigarettes

Originally Published: December 14, 2012
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Dear Alice,

I was curious on which is more dangerous drinking alcohol or smoking cigarettes?

Dear Reader,

It’s impossible to determine whether drinking alcohol or smoking cigarettes is worse for one’s health because the ways they’re ingested and the effects they have on the body are highly variable. However, as you mention in your question, both are dangerous, especially when used in unsafe contexts and in large quantities. Many years ago, the risks of drinking and smoking were unknown. Fortunately, contemporary research has clearly defined the negative side effects of alcohol consumption and cigarette smoking, so now it’s possible to know exactly what one is risking when lighting up or taking one too many shots. Before going further, it may be important to note that consuming alcohol does not necessarily cause harm. The same cannot be said of tobacco use.

Excessive alcohol consumption is known to cause many serious health problems, including the development of 60 major types of disease and approximately 2.5 million deaths per year, more than HIV or tuberculosis. The following list includes some of the ailments that have been directly linked to excessive alcohol consumption:

  • Unintentional injuries due to impairment of psychomotor abilities, such as falls, drowning, and poisoning
  • Intentional injuries including suicide and self-harm
  • Weakened immune system, which increases susceptibility to the common cold and other viruses
  • Cancers of the throat, mouth, liver, esophagus, breast, and colon
  • Neuropsychiatric disorders, such as epilepsy and withdrawal-induced seizures

Alcohol is ranked globally as the third leading cause of disease and disability, after child malnutrition and unprotected sex. In fact, because alcohol is known to reduce inhibitions, individuals are more inclined to take risks while under the influence, including engaging in unsafe sex. Further, unprotected sex while under the influence may lead to a multitude of sexually transmitted infections such as chlamydia, gonorrhea, herpes, and HIV. Additionally, it’s important to know that all of these risks are exacerbated by the fact that alcohol is an addictive substance, which can increase exposure to these risks. The most critical factors with alcohol are how much is consumed (short and long-term) and the decisions a person makes after consuming. Using harm reduction strategies a person can make the choice to consume alcohol in moderation and not experience any short or long term negatives.

Now with cigarettes it’s key to note that they are highly addictive. There are more than 4,000 chemicals found in the average cigarette. The purpose of some of these chemicals is to stimulate addiction, which increases the urge to smoke more frequently. There is also a genetic component that contributes to the addiction factor for most people. Put simply, there is no safe level of cigarette use.

Cigarette smoke inhalation is linked with many diseases and ailments that are also associated with alcohol consumption. Such diseases include:

  • Cardiovascular diseases such as Abdominal Aortic Aneurysm, Cerebrovascular Disease, and Coronary Heart Disease
  • Reproductive effects, such as reduced female fertility, preterm delivery, low birth weight, and fetal death
  • Cancers of the bladder, cervix, esophagus, kidney, lungs, and mouth
  • Cigarette smoking can also cause coughing, wheezing, lung function decline, and susceptibility to acute respiratory illnesses such as pneumonia

Cigarette smoking causes approximately six million preventable deaths per year (which includes nonsmokers who are exposed to smoke in their environments), and makes up six to eight percent of healthcare costs in the United States. In fact, tobacco kills up to half of its users. However, the good news is that many smokers want to quit, and smoking cessation programs are accessible through many health care providers, even here at Columbia. Perhaps more promising is the fact that the degenerative effects of cigarette smoke on the lungs are reversible to a point, so quitting is well worth it.

For more information about alcohol and cigarettes, take a look at other Q&As in the Alcohol and Other Drugs archive or take the anonymous alcohol self-assessment. If you’re a Columbia student and you want to discuss cigarette and alcohol use with a health care provider, you can schedule an appointment with Medical Services on the Morningside campus, or if you’re a student on the medical campus, contact Student Health for an appointment.

Alice