Alcohol use among adult smokers, NHANES 2005-2008

Objective Both smoking and excessive drinking increase the risk of adverse health outcomes. Combining these behaviors has synergistic adverse health effects, such as increased incidence of some cancers. We used national data to examine alcohol use among current cigarette smokers.

Methods We analyzed data from 3,539 US adult current smokers aged >= 20 years who participated in the 2003-2008 National Health and Nutrition Examination survey. Current smokers reported the number cigarettes per day (CPD) and were categorized into three sub-groups (1-9, 10-19, 20+). Categories of alcohol use were based on the reported quantity and frequency of alcohol use during the past 12 months, and participants were classified as nondrinkers (consumed no alcohol), non-excessive drinkers (<=14 drinks/week for men, or <=7 drinks/week for women, and never < 5 in a single day), and excessive drinkers (> 14 drinks/week for men, or > 7 drinks/week for women, and/or >= 5 drinks in a single day once or more).

Results Among current smokers, 47.4% (95%CI=44.3–50.5) were excessive drinkers, 32.7% (95%CI=30.3–35.1) were non-excessive drinkers, and 19.8% (95%CI=17.5–22.2) were nondrinkers. Among non-smokers 34.4% (95%CI=31.7–37.3) were excessive drinkers, 44.2% (95%CI=42.2–46.3) were non-excessive drinkers, and 21.3% (95%CI=19.6–23.1) were nondrinkers. Cigarette consumption was highest among smokers who drank excessively and lowest among smokers who were nondrinkers.

Conclusion A large percent of smokers are excessive drinkers. The combined health threats of smoking and excessive drinking are clear. Future prevention efforts should include strategies that combine health messages to address the co-use of alcohol and smoking.