Arielle Cruz
Smoking and alcohol consumption are two of the leading causes of preventable death worldwide. Despite enormous progress in reducing smoking, tobacco use is still the leading cause of preventable death in the United States, killing more than 400,000 people annually. On the other hand, alcohol is a component cause of more than 200 diseases, injuries, and health problems, and it kills about 2.5 million people globally each year. While smoking is responsible for a higher number of deaths compared to alcohol, both substances have detrimental effects on health and contribute significantly to mortality rates.
| Characteristics | Values |
|---|---|
| Global deaths caused by tobacco | 8% of all deaths |
| Global deaths caused by alcohol | 5% of all deaths |
| Annual deaths in the US caused by tobacco | 490,000+ |
| Annual deaths in the US caused by alcohol | 100,000 |
| Mortality risk with increase in consumption | Tobacco: Linear; Alcohol: Non-linear |
| Memory issues | Both tobacco and alcohol cause memory issues |
| Combination impact | People who consume both have difficulty thinking and problem-solving |
| Cognitive impact | Smokers are aware of the health risks but believe they will not be affected |
| Cost to the NHS in England | Tobacco: £2.5 billion; Alcohol: £3.5 billion |
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What You'll Learn
Tobacco kills more people than alcohol in the US
Tobacco use is distinct in the harm it causes, and its production is governed by an industry that has repeatedly compromised ethical responsibilities in pursuit of profit. Tobacco companies have a long history of collaborating with the alcohol industry, influencing policies that affect both sectors. While moderate alcohol consumption is not a risk, excessive drinking is known to cause serious health issues, and alcohol is a component cause of more than 200 diseases, injuries, and health problems. It is estimated that alcohol kills approximately 5% of people globally, while tobacco kills about 8%.
The dangers of smoking are well-documented, yet smoking remains prevalent, with 53 million Americans smoking annually. The close association between nicotine addiction and alcoholism is established, with 80% of alcoholics smoking and 30% of smokers being alcoholics. Studies have shown that abstinence from alcohol can eliminate premature deaths from active alcoholism, but similar studies have not shown the same for nicotine addiction. While alcohol consumption rates have increased across all levels of society, leading to concerns about an epidemic of alcohol liver disease, tobacco remains the more deadly substance in the US.
The high number of tobacco-related deaths is indicative of the potent toxicity of tobacco smoke, and the US continues to bear the burden of tobacco-related healthcare costs and productivity losses. While alcohol consumption also has significant health and social implications, the US faces a more pressing challenge in addressing the harmful effects of tobacco use. Tobacco exceptionalism, the idea that tobacco is a unique threat to health, has been crucial in advancing tobacco control. However, recognizing that alcohol poses similar challenges can help develop effective policies to protect public health and reduce the harmful impact of both substances on individuals and society.
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Alcohol is a causal factor in over 200 diseases
While tobacco kills more people than alcohol globally, alcohol is still a causal factor in over 200 diseases, injuries, and health conditions. Alcohol consumption is a risk factor for many chronic diseases and conditions. The average volume of alcohol consumed, consumption patterns, and quality of alcoholic beverages consumed all have a causal impact on mortality and morbidity related to chronic diseases. Twenty-five chronic disease and condition codes in the International Classification of Disease (ICD)-10 are entirely attributable to alcohol. Alcohol also plays a component-risk role in certain cancers, other tumors, neuropsychiatric conditions, and numerous cardiovascular and digestive diseases.
Alcohol is an established carcinogen and is toxic. It kills at younger ages and in different ways to tobacco, including through violence associated with intoxication. Alcohol also causes significant harm to others, not just the drinker. A significant part of alcohol-attributable disease burden arises from injuries such as road traffic accidents. In 2019, of a total of 298,000 deaths from alcohol-related road crashes, 156,000 deaths were caused by someone else’s drinking.
Other injuries, intentional or unintentional, include falls, drowning, burns, sexual assault, intimate partner violence, and suicide. Alcohol consumption during pregnancy increases the risk of fetal alcohol spectrum disorders (FASDs), which are associated with developmental disabilities and birth defects. Alcohol is also causally related to the development of unipolar depressive disorder. Alcohol dependence is also linked to an increased risk of depressive disorders.
Most alcohol-related harm comes from heavy episodic or continuous alcohol consumption, and the likelihood of certain harms begins at relatively low amounts. For example, even drinking within the current US Dietary Guidelines can increase the risk of hypertension, arrhythmias, and female breast cancer.
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Excessive drinking is linked to at least 60 major types of disease
Alcohol kills fewer people than tobacco globally, with alcohol accounting for about 5% of deaths and tobacco 8%. However, excessive drinking is linked to a wide range of diseases and health problems. Excessive alcohol consumption can have immediate and long-term health risks, and the more you drink, the higher these risks become.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) identifies heavy alcohol use as a major cause of endocrine system disruption, affecting the hormones that maintain health and stability in the body. This disruption can lead to thyroid diseases, abnormal cholesterol levels, reproductive issues, stress intolerance, and diabetes. Alcohol consumption can also negatively impact the gastrointestinal tract, causing a 'leaky gut' that allows toxins to enter the body and increasing the risk of colorectal cancer.
Excessive drinking is also associated with an increased risk of heart problems. Research shows that long-term heavy drinking weakens the heart muscle, leading to cardiomyopathy. It also raises the risk of ischemic heart disease and myocardial infarction (heart attack). Even low drinking levels may increase the risk of heart issues. Alcohol misuse can further lead to high blood pressure, an irregular heartbeat, and an increased heart rate.
Additionally, drinking excessively can weaken the immune system, making it harder for the body to fight off infections. This effect can last up to 24 hours after a drinking session. Both acute and chronic heavy alcohol use can interfere with the immune response, leading to inflammation and organ damage. It can also cause specific blood deficiencies, such as anemia and leukopenia.
Alcohol use can also contribute to mental health issues, including depression and anxiety, as well as memory problems and dementia. It can disrupt sleep and increase the risk of relationship problems, work issues, and social problems. Furthermore, excessive drinking is linked to a higher risk of developing certain types of cancer, with more than 20,000 people dying from alcohol-related cancers each year in the United States alone.
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Tobacco is the leading cause of preventable death in the US
The dangers of smoking are well-documented, with tobacco containing numerous carcinogens that cause various diseases and conditions. These include lung cancer, asthma, bronchitis, emphysema, cardiovascular diseases such as heart disease and stroke, and cancers of the colon, rectum, and liver. Smoking also weakens the immune system and can lead to erectile dysfunction. The high number of carcinogens in cigarettes and the inhalation of tobacco smoke are directly linked to the high mortality rates associated with smoking.
While moderate alcohol consumption is not a risk, excessive drinking is known to cause serious health issues. Alcohol is a component cause of more than 200 diseases, injuries, and health problems, with more than 40 being wholly attributable to alcohol consumption. Excessive drinking has been implicated in at least 60 major types of disease, and alcohol is the third-leading cause of preventable death in the US. It is estimated that more than 2.5 million people die globally each year due to excessive alcohol consumption.
The close association between nicotine addiction and alcoholism is well-established, with 80% of alcoholics smoking and 30% of smokers being alcoholics. Studies have shown that abstinence from alcohol can eliminate premature deaths or increased mortality rates from active alcoholism. However, similar studies have not shown the same reduction in mortality rates from abstinence in nicotine addiction. The stimulant effect of nicotine can also augment the pleasurable effects of alcohol, leading to a cycle of increased consumption of both substances.
Despite the enormous progress in reducing smoking rates, tobacco use remains the leading cause of preventable death in the US. The tobacco industry's influence and the collaboration between tobacco and alcohol companies have hindered progress in global health and regulation. The unique harm caused by tobacco and the industry's ethical transgressions call for a special form of regulation to address this public health crisis.
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The dangers of smoking are well-documented
The high number of carcinogens in cigarettes is responsible for many diseases and conditions, including lung cancer, asthma, bronchitis, emphysema, cardiovascular diseases such as heart disease and stroke, and colon, rectal, and liver cancers. Smoking also weakens the immune system and can lead to a poor response to arthritis treatment and erectile dysfunction. It is a highly addictive habit, with genes responsible for the production of chemical messengers that communicate feelings of pleasure and reward, compelling smokers to persist with the habit even when they know the harm it is causing.
In addition to the direct health consequences, smoking also has indirect costs. For example, smoking during pregnancy or exposing children to second-hand smoke can cause health and developmental problems in infants and children. There are also costs associated with smokeless tobacco use, adult second-hand smoke exposure, and pipe or cigar smoking. Smoking-caused fires result in residential and commercial property losses, and smoking-caused deaths can lead to expenditures through Social Security Survivors Insurance for children who have lost a parent.
While alcohol is also harmful and can be toxic, the number of deaths caused by alcohol is lower than that of tobacco. Alcohol kills fewer people than tobacco globally, with alcohol causing approximately 5% of all deaths compared to 8% for tobacco. Excessive drinking has been implicated in the formation of at least 60 major types of disease, and more than 2.5 million people die every year because of it. Alcohol is also a causal risk factor for over 200 disease conditions, and alcohol use can increase the desire to smoke more, with the nicotine in cigarettes augmenting the pleasurable effects of alcohol.
In summary, the dangers of smoking are clear and well-documented, with tobacco causing more deaths than alcohol and imposing a significant toll on individuals, families, and society as a whole.
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Frequently asked questions
Yes, tobacco kills more than 490,000 people annually in the United States, including from second-hand smoke exposure. This is more than alcohol, AIDS, car accidents, illegal drugs, murders, and suicides combined. Globally, alcohol kills fewer people than tobacco, approximately 5% compared to 8% of all deaths.
The high number of carcinogens in cigarettes is responsible for many diseases and conditions, including lung cancer, asthma, bronchitis, emphysema, heart disease, stroke, and liver cancer. Smoking is also the leading cause of preventable death in the United States, with smokers losing about 10 years of life due to their smoking.
Excessive drinking has been implicated in the formation of at least 60 major types of diseases, and more than 2.5 million people die every year because of it. Alcohol is also a component cause of more than 200 diseases, injuries, and health problems, and is responsible for social problems such as increased healthcare costs and violent behaviour.
