Smoking and alcohol co-use has seen an exponential rise across many nations, increasing risk of throat and esophageal cancer, while slowing cigarette metabolization processes, prolonging exposure to carcinogens.

Moderate alcohol intake appears to reduce cardiovascular disease risk, while tobacco smoking significantly raises this risk. Furthermore, mood and anxiety disorders often co-occur with heavy alcohol use or nicotine dependence.

High blood pressure

High blood pressure is one of the world’s leading preventable diseases, increasing risks such as heart disease, stroke and dementia. Alcohol use contributes significantly to high blood pressure but its influence is often overlooked by both the general public and healthcare providers – being seen as less significant than physical activity, eating habits or smoking – which is an error, given that excessive alcohol use is the root cause of high blood pressure.

Alcohol affects the muscles in blood vessels and narrows them, forcing the heart to work harder in pushing blood through your body, which may result in high blood pressure (hypertension). Unfortunately, hypertension is a prevalent yet often underestimated health issue that can damage heart, kidneys, brain and cause additional risk factors for diabetes and kidney disease if left untreated.

This study, presented at the American College of Cardiology’s 68th Annual Scientific Session, involved 17,000 participants enrolled in the National Health and Nutrition Examination Survey (NHANES). Researchers discovered that moderate alcohol consumption of seven to 13 drinks weekly significantly increases one’s risk for hypertension – contrary to some earlier findings which linked moderate drinking with lower risks of heart disease.

This may be because nicotine and alcohol work together in the body to produce its effects, with both acting on the mesolimbic dopamine system of the brain which regulates reward, emotion and memory. Nicotine binds to small docking molecules called nicotinic receptors while alcohol may interfere with these receptors to prevent nicotine binding to them and thus decrease cravings for tobacco products.

Smoking and alcohol increase the risk of cancers affecting the throat, larynx, esophagus, lungs and colon. They may also work together to increase liver cancer risks; smoking increases cardiovascular risks like heart disease and stroke more significantly in smokers than nonsmokers.

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High triglycerides

Triglycerides, or blood fats, increase when you eat too much fat – particularly foods high in sugar – which puts your risk for cardiovascular disease higher. You can reduce triglyceride levels by losing weight, exercising regularly (30 minutes a day at least), eating a diet low in both fat and sugar and changing lifestyle choices to include losing weight, exercise (at least 30 minutes per day), diet modification or prescription of medications such as nicotinic acid (niacin), fibrates (e.g fenofibrate gemfibrozil), omega-3 fatty acids (found in fish oil supplements), etc. It is important to inform your doctor of all medications as some — such as beta-blockers or birth control pills — may raise triglycerides further.

Alcohol has also been linked with elevated triglycerides. Heavy drinking has been shown to lead to health issues including high blood pressure, stomach ulcers, liver disease, pancreatitis and memory impairment – in pregnancy it may even result in low birth weight babies! In addition, alcohol interferes with some cancer medications by worsening side effects like nausea and vomiting while increasing dehydration risks and decreasing chemotherapy efficacy.

Cigarette smoking and alcohol consumption both increase your risk for high triglycerides, with smokers being especially at an increased risk. It could be that those who smoke and/or drink tend to eat more fatty foods which cause their triglyceride levels to spike. Also, tobacco and alcohol contain toxins which damage cells that produce triglycerides, thus hindering them from performing their task effectively. Our research involved comparing groups of participants who smoked or drank with those who didn’t smoke/drink at all. We employed multivariate logistic regression models to explore the association between alcohol consumption, cigarette smoking, and composite outcomes. We controlled for age, sex, Carlson comorbidity score, CURB-65 scores on admission, time from illness onset to hospitalisation and centre as random effect; odds ratios and 95% confidence intervals were estimated; the results are presented in Supplementary Tables. Smokers and drinkers had significantly increased risks compared with nonsmokers/drinkers, particularly men.

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Blood clotting

Blood has an almost impossible job: it must continuously circulate throughout your body throughout life while also quickly shutting off when injured to avoid blood clots that could potentially block blood flow and lead to heart attacks or stroke. Clot formation depends on a series of complex chemical interactions.

Blood clots are more likely to form when you are ill or injured, pregnant, taking certain medicines, and having cancer, liver or kidney disease as these increases can raise vein pressure in your pelvis and legs, increasing risk. Being overweight or obese increases that risk as do having cancer, liver or kidney disease as well as having a family history of blood clots as well as having an inherited clotting disorder such as protein C or protein S deficiency which increases vulnerability further.

Smoking and drinking alcohol can both have detrimental effects on blood clotting by increasing your clotting factor concentrations, making platelets more likely to stick together, and blocking the body’s natural anticoagulation abilities. Furthermore, drinking and smoking may result in higher homocysteine levels which damage the lining of blood vessels resulting in blood clot formation.

How tobacco and alcohol impact the clotting system depends on how frequently you smoke or drink. Heavy smokers or drinkers are more likely to develop blood clots than light smokers or nondrinkers.

Alcohol and tobacco may interact with some cancer medications to diminish their effectiveness or increase side effects such as nausea, dehydration and digestive upset. Furthermore, drinking and smoking may even interfere with chemotherapy treatments, preventing your body from experiencing its full benefits of treatment.

Moderate alcohol use reduces cardiovascular disease risks; however, more research must be conducted in order to ascertain if combining alcohol and cigarettes increases these risks any more than smoking alone (Supplemental material). (For more details please see Supplementary material.)

Liver cancer

Cigarette smoking and excessive alcohol drinking both increase the risk for certain forms of cancer, as well as contributing to heart disease, stroke, respiratory illness (emphysema, chronic bronchitis, pneumonia), high blood pressure and diabetes – with smokers also having an increased chance of giving birth prematurely.

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While many are aware of the health risks associated with smoking, many do not understand that excessive alcohol consumption can also pose health issues. This may be because older generations began drinking before it was generally acknowledged to be harmful for health.

Studies have demonstrated that heavy alcohol drinking and smoking increase your risk of Hepatocellular Carcinoma (HCC). Hepatocellular Cancer is the most prevalent form of liver cancer, developing when normal cells in your liver mutate uncontrollably and start growing out of control. Hepatitis B virus infection, Hepatitis C virus infection or alcohol related liver damage may all increase this risk.

Recent meta-analyses conducted by the US Surgeon General have shown that heavy alcohol use increases your risk of Hepatocellular Carcinoma by 51-70%, with those living with Hepatitis C being especially at increased risk. Researchers believe this increased risk could be attributed to multiple mechanisms, including production of acetaldehyde, increased oxidative stress levels, inducing of Cytochrome P-450 2E1 enzyme activity which causes lipid peroxidation as well as disturbed methyltransfer and DNA hypomethylation as well as iron overloading which impair immune responses and impaired immune responses.

The authors of this meta-analysis utilized data from a large cohort of Chinese patients with severe COVID-19 infections. They classified them according to whether they smoked, drank, or both and used a Cox proportional hazards model to calculate adjusted hazard ratios and 95% confidence intervals. Their researchers concluded that current and past drinking or both smoking and drinking significantly increased the odds of severe COVID-19 and poor outcomes; neither smoking nor drinking alone had direct impacts.

The authors of the study would like to thank patients and medical staff for providing us with such valuable data, and for being such a part of providing care for patients.