Smoking, heavy drinking and poor nutrition tend to cluster

December 19, 2000

The embargo on this release has been broken inadvertantly by a news organization, and the news release is available for immediate use.

A lifestyle of smoking and heavy drinking may predispose individuals to make poor food choices and increase their health risks, according to the results of a survey of more than 6,700 individuals.

"The combination of smoking, liberal drinking and poor nutrition conceivably elevates the risk for various chronic diseases such as cancer and cardiovascular disease," said one of the study authors Nancy Betts, PhD, RD, of the Department of Nutritional Science and Dietetics at the University of Nebraska in Lincoln. "These findings imply that health promotion efforts need to target multiple risk factors simultaneously or sequentially."

Betts and colleagues analyzed data from the Continuing Survey of Food Intakes by Individuals, a large-scale nation-wide U.S. Department of Agriculture survey conducted from 1994 through 1996.

Similar to previous studies that found a relationship between cigarette smoking and alcohol consumption, Betts and colleagues found heavy drinking to be more common among current smokers than former or nonsmokers. Heavy drinking was defined for men as more than two drinks a day and for women as more than one drink a day.

According to the researchers, the relationship between nicotine and alcohol is not well understood. "Chronic use of one drug may increase tolerance to the other, or, conversely, nicotine may cause a stimulating effect that is depressed by ethanol," said Betts. "Or, some individuals may be genetically predisposed to heavy alcohol or tobacco use or to addictive behaviors in general."

While the combination of smoking and drinking was not more potent than either behavior alone, both exerted a negative effect on eating habits that corresponded to drug dosage. In other words, as the number of daily cigarettes and alcohol drinks increased among study participants, the intake of nutritious grains, fruits and vegetables decreased, Betts and colleagues found.

The study findings are published in the current issue of the American Journal of Health Promotion.

"Efforts to examine the role dietary intake plays in the development of chronic diseases should take into account the effects of cigarette smoking and alcohol consumption because both appear to adversely affect food choice behaviors and nutrient demands," said Betts.

This research supports previous studies, which found that smokers and excessive drinkers tend to eat more unhealthy foods like ice cream and fatty meat products, and less fruit, cereal and vegetables. Such tendencies are particularly dangerous for these individuals, since smoking and drinking both increase the body's demand for healthy foods containing the antioxidant vitamins A, C and E.

"Further research should investigate fundamental mechanisms explaining these clustering phenomena, which can guide the design of health promotion interventions," concluded Betts.
The American Journal of Health Promotion is a bimonthly peer-reviewed journal dedicated to the field of health promotion. For information about the journal call 248-682-0707 or visit the journal's website at

Posted by the Center for the Advancement of Health For more research news and information, go to our special section devoted to health and behavior in the "Peer-Reviewed Journals" area of Eurekalert!, For information about the Center, call Petrina Chong, 202-387-2829.

Center for Advancing Health

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