Medically Reviewed:
Dr. Michael Vines, MD
Ray Hamilton, DNP, PMHNP-BC, FNP-C
Last Updated: June 9, 2025
Alcohol and tobacco are two of the most commonly used addictive substances worldwide. In the United States, millions of people who smoke also drink alcohol, often simultaneously. This combination, known as drinking and smoking, significantly increases the risk of serious health problems.
Understanding the effects of smoking cigarettes, the impact of cigarette smoke, and how alcohol and tobacco interact is crucial for making informed decisions about your health.
Tobacco use, primarily through cigarette smoke, affects nearly every organ system in the body. The effects of smoking are well-documented and contribute to a wide range of serious health problems.
Cigarette smoke contains thousands of chemicals, many of which are toxic or carcinogenic. These chemicals damage the lining of the lungs, leading to chronic obstructive pulmonary disease (COPD), emphysema, and chronic bronchitis. Long-term smoking is the leading cause of lung cancer, which remains one of the deadliest cancers worldwide.
Smoking causes blood vessels to constrict and promotes the buildup of plaque in arteries. This process increases blood pressure and reduces oxygen delivery to the heart and other organs. As a result, people who smoke have a significantly higher risk of heart attack, stroke, and peripheral artery disease.
The toxins in cigarette smoke weaken the immune system, making the body less able to fight infections and heal wounds. This suppression increases susceptibility to respiratory infections and slows recovery from illnesses.
Smoking also contributes to diseases including diabetes, osteoporosis, and reproductive issues. It accelerates skin aging and increases the risk of complications during pregnancy.
Nicotine is the primary addictive substance in tobacco. The amount of nicotine in a cigarette varies by brand and type but typically ranges from 8 to 20 milligrams per cigarette. However, the actual amount absorbed by the body is usually about 1 to 2 milligrams per cigarette smoked.
Nicotine rapidly enters the bloodstream and reaches the brain within seconds of inhalation. This quick delivery contributes to its highly addictive nature. The effect of nicotine includes stimulation of the central nervous system, release of dopamine (the “feel-good” neurotransmitter), and temporary relief of withdrawal symptoms.
Combining alcohol and tobacco use is more harmful than using either substance alone. The effects of smoking cigarettes and drinking alcohol together create a dangerous synergy that increases the risk of multiple diseases, such as lung cancer, heart attack, and other chronic conditions.
People who smoke and drink alcohol have a dramatically higher risk of developing cancers of the mouth, throat, esophagus, and lungs.
Cigarette smoke contains numerous carcinogens, and alcohol acts as a solvent that enhances their penetration into the tissues lining the mouth and throat. This interaction increases the risk of cancer far beyond the effect of either substance alone.
Additionally, the combination increases the risk of cardiovascular diseases, including heart attack and stroke. Both alcohol and tobacco independently raise blood pressure and damage blood vessels. Together, they accelerate the development of atherosclerosis, increasing the likelihood of a heart attack.
Alcohol and tobacco are highly addictive substances. When used together, they reinforce each other’s addictive properties. Nicotine dependence is common among people who smoke, and alcohol dependence often coexists.
Drinking alcohol can increase cravings for cigarettes, while smoking can intensify the urge to drink. This mutual reinforcement makes quitting either substance more difficult.
For individuals undergoing treatment for diseases such as cancer or heart disease, continued drinking and smoking can reduce the effectiveness of therapies and worsen side effects. For example, cigarette smoke impairs lung function, complicating recovery from surgery or chemotherapy. Alcohol can interfere with medication metabolism, reducing treatment efficacy.
Both nicotine and alcohol are addictive substances, but they differ in their addiction profiles.
Nicotine is considered one of the most highly addictive substances known. It causes nicotine dependence by altering brain chemistry and creating strong cravings. People who smoke often find it difficult to stop smoking due to withdrawal symptoms such as irritability, anxiety, and difficulty concentrating.
Alcohol dependence also develops through changes in brain function, but the addiction process can be more variable depending on genetic, psychological, and social factors.
Nicotine withdrawal symptoms tend to be shorter but intense, often lasting a few weeks. Alcohol withdrawal can be more dangerous, sometimes requiring medical supervision due to risks like seizures.
Relapse rates are high for both addictions. However, nicotine dependence is often lifelong without treatment, while some people can recover from alcohol dependence with appropriate support.
Some research has explored whether nicotine can help with alcohol withdrawal symptoms, but the results are mixed. Nicotine’s effect on the brain’s reward pathways may temporarily reduce some withdrawal symptoms, such as irritability and anxiety. Some studies suggest that nicotine replacement therapy might help reduce alcohol cravings in certain individuals.
However, nicotine use during alcohol withdrawal can also reinforce addictive behaviors, making it harder to achieve full sobriety. Using tobacco products to manage alcohol withdrawal can lead to dual dependence, complicating treatment.
While there are no direct harmful interactions between the nicotine patch and moderate alcohol consumption, mixing both substances can be dangerous as they affect the cardiovascular system.
Generally, it is also not recommended to drink alcohol while trying to quit smoking. Alcohol lowers inhibitions and increases the likelihood of relapse into smoking. Drinking alcohol can also intensify side effects such as dizziness, nausea, and increased heart rate.
The combined use of alcohol and tobacco significantly increases the risk of serious health problems, including lung cancer, heart attack, and other diseases. Cigarette smoke and alcohol together create a dangerous synergy that worsens side effects and complicates recovery.
Understanding the risks of drinking and smoking is essential for protecting your health. If you or someone you know struggles with alcohol or tobacco dependence, seek support from healthcare professionals and cessation programs to improve your chances of success.
Our premier addiction treatment centers in Scottsdale, Arizona, offer compassionate, evidence-based care for individuals facing alcohol dependency. Armed by experienced addiction specialists, our programs are thoughtfully tailored to meet the unique needs of each client, promoting lasting recovery and personal growth.
Reach out today and take the first step toward a healthier, more fulfilling life.
