A prospective study of the association between smoking and later alcohol drinking in the general population

ABSTRACT Aims To address the possible prospective association between smoking habits and risk of later heavy drinking in the adult population. Design Pooled population‐based long‐term cohort studies with repeated assessments of smoking and alcohol habits. Setting Copenhagen, Denmark. Participants A total of 14 130 non‐ to moderate drinkers at baseline, who attended re‐examination. Measurements Among the non‐ to moderate drinkers we addressed the relation between smoking habits at first examination and the risk of becoming a heavy and excessive drinker at follow‐up. Findings Level of tobacco consumption at first examination predicted an increased risk of becoming a heavy and excessive drinker in a dose‐dependent manner. Men who smoked more than 25 g of tobacco per day had adjusted odds ratios of 2.12 (95% confidence interval (CI): 1.44–3.11) and 3.95 (95% CI: 1.93–8.95) for becoming heavy and excessive drinkers, compared to participants who had never smoked. Equivalent estimates among women were 1.76 (95% CI: 1.02–3.04) and 2.21 (95% CI: 1.00–4.58), respectively. Conclusions This study suggests that tobacco use is associated quantitatively with later risk of heavier drinking.