Is Smoking or Drinking Worse for Your Health?

Dr. Shyla Khatiwala, MD

Medical Director

Dr. Khatiwala serves as the onsite medical director at Rushton Recovery. She plays an integral role in overseeing the medical department, admitting and assessing new clients upon arrival, and managing the daily medical needs of detox and residential clients. Her expertise, dedication, and compassionate approach shine through in her commitment to helping clients overcome alcohol and substance use disorders.

Before joining Rushton Recovery, Dr. Khatiwala completed her residency in family medicine through Wayne State University at the Detroit Medical Center. She spent nearly 12 years in private practice in Plymouth, Michigan, earning a reputation for delivering high-quality, compassionate care. Following this, she served as medical director at Acadia Healthcare, an outpatient opioid treatment center, where she successfully led her team for four years.

Continuing her mission to combat the opioid epidemic, Dr. Khatiwala became medical director at Community Medical Services, where she oversaw outpatient opioid treatment centers across Michigan.

Beyond her professional achievements, Dr. Khatiwala is a proud wife and mother to three active boys, balancing her career with a deep dedication to her family.

Dr. Shyla Khatiwala, MD

Medical Director

Continuing her mission to combat the opioid epidemic, Dr. Khatiwala became medical director at Community Medical Services, where she oversaw outpatient opioid treatment centers across Michigan.

Beyond her professional achievements, Dr. Khatiwala is a proud wife and mother to three active boys, balancing her career with a deep dedication to her family.

Published on:

November 20, 2025

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Smoking tobacco/nicotine products and drinking alcohol are two common behaviors in the US. Around 30 million US adults smoke cigarettes, 143 million consume alcohol, and 22 to 26 million report using both [1].

Smoking tobacco products is generally considered worse for your health and has higher rates of premature death, although alcohol is also risky, and both are two of the leading causes of cancer. Read on to explore the health risks of both and tips for quitting.

Health Risks of Smoking

Smoking is considered one of the top causes of preventable death. It’s associated with several other health risks, including [2]:

Lung diseases such as COPD, lung cancer, and interstitial pneumonia. Vaping is associated with “popcorn lung” (bronchitis), and EVALI (a deadly growing medical condition related to electronic cigarette use) [3].
Increased risk of heart attack, stroke, blood clotting, and clogged arteries.
Disrupt hormones, damage reproductive organs, and increase the risk of infertility.
High link to oral cancer, gum disease, and tooth decay.
Premature aging, reduced skin elasticity, and skin dehydration.
Can lower bone density and increase the risk of bone fractures.
Higher risk of infections, long-term COVID, and a weaker immune system.

Health Risks of Alcohol

Nearly 20,000 adults die each year from alcohol-related cancer deaths, and even more from other health problems, alcohol addiction, or alcohol related accidents. Long-term evidence confirms that excessive alcohol use is linked to reduced life span [4].

According to the WHO, health risks of alcohol include [5]:

Heart disease, cardiovascular problems such as arrhythmias, increased blood pressure, clogged arteries.
Liver damage such as cirrhosis and alcoholic hepatitis.
Pancreatitis, inflammation of the pancreas, weakened immune system.
Cognitive decline, memory loss, neuropathy, and risk of wet brain syndrome or stroke.
Increased risk of mental health disorders such as depression, anxiety, bipolar disorder, and suicide.
Alcohol use disorder, addiction, and complications of physical and psychological dependence.
Accidents, injuries, alcohol alcohol-related violence. Nearly 17,000 traffic deaths per yar are alcohol-related.
Chronic stomach problems, alcohol-induced gastritis, and ulcers.

Is Smoking or Alcohol Associated with More Deaths?

In the US, smoking causes more deaths annually than alcohol. According to the CDC, tobacco smoking and secondhand smoke lead to nearly 480,000 deaths each year. Alcohol-related deaths, including those from liver disease, accidents, overdoses, and violence, account for around 178,000 deaths annually [2][4].

This same pattern is reflected globally. According to the WHO, tobacco kills more than 8 million people per year, in comparison to about 2.6 million from alcohol.

Are Alcohol and Tobacco The Leading Causes of Cancer?

According to the National Cancer Institute, cigarette smoking is the leading cause of preventable, premature death. It harms almost every organ of the body, contributing to several kinds of cancer and chronic diseases. Smoking contributes to around 20% of all cancer cases, 30% of cancer deaths, and 80% of lung cancer deaths [6].

Alcohol use is also linked to several kinds of cancer, especially stomach, esophageal, and liver and kidney cancer. Smoking and drinking combined further increase the risk, especially when combined with other cancer-increasing lifestyle factors such as lack of physical activity, high body mass index, and a diet heavy in processed or unhealthy foods. One study found that consuming a bottle of wine per week has a similar risk of smoking 10 cigarettes per week [7].

What To Know About Quitting Both

Quitting alcohol or smoking can be a challenge, but it’s possible to do both. Most individuals can quit smoking on their own with the help of nicotine substitutes (patches or gum), behavioral therapy, and emotional or social support.

Tips for Quitting Smoking

Some helpful tips to quit smoking include:

Nicotine Replacement Therapy (NRT): Products like nicotine patches, gum, lozenges, inhalers, or nasal sprays can reduce cravings and withdrawal by providing controlled nicotine without harmful toxins found in cigarettes.
Prescription Medications: Some medications, like varenicline and bupropion, are FDA-approved to reduce cravings and withdrawal symptoms. Varenicline, in particular, has the highest success rate and may be combined with NRT for better outcomes [8].
Behavioral Therapy: Counseling, such as in-person, online, or in group, and motivational interviewing, can increase quit rates when combined with pharmaceuticals. Quitline support, such as through the CDC 1-800-QUIT-NOW, can provide support during moments of cravings or setbacks.
Prepare: Set a quit date, identify your triggers, and create strategies to cope with cravings such as deep breathing, exercise, or distraction.
Stay Persistent: Quitting may require multiple attempts and different approaches. Continuous follow-up, method adjustments, and seeking help when needed improve the chances of long-term success. Be easy on yourself and know that quitting cold turkey forever doesn’t always happen overnight, and it’s not an easy process.
Stay hydrated, get rest, distract yourself with friends or social support. Nicotine withdrawal can cause headaches, aggression, and general discomfort, but doesn’t usually require a medically supervised detox program.

Quitting Alcohol and the Importance of Supervised Detox

For long-term or excessive alcohol use, it’s important to connect with a supervised detox program that can prevent complications from occurring. Alcohol causes changes in neurotransmitters such as GABA that can cause intense withdrawal symptoms, including nausea, vomiting, anxiety, the shakes, and in some cases, fever, hallucinations, and seizures.

A supervised detox program ensures individuals withdrawing from alcohol stay hydrated, monitor their vitals, and can prescribe medication to alleviate cravings or withdrawal pain.

Empowering Our Community To Make Informed Choices About Tobacco and Alcohol

Rushton Recovery is a detox and residential treatment center in Michigan that offers a healing space to embark on your journey toward sobriety. We are also committed to empowering our community with accurate, evidence-based information about substance use and mental health.

We believe that informed choices are the foundation of healthier lives. Our educational resources and support aim to raise awareness about the effects of smoking and alcohol use. Join us in fostering a community built on knowledge, understanding, and healthier habits.

Connect with our team to learn more.