Alcohol vs smoking: Which habit should you quit first and why?

Whether someone should give up smoking before alcohol - or vice versa - is not governed by any universal rule, says Dr Bhanu Mishra, Consultant Nephrologist, Fortis Hospital, Shalimar Bagh.

"There is no universal law stating that a person must stop consuming alcohol before quitting smoking, or vice versa. It depends entirely on an individual's pattern of consumption, overall health and underlying medical conditions," he says.

Why smoking remains the bigger health threat

While the decision should be individualised, Dr Mishra says tobacco remains the leading cause of preventable disease and premature death from a public health perspective.

"Tobacco use is the number one cause of preventable diseases and early deaths. Smoking significantly increases the risk of lung cancer, chronic obstructive pulmonary disease (COPD), heart disease, stroke and several other illnesses," he explains.

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He adds that there is no safe level of tobacco use.

"Even occasional smoking is harmful. There is no such thing as a 'healthy dose' of tobacco," he says.

Alcohol carries serious health risks too

Alcohol is far from harmless, Dr Mishra cautions.

"Excessive alcohol consumption can lead to liver and pancreatic diseases, hypertension, heart problems, certain cancers, mental health disorders and a greater risk of accidents and injuries," he says.

He also points to growing scientific evidence on alcohol consumption and cancer risk.

"Current research suggests there is no amount of alcohol that can be considered completely safe when it comes to cancer prevention," he adds.

Using both? The risks multiply

For people who both smoke and drink regularly, Dr Mishra recommends working towards giving up both habits.

"The ideal approach is to quit both smoking and alcohol. The combination has a synergistic effect, meaning the two together increase the risk of cancers of the mouth, throat and oesophagus far more than either habit alone," he says.

If you have to prioritise, which should come first?

If quitting both at once feels overwhelming, Dr Mishra says smoking cessation often provides the greatest long-term reduction in health risks.

"The benefits of quitting smoking begin almost immediately. Within days and weeks, circulation and lung function improve, while the long-term risk of heart disease, stroke and cancer continues to decline over time," he explains.

The best approach is a personalised one

Ultimately, Dr Mishra stresses that there is no one-size-fits-all approach to overcoming addiction.

"Quitting either habit is a positive step, but the strategy should always be personalised. Healthcare professionals assess the severity of nicotine and alcohol dependence, a patient's motivation, mental health and any co-existing illnesses before recommending a cessation plan," he says.

He adds that professional support can significantly improve the likelihood of long-term success.

"Behavioural counselling, support groups, nicotine replacement therapy or medications for tobacco dependence, along with evidence-based treatment for alcohol use disorder, can greatly improve the chances of successful and sustained recovery," Dr Mishra concludes.