19.APR.2017 5 MIN READ | 5 MIN READ

Most people are aware that smoking and heavy drinking are unhealthy habits, but not many realise just how much harm they can cause.

Last updated on 3 September 2020

Dr Stanley Chia, cardiologist at Mount Elizabeth Hospitals, explains the effects of smoking and drinking on our health.

Growing up, many children may view drinking and smoking as privileges of adults and therefore ‘cool’ activities to engage in. Media portrayal of smoking and alcohol use has certainly helped to perpetuate the appeal of these social habits. The importance of public awareness about the dangers of heavy smoking and drinking has never been greater.

The danger of smoking

Cigarettes contain more than 4,000 chemical compounds and 400 toxic chemicals that include tar, carbon monoxide, DDT, arsenic and formaldehyde. The nicotine in cigarettes, in particular, makes them highly addictive. There are so many diseases caused by smoking that it’s hard to decide where to begin.

Any amount and type of smoking is bad for your health. Besides being a notorious risk factor for lung cancer, coronary artery disease, heart attack and stroke, smoking can damage almost any organ in our body, leading to leukaemia and cancers of the kidney, pancreas, bladder, throat, mouth and uterus. It can damage the airways and air sacs of our lungs to cause chronic bronchitis and breathing difficulties. It can also raise our blood pressure and cholesterol levels, reduce bone density in women and increase the risk of infertility, preterm delivery, stillbirth and sudden infant death syndrome.

The danger of heavy drinking: How much alcohol is too much?

Most people like to have a drink or two, be it beer, wine or spirits. Light drinking is acceptable and may even be beneficial for the heart. Heavy and binge drinking, on the other hand, can lead to serious medical problems.

Drinking 7 or more drinks per week is considered excessive drinking for women, while 15 drinks or more per week is deemed to be excessive for men.

A healthy limit for drinking is usually no more than 2 drinks (3 units of alcohol) a day for men and 1 drink (2 units) a day for women. Binge drinking means having 5 or more drinks for men and 4 or more drinks for women on one occasion.

Certain groups of people should not drink alcohol at all. These include young people under the age of 18, pregnant women, people with certain health conditions, patients on medication that will interact with alcohol, recovering alcoholics, and people who intend to drive or do activities that require attention and coordination.

Heavy drinking can lead to many serious health conditions. Binge drinking can cause immediate problems such as acute intoxication, nausea and vomiting, blurred vision, impaired judgment and alcohol poisoning.

In the long term, heavy alcohol consumption can cause high blood pressure, gastric problems, liver cirrhosis, liver cancer, pancreatitis, memory impairment, alcohol dependence and various psychological conditions. Excessive alcohol drinking can also result in accidental injuries and even death. Pregnant women who drink heavily can harm their babies.

Effects of smoking and drinking on the heart

Both tobacco and alcohol can affect the heart. While the deleterious effect of smoking on the risk of cardiovascular disease is well-recognised and straightforward (the risk of heart disease increases with the amount of smoking), the impact of drinking is more complex.

Some evidence suggests that moderate drinking (3 – 14 drinks a week) may be associated with a lower risk of heart attack, while heavier drinking may well increase the risk of heart attack, heart failure, stroke and high blood pressure.

As smoking is also common among alcohol drinkers, and smokers and drinkers frequently share similar behavioural and lifestyle patterns, it is currently unclear whether it is the combined or independent effects of smoking and alcohol that greatly raises cardiovascular risk.

Nonetheless, the health problems associated with excessive smoking and drinking are extensive. Public health efforts to minimise the dangers of both smoking and drinking may significantly improve the well-being of society.

Benefits of kicking the habit

It is important to realise that quitting smoking can improve your quality of life – physically, emotionally and financially. It can help you and those around you breathe better and live longer.

People who stop smoking generally have an improved sense of smell and taste, feel less stressed and become more energetic. They will usually have younger looking skin and improved fertility. Their loved ones will be healthier as passive smoking is reduced.

For people who drink too much, alcohol tolerance can lead to false reassurance that they are drinking within limits, since they do not feel drunk. Health benefits of reducing alcohol intake include weight loss, a reduced risk of many forms of cancer, less anxiety, clearer skin, no hangovers and better self-esteem.

Withdrawal symptoms of smoking

While you’re trying to quit smoking, you will experience some withdrawal symptoms. These symptoms are usually the worst in the first week and then gradually improve. Common physical symptoms to expect include:

  • Appetite increase. You will feel hungry more often as the effects of chemicals from cigarettes are no longer present.
  • Nicotine cravings. Each craving will only last about 15 – 20 minutes but it will happen often and throughout the quitting process.
  • Cough. This may last for a few weeks as your respiratory system cleans itself.
  • Mild headaches and dizziness. These are often the first withdrawal symptoms to appear but they also resolve quickly.
  • Tiredness. In the absence of nicotine, which is a stimulant, you will likely feel tired, restless, and might have insomnia.
  • Constipation. This may occur in the first month of quitting.
  • Mental and emotional symptoms. These include anxiety, depression, irritability, and mental fog.

How to quit: Smoking cessation

Smoking cessation means abstaining from cigarettes and/or other tobacco products for at least 6 months, but preferably for a year. This can be a challenging attempt as the nicotine in tobacco is addictive and cause dependence. You will experience several unpleasant short-term effects and withdrawal symptoms as you embark on this effort. Nevertheless, smokers can and do quit smoking for good.

Smokers who quit smoking with support are more likely to succeed than those who do it on their own. Hence, it is helpful for those trying to stop to consult a health professional on engage a smoking cessation programme.

For regular, very heavy drinkers, stopping alcohol consumption abruptly can be dangerous. They should therefore consult their doctors to manage the withdrawal symptoms.

Always remember that our health is important to us and our families, and we should take care to safeguard it.


Article contributed by Dr Stanley Chia, cardiologist at Mount Elizabeth Hospital


What is Nicotine Withdrawal? (n.d.) Retrieved September 2, 2020, from https://www.webmd.com/smoking-cessation/understanding-nicotine-withdrawal-symptoms#2

A Review of Smoking Cessation Interventions. (n.d.) Retrieved September 2, 2020, from https://www.medscape.com/viewarticle/504516

Chia Stanley
Mount Elizabeth Hospital

Dr Stanley Chia is an interventional cardiologist and physician at Mount Elizabeth Hospital and Mount Elizabeth Novena Hospital, Singapore.