Study shows alcohol, tobacco cause more health harm than illegal drugs

A pint of beer and a cigarette

It’s smoking tobacco and drinking alcohol – and not taking illegal drugs – that pose the greatest risks to people’s health, a new international study contends.

Researchers found that alcohol and tobacco use combined cost more than a quarter of a billion disability-adjusted life-years worldwide, while illegal drugs only accounted for tens of millions in comparison. Disability-adjusted life-years is a measurement of overall disease burden, expressed as the number of years lost due to ill health, disability or early death.

High levels of alcohol use

Worldwide, more than one in seven adults smoke tobacco, and one in five reports at least one occasion of heavy drinking in the past month, the review of 2015 data found.


Central, Eastern, and Western Europe have the highest alcohol consumption per person, and the highest rates of heavy consumption among drinkers (50.5%, 48%, and just over 42%, respectively), according to the report, published in the journal Addiction.

In South Africa, 5% of women may be considered to be risky drinkers whereas 28% of men are considered risky drinkers. Risky drinkers are defined as “someone who has drunk five or more standard measurements of alcohol on a single occasion in the past 30 days”.

Those same areas also have the highest rates of tobacco smoking – Eastern Europe 24.2%, Central Europe 23.7%, and Western Europe almost 21%. According to Stats SA, 6% of women smoke tobacco daily, compared to 30% of men in South Africa.


Illicit drug use was far less common worldwide, with fewer than one in 20 people estimated to use marijuana in the past year, with much lower rates of use for amphetamines, opioids, and cocaine, the researchers said.

But the United States and Canada had among the highest rates of dependence on marijuana (749 cases per 100 000 people), opioids (650 cases per 100 000) and cocaine (301 cases per 100 000), according to study co-author Robert West, of University College London and colleagues.

According to UCT researcher, Anine Kriegler, 65% to 70% of drug possession arrests and charges, in South Africa, is for the possession of marijuana. In 2017 a court judge ruled that it would be legal to grow and use marijuana in the privacy of your home. This ruling, however, has yet to be ratified.

In addition, Australia and New Zealand had the highest rate of amphetamine dependence (491.5 per 100 000 people), as well as high rates of dependence on marijuana (694 cases per 100 000 people), opioids (510 per 100 000) and cocaine use (160.5 per 100 000 people). 

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