Racial Differences in Alcohol Consumption and Smoking Behaviors

Alcohol and cigarette use are more common in White than Black/African American individuals, and Black/African American individuals are more likely to have recurring problems with alcohol and continue to smoke later into adulthood than White individuals. Oftentimes, alcohol consumption and cigarette use go together. A recent study by a team of researchers within the National Institute on Alcohol Abuse and Alcoholism, National Institute on Drug Abuse, and National Institute on Minority Health and Health Disparities intramural research programs, American University, and Charles R. Drew University of Medicine and Science, found racial differences in alcohol consumption and cigarette smoking and how strongly the two behaviors were associated.

Many factors, including racial background, are associated both with starting and with continuing to use alcohol and cigarettes. To take a closer look at the relationship of race with alcohol consumption and cigarette smoking, researchers analyzed data on 1,692 Black/African American and White individuals who had expressed interest in taking part in research studies on alcohol at the NIH. Over half (58.3%) of the participants met the criteria for alcohol use disorder and 37.8% smoked cigarettes. All participants answered questions about their past and present alcohol and cigarette use.

Researchers found that more Black/African American study participants smoked cigarettes and had alcohol use disorder than White participants. Black/African American participants also had higher risks of alcohol problems than White participants. The relationship between cigarette smoking and alcohol consumption was stronger in White than Black/African American participants. For example, among White participants, smoking cigarettes at a younger age was associated with a higher risk of alcohol use disorder in adulthood. This relationship was not significant in Black/African American participants. The relationship between cigarette consumption and alcohol use disorder was also stronger in White than in Black/African American participants.

In summary, these findings suggest that future studies should look more closely at how the relationship between alcohol consumption and cigarette smoking behaviors differ across racial categories, what factors drive these racial differences, and how these differences relate to disparities in health outcomes. The researchers suggest that future studies could ask participants about their experiences with racism and discrimination, as well as any health problems that may be associated with their use of alcohol or cigarettes. A better understanding of the relationship between race and the use of alcohol and cigarettes could lead to more specific prevention and treatment strategies to help reduce associated disparities in health outcomes for alcohol-associated liver disease, alcohol-related esophageal and pancreatic cancers, and other alcohol- and cigarette-related conditions.


Harris, J. C., Mereish, E. H., Faulkner, M. L., Assari, S., Choi, K., Leggio, L., & Farokhnia, M. (2021). Racial Differences in the Association Between Alcohol Drinking and Cigarette Smoking: Preliminary Findings From an Alcohol Research Program. Alcohol and Alcoholism. Alcohol and Alcoholism. Online ahead of print. DOI: https://doi.org/10.1093/alcalc/agab038

Page updated December 28, 2021