AUTHOR=Jaswal Harpreet , Sohi Ivneet , Rehm Jürgen , Churchill Samuel , Sherk Adam , Stockwell Tim , Levesque Christine , Sanger Nitika , Edalati Hanie , Butt Peter R. , Paradis Catherine , Shield Kevin D. 

TITLE=A drink equals how many cigarettes? Equating mortality risks from alcohol and tobacco use in Canada

JOURNAL=Frontiers in Public Health

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1331190

DOI=10.3389/fpubh.2024.1331190

ISSN=2296-2565

ABSTRACT=Objective: To quantify and communicate risk equivalencies for alcohol- and tobacco-attributable mortality by comparing per standard drinks consumed to per number of cigarettes smoked in Canada.
Method: Alcohol- and tobacco-attributable premature deaths (≤75 years of age) and years of life lost (YLL) were estimated using a lifetime risk modelling approach. Alcohol-attributable death statistics were obtained from the 2023 Canadian Guidance on Alcohol and Health data source. Tobacco-attributable death statistics were derived from the Mortality Population Risk Tool (MPoRT) model.
Results: The risk of alcohol use on premature death and YLL  increased non-linearly with the number of drinks consumed, while the risk for tobacco use on these two measures increased linearly with the number of cigarettes smoked. Males who consumed 5 drinks/day — a standard drink contains 13.45 grams of alcohol in Canada — had an equivalent risk as smoking 4.9 cigarettes/day (when modelling for premature death) and 5.1 cigarettes/day (when modelling for YLL). Females who consumed 5 drinks/day experienced an equivalent risk as smoking 4.2 cigarettes/day for premature deaths and YLL. At all levels of alcohol consumption females and males who consumed <5 drinks/day have less risks from consuming a standard drink than from smoking a cigarette. For males who consumed 5 drinks/day, the increased risks  of death from per drink consumed and per cigarette smoked were equal.
Conclusions: Risk equivalencies comparing alcohol use to tobacco use could help people who drink improve their knowledge and understanding of the mortality risks associated with increased number of drinks consumed per day.