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Data were from a representative household survey of adults in England (<jats:italic>n<\/jats:italic>\u2009=\u2009188,878). Participants who reported former or current smoking scored approximately 1 point higher, on average, on the AUDIT-C (which measures alcohol consumption) than those who had never regularly smoked (<jats:italic>B<\/jats:italic>\n            <jats:sub>adj<\/jats:sub>=0.97 [95%CI 0.93\u20131.00] and 0.92 [0.87\u20130.96], respectively) and had double the odds of risky drinking (AUDIT-C\u2009\u2265\u20095: OR<jats:sub>adj<\/jats:sub>=2.04 [1.98\u20132.10] and 2.03 [1.97\u20132.10], respectively), while differences for those who did versus did not use non-combustible nicotine use were less pronounced (AUDIT-C: <jats:italic>B<\/jats:italic>\n            <jats:sub>adj<\/jats:sub>=0.14 [0.08\u20130.21]; AUDIT-C\u2009\u2265\u20095: OR<jats:sub>adj<\/jats:sub>=1.09 [1.04\u20131.13]). Among participants who engaged in risky drinking, those who smoked (vs. not) were more likely to report receiving alcohol brief interventions, and those attempting to quit smoking (vs. not) were more likely to report alcohol reduction attempts. Overall, combustible and - less so - non-combustible nicotine use is associated with higher levels of alcohol consumption and risky drinking.<\/jats:p>","DOI":"10.1038\/s41598-025-89750-2","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T06:09:23Z","timestamp":1740550163000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Smoking, and to a lesser extent non-combustible nicotine use, is associated with higher levels of alcohol consumption and risky drinking"],"prefix":"10.1038","volume":"15","author":[{"given":"Sarah E.","family":"Jackson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Oldham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Garnett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lion","family":"Shahab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Cox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"89750_CR1","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1016\/S0140-6736(18)31310-2","volume":"392","author":"MG Griswold","year":"2018","unstructured":"Griswold, M. 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LS has received honoraria for talks, unrestricted research grants and travel expenses to attend meetings and workshops from manufactures of smoking cessation medications (Pfizer; J&J), and has acted as paid reviewer for grant awarding bodies and as a paid consultant for health care companies. All authors declare no financial links with tobacco or alcohol companies, e-cigarette manufacturers, or their representatives.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Ethical approval for the Smoking Toolkit Study was granted originally by the UCL Ethics Committee (ID 0498\/001). All methods were performed in accordance with the relevant guidelines and regulations. Informed consent was obtained from all participants. The data were collected by IPSOS MORI and were anonymised when received by UCL.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}],"article-number":"6851"}}