The cost of smoking, drinking and drugs

It seems that the last couple of years there have been many news stories and advertisements proclaiming the tragedy of opioid use as well as other drug use. Recently, in the last couple of months, however, there have been articles and newscasts highlighting the heavy use of alcohol and the deaths that are caused by alcohol. So which is the most abused, alcohol or drugs?

What’s a fellow to believe with what sounds like contradictory information?

So I had to do a little research. Two organizations, NIH (National Institutes of Health) and CDC (Centers for Disease Control and Prevention) have a wealth of information on the topic of causes of death.

So I discovered that it was neither alcohol or drugs. The No. 1 cause turns out to be tobacco and the No. 2 cause is poor diet and exercise. That pushed alcohol down to being the No. 3 cause outranking drugs as No. 4. Placing a person’s death in one of the categories is not really a straight forward process as there can be multiple causes, but they have apparently come up with criteria that allow for designating the major cause.


Now for some facts. The estimate is that in the U.S. 480,000 persons per year die because of tobacco and that includes 41,000 who have been judged to die because of secondhand smoke. Currently about 16 million persons in the U.S. have some tobacco-influenced disease. Generally the estimate is that smokers on the average die 10 years younger than non-smokers.

Have we done enough as a nation trying to get people to quit smoking?

Many states and other entities have programs to help people to quit. Much of the funding comes as a result of the tobacco companies having been sued to provide funds. Unfortunately, a vast percentage of those funds that are collected do not go toward helping individuals quit. The states have collected $270,000,000,000, that’s two-hundred-seventy billion dollars, in other words, a little more than a quarter of a trillion dollars. The states have spent roughly $665 MILLION for prevention. Compare that to the amount that tobacco companies currently spend on advertising and promotion: $9 BILLION.

There is also a broader cost that needs to be mentioned, namely direct medical care is estimated at $300 BILLION a year. As one of my former teachers would say, “Oh, shucky darns!” or as I would say, “Oh, Fiddlesticks!”


There are conflicting estimates on the numbers in each of the categories mentioned, but the Journal of the American Medical Association a few years ago estimated that poor diet and inactivity accounts for about 400,000 deaths per year. One item that seems to be true is that inactivity is more of a problem than general obesity.

Moving on to the No. 3 cause, alcohol. Here the numbers drop considerably. It is estimated that 88,000 deaths per year in the U.S. are alcohol related, 62,000 per year for men and 26,000 per year for women. Significantly about 10,000 of the 88,000 deaths were for alcohol leading to driving fatalities. There also seems to be a trend that the number of women is increasing compared to the number of men.

Binge drinking has also shown an interesting fact in that the number of binge drinkers (on the basis of five or more drinks on one occasion) has not increased but the consumption of drinks by a binge drinker has increased from 472 per person in 2011 to 529 per person in 2017.

Alcohol deaths doubled from 35,914 in 1997 to 72,558 in 2017 and now at the 88,000 level.

As for beer drinkers, the indication is that the amount of beer consumed has been decreasing. The Brewers Association has data about regular beer versus craft beers versus imported beers.

The decline was 1% from 2017 to 2018. More trivia: Sales were 194,278,588 barrels in total, with sales of craft beers up to 25,632,766 barrels and Import Beers up to 35,660,588 barrels.

As for the No. 4 cause of death, drugs, the estimate is about 70,000 deaths per year with opioids as part of that numbering close to 47,000 deaths per year.


This past Sunday, I happened on an item in the Sunday Star Tribune titled: “As millennial drinking declines, Twin Cities bars are going dry.”

Several bars are mentioned that are downplaying alcoholic drinks. One bar no longer has a display of 192 bottles of alcohol, but instead are some other more generic bottles, many without alcohol. Alcohol is still available, but there are other “cocktails” featured with no alcohol, but some unusual ingredients. The statement is made that, “More than half of Americans 21 and older abstain from alcohol at some point in the year.” Healthier living. Try kombucha and sparkling water. Verjus (non-fermented grape juice). Drinks flavored with a syrup from milkweed flowers mixed with rice vinegar. Switchel. Oxymel. Seabuckthorn. Check your on-line dictionary for what all of these are.

Until next time: Oh, Fiddlesticks!