Substance Abuse – Alcohol
Alcohol is in third position in terms of lifestyle factors that contribute to death from disease and accidents. Approximately 100,000 deaths each year are attributed to alcohol use, many of these are from automobile accidents that involve drinking. Some 18 million Americans suffer from alcohol dependence.

Drinking too much alcohol is highly associated with cirrhosis of the liver and increased risk of certain types of cancer, that of the mouth, esophagus, and throat. The combination of drinking with smoking significantly increases the risk of these cancers and people who drink are more likely to smoke.

Alcohol is interesting because moderate intake is known to have health benefits whereas over-consumption contributes to serious disease. A glass of wine daily is associated with improved cardiovascular health, particularly with lowering cholesterol. Red wine has been shown to have the most positive association.