The triple threat of smoking, drinking and being overweight in England

One in fifty people aged 16 or over in England is at high risk of premature death due to a triple combination of risky behaviors: smoking, excessive alcohol consumption, and being overweight. According to an analysis by the NGO Action on Smoking and Health (ASH), around 1 million people are affected by this situation, or 2.2% of the population.[1].

A combination of health risks

The study shows that among adults in England in 2022, 64% of people are overweight or obese, 24% of people consume alcohol with increased or high risk, and 13% of people smoke. About 22% of the adult population, or 10 million people, have two or more of these risk factors simultaneously, with a strong association between some of them, such as smoking and alcohol consumption, and 33.9 million (nearly 74% of people) have at least one of these risky behaviors.

The most disadvantaged populations are more affected by the multiple presence of these risks, which accentuates health inequalities.

Those who combine smoking, alcoholism and are overweight consume more than 14 units of alcohol per week and have a body mass index (BMI) greater than or equal to 25 (overweight or obese).

This "toxic trio" significantly increases the risk of chronic diseases such as cancer, diabetes, heart and liver disease, and could lead to a 20-year reduction in life expectancy, according to Professor Sir Ian Gilmore, chairman of the Alcohol Health Alliance.

Regarding these three risk factors, the study reports the following distributions: 12.7 % (5.9 million) are overweight and consume too much alcohol, but do not smoke; 5.5 % (2.5 million) are overweight and smoke, but consume little alcohol; finally, 1.4 % (600,000 people) smoke and consume too much alcohol, but have a weight considered normal.

A response expected in the future health plan

Caroline Cerny, deputy director of ASH, described the findings as worrying, noting that they illustrate the current and future challenges facing the UK healthcare system. According to the Health Foundation, nearly 9 million more people could be living with chronic conditions by 2040, including cancer, diabetes, kidney disease, dementia, and depression.

Cerny called on Health Secretary Wes Streeting to include ambitious measures in the government's 10-year health plan. She recommends setting targets for reducing smoking, alcohol consumption, and excess weight, minimum unit pricing for alcohol, and expanding the sugar tax to other processed foods.

The Department of Health confirmed that the next health plan will focus more on prevention. It also highlighted ongoing initiatives, such as the ban on advertising unhealthy products before 9 p.m., the upcoming food strategy, the Tobacco and E-Cigarettes Bill, an increase in the public health budget, and a £310 million (approximately €362 million) allocation for treating alcohol and other drug addictions.

Recently, an English survey showed that Reducing tobacco consumption has significant economic benefits, by reducing costs for health systems, increasing productivity and tax revenues through better health of the population but also by reallocating freed-up purchasing power towards goods and services that generate economic activity. Furthermore, new data from ASH has alerted us to the fact that although smoking is decreasing among young people, Nicotine pouches are enjoying growing popularity among young English people, the prevalence of consumption among 18-34 year olds having increased from 1.2 % in 2023 to 2.6 % in 2025.

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[1]ASH, Alcohol Health Alliance, Obesity Health Alliance, The three big killers: how smoking, alcohol consumption and overweight/obesity overlap and interact in the population, ASH, published June 2025, accessed June 30, 2025

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