Skip to main content
    • Aa
    • Aa
  • Access
  • Cited by 20
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Achilonu, Matthew C. and Umesiobi, Dennis O. 2015. Bioactive Phytochemicals: Bioactivity, Sources, Preparations, and/or ModificationsviaSilver Tetrafluoroborate Mediation. Journal of Chemistry, Vol. 2015, p. 1.

    Vernarelli, Jacqueline A. Mitchell, Diane C. Rolls, Barbara J. and Hartman, Terryl J. 2015. Dietary energy density is associated with obesity and other biomarkers of chronic disease in US adults. European Journal of Nutrition, Vol. 54, Issue. 1, p. 59.

    Botti Abbade, Eduardo and Dewes, Homero 2014. Brazilian dry-beans and food security in developing countries. Journal of Agribusiness in Developing and Emerging Economies, Vol. 4, Issue. 2, p. 115.

    Maatoug, Jihene Harrabi, Imed Hmad, Sonia Belkacem, Mylene al’Absi, Mustafa Lando, Harry and Ghannem, Hassen 2013. Clustering of Risk Factors With Smoking Habits Among Adults, Sousse, Tunisia. Preventing Chronic Disease, Vol. 10,

    Shimotsu, Scott T. Jones-Webb, Rhonda J. MacLehose, Richard F. Nelson, Toben F. Forster, Jean L. and Lytle, Leslie A. 2013. Neighborhood socioeconomic characteristics, the retail environment, and alcohol consumption: A multilevel analysis. Drug and Alcohol Dependence, Vol. 132, Issue. 3, p. 449.

    Friedlander, Arthur H. Tajima, Tracey and Garrett, Neal R. 2012. Panoramic Radiographs of Head and Neck Cancer Patients Are Often Evidence of Carotid Artery Atherosclerotic Lesions: A Sign of High-Risk Comorbid Illness. Journal of Oral and Maxillofacial Surgery, Vol. 70, Issue. 5, p. 1096.

    Shimotsu, Scott T. Jones-Webb, Rhonda J. Lytle, Leslie A. MacLehose, Richard F. Nelson, Toben F. and Forster, Jean L. 2012. The Relationships Among Socioeconomic Status, Fruit and Vegetable Intake, and Alcohol Consumption. American Journal of Health Promotion, Vol. 27, Issue. 1, p. 21.

    Choi, Sun-Ja Park, Sung-Hee and Park, Hyun-Young 2011. Increased Prevalence of low High-density Lipoprotein Cholesterol (HDL-C) Levels in Korean Adults: Analysis of the Three Korean National Health and Nutrition Examination Surveys (KNHANES 1998–2005). Osong Public Health and Research Perspectives, Vol. 2, Issue. 2, p. 94.

    Breslow, Rosalind A. Guenther, Patricia M. Juan, Wenyen and Graubard, Barry I. 2010. Alcoholic Beverage Consumption, Nutrient Intakes, and Diet Quality in the US Adult Population, 1999-2006. Journal of the American Dietetic Association, Vol. 110, Issue. 4, p. 551.

    Gopinath, B. Flood, V. M. McMahon, C. M. Burlutsky, G. Smith, W. and Mitchell, P. 2010. The Effects of Smoking and Alcohol Consumption on Age-Related Hearing Loss: The Blue Mountains Hearing Study. Ear and Hearing, Vol. 31, Issue. 2, p. 277.

    Martínez, Elisa Llull, Rosa del Mar Bibiloni, Maria Pons, Antoni and Tur, Josep A. 2010. Adherence to the Mediterranean dietary pattern among Balearic Islands adolescents. British Journal of Nutrition, Vol. 103, Issue. 11, p. 1657.

    Vilaró, Jordi Ramirez-Sarmiento, Alba Martínez-Llorens, Juana Ma Mendoza, Teresa Alvarez, Miguel Sánchez-Cayado, Natalia Vega, Ángeles Gimeno, Elena Coronell, Carlos Gea, Joaquim Roca, Josep and Orozco-Levi, Mauricio 2010. Global muscle dysfunction as a risk factor of readmission to hospital due to COPD exacerbations. Respiratory Medicine, Vol. 104, Issue. 12, p. 1896.

    Puigpinós, Rosa Borrell, Carme Antunes, José Leopoldo Ferreira Azlor, Enric Pasarín, M Isabel Serral, Gemma Pons-Vigués, Mariona Rodríguez-Sanz, Maica and Fernández, Esteve 2009. Trends in socioeconomic inequalities in cancer mortality in Barcelona: 1992–2003. BMC Public Health, Vol. 9, Issue. 1,

    Kim, Soo Yeon Breslow, Rosalind A. Ahn, Jiyoung and Salem, Norman 2007. Alcohol Consumption and Fatty Acid Intakes in the 2001?2002 National Health and Nutrition Examination Survey. Alcoholism: Clinical and Experimental Research, Vol. 31, Issue. 8, p. 1407.

    Covas, María Isabel 2005. Comprehensive Handbook of Alcohol Related Pathology.

    Heitzer, T. and Meinertz, T. 2005. Rauchen und koronare Herzkrankheit. Zeitschrift für Kardiologie, Vol. 94, Issue. S3, p. iii30.

    Martínez-Llorens, Juana M. Orozco-Levi, Mauricio José Masdeu, María Coronell, Carlos Ramírez-Sarmiento, Alba Sanjuas, Carles Broquetas, Joan M. and Gea, Joaquim 2004. Disfunción muscular global durante la exacerbación de la EPOC: un estudio de cohortes. Medicina Clínica, Vol. 122, Issue. 14, p. 521.

    Romberger, Debra J. and Grant, Kathleen 2004. Alcohol consumption and smoking status: the role of smoking cessation. Biomedicine & Pharmacotherapy, Vol. 58, Issue. 2, p. 77.

    Tur, Josep A. Romaguera, Dora and Pons, Antoni 2004. Adherence to the Mediterranean dietary pattern among the population of the Balearic Islands. British Journal of Nutrition, Vol. 92, Issue. 03, p. 341.

    Zamora, A. Elosua, R. and Marrugat, J. 2004. El tabaco como factor de riesgo cardiovascular en las poblaciones mediterráneas. Clínica e Investigación en Arteriosclerosis, Vol. 16, Issue. 5, p. 207.


Tobacco and alcohol consumption: impact on other cardiovascular and cancer risk factors in a southern European Mediterranean population

  • Helmut Schröder (a1) (a2), Jaume Marrugat (a1), Roberto Elosua (a1) and Maribel I. Covas (a1)
  • DOI:
  • Published online: 01 March 2007

Tobacco and alcohol consumption are strongly related to other cardiovascular and cancer risk factors. The aim of the present study was to analyse the association of nutrient intake, blood lipid variables and leisure-time physical activity with tobacco and alcohol consumption status. Participants were recruited in a cross-sectional population-based survey, including cardiovascular risk factor measurements and evaluation of physical activity and diet intake in a Mediterranean population (n 1748). Multiple linear regression analysis, adjusted for several confounders, showed a direct association of saturated fatty acids (g and % total energy intake), dietary cholesterol intakes and serum triacylglycerol with smoking. An inverse association was observed for smoking and unsaturated fatty acids (% energy intake), vitamin C, α-tocopherol and β-carotene intakes, leisure-time physical activity and HDL-cholesterol. These associations were not observed for alcohol drinking. After adjusting for the confounders earlier mentioned, low dietary intakes of vitamin C and dietary fibre were more likely in heavy-smokers as compared with non-smokers (odds ratio 1·74 (95 % CI 1·07, 2·73) and 1·94 (95 % CI 1·29, 2·92) of low vitamin C (<60 mg/d) and dietary fibre intakes (<10 g/d) respectively). Alcohol consumption was directly associated with HDL-cholesterol and triacylglycerol, and attenuated the effects of smoking on HDL-cholesterol. These results suggest that the dietary intake of fibre and several antioxidant components of the Mediterranean diet is reduced in smokers, who also show an adverse lipid profile. However, the worst triacylglycerol levels are associated with the combination of heavy smoking and heavy alcohol drinking. Moderate alcohol consumption was not associated with an unhealthy diet pattern or adverse lipid profile. The health benefits of the Mediterranean diet appear to be strongly counteracted by smoking.

    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Tobacco and alcohol consumption: impact on other cardiovascular and cancer risk factors in a southern European Mediterranean population
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Tobacco and alcohol consumption: impact on other cardiovascular and cancer risk factors in a southern European Mediterranean population
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Tobacco and alcohol consumption: impact on other cardiovascular and cancer risk factors in a southern European Mediterranean population
      Available formats
Corresponding author
*Corresponding author:Professor Jaume Marrugat, fax +34 93 2213237, email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

MD Ballesteros Pomar , MA Rubio Herrera , JA Gutiérrez Fuentes , JA Gómez Gerique , A Gómez da la Cámera , O Pascual , I Gárate , R Montero & Campiñia SThe DRECE Study Group (2000) Dietary habits and cardiovascular risk in the Spanish population: The DRECE study (II) micronutrient intake. Annals of Nutrition and Metabolism 44, 177182.

J Cosin-Aguilar , F Andres-Conejos , A Hernandiz-Martinez , J Solaz-Minguez , J Marrugat & A Bayes-De-Luna (1995) Effect of smoking on sudden and premature death. Journal of Cardiovascular Risk 2, 345351.

WY Craig (1993) The effect of compounds associated with cigarette smoking on the secretion of lipoprotein lipid by HepG2 cells. Biochimica et Biophysica Acta 1165, 249258.

B D'Avanzo , C La Vecchia , C Braga , S Franceschi , E Negri & M Parpinel (1997) Nutrient intake according to education, smoking, and alcohol in Italian women. Nutrition and Cancer 28, 4651.

R Doll , R Peto , K Wheatley , R Gray & I Sutherland (1994) Mortality in relation to smoking: 40 years observations on male British doctors. British Medical Journal 309, 901911.

SJ Duthie , M Ross & AR Collins (1995) The influence of smoking and diet on the hypoxanthine phosphoribosyltransferase (hprt) mutant frequency in circulating T lymphocytes from a normal human population. Mutation Research 331, 5564.

R Elosua , M Garcia , A Aguilar , L Molina , MI Covas & J Marrugat (2000) Validation of the Minnesota leisure time physical activity questionnaire in Spanish woman. Medicine and Science in Sports and Exercise 32, 14311437.

DJ Freeman , BA Griffin , E Murray , GM Lindsay , D Gaffney , CJ Packard & J Shepherd (1993) Smoking and plasma lipoproteins in man: effects on low density lipoprotein cholesterol levels and high density lipoprotein subfraction distribution. European Journal of Clinical Investigation 23, 630640.

E Gióvannucci & ME Martinez (1996) Tobacco, colorectal cancer, and adenomas: a review of the evidence. Journal of the National Cancer Institute 88, 17171730.

U Goldbourt , E Holtzman & HN Neufeld (1985) Total and high density lipoprotein cholesterol in the serum and risk of mortality: evidence of a threshold effect. British Medical Journal 290, 12391243.

DR Jacobs & S Gottenborg (1981) Smoking and weight: The Minnesota Lipid Research Clinic. American Journal of Public Health 71, 391396.

GC Kabat (1996) Aspects of the epidemiology of lung cancer in smokers and nonsmokers in the United States. Lung Cancer 15, 120.

JB McPhillips , CB Eaton , KM Gans , CA Derby , TM Lasater , JL McKenny & RA Carleton (1994) Dietary differences in smokers and nonsmokers from two southeastern New England communities. Journal of the American Dietetic Association 94, 287292.

BM Margetts & AA Jackson (1993) Interactions between people's diet and their smoking habits: the dietary and nutritional survey of British adults. British Medical Journal 307, 13811384.

R Masiá , A Pena , J Marrugat , J Sala , J Vila , M Pavesi , M Covas , C Aubó & R Elosua (1998) High prevalence of cardiovascular risk factors in Gerona, Spain, a province with low myocardial infarction disease. Journal of Epidemiology and Community Health 52, 707715.

A Menotti , D Kromhout , H Blackburn , F Fidanza , R Buzina & A Nissinen (1999) Food intake patterns and 25-year mortality from coronary heart disease: cross-cultural correlations in the Seven Countries Study. The Seven Countries Study Research Group. European Journal of Epidemiology 15, 507515.

JD Morrow , B Frei , AW Longmire , JM Gaziano , SM Lynch , Y Shyr , WE Strauss , JA Oates & LJ Roberts 2nd (1995) Increase in circulating products of lipid peroxidation (F2-isoprostanes) in smokers. Smoking as a cause of oxidative damage. New England Journal of Medicine 332, 11981203.

M Paunio , J Virtamo , CG Gref & OP Heinonen (1996) Serum high density lipoprotein cholesterol, alcohol, and coronary mortality in male smokers. British Medical Journal 312, 12001203.

P Primatesta , E Falaschetti , S Gupta , MG Marmot & NR Poulter (2001) Association between smoking and blood pressure: evidence from the health survey for England. Hypertension 37, 187193.

EB Rimm , P Williams , K Fosher , M Criqui & MJ Stampfer (1999) Moderate alcohol intake and lower risk of coronary heart disease: meta-analysis of effects on lipids and haemostatic factors. British Medical Journal 319, 15231528.

U Ringborg (1998) Alcohol and risk of cancer. Alcoholism Clinical and Experimental Research 22, 323S328S.

H Schröder , MI Covas , J Marrugat , A Pena , M Alcántara & R Masiá (2001) Use of a three-day estimated food record, a 72-hour recall, and a food frequency questionnaire for dietary assessment in a Mediterranean Spanish population. Clinical Nutrition 20, 429430.

I Thune , I Njolstad , ML Lochen & OH Forde (1998) Physical activity improves the metabolic risk profiles in men and women: the Tromso Study. Archives of Internal Medicine 158, 16331640.

S Todd , M Woodward , H Tunstall-Pedoe & C Bolton-Smith (1999) Dietary antioxidant vitamins and fibre in the etiology of cardiovascular disease and all-causes mortality: results from the Scottish Heart Health study. American Journal of Epidemiology 150, 10731080.

A Trichopoulou & P Lagiou (1997) Healthy traditional Mediterranean diet: an expression of culture, history and lifestyle. Nutrition Reviews 55, 383389.

WM Verschuren , DR Jacobs , BP Bloemberg , D Kromhout , A Menotti , C Aravanis , H Blackburn , R Buzina , AS Dontas , F Fidanza , MJ Karvonen , S Nedeljkovic , A Nissinen & H Toshima (1995) Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study. Journal of the American Medical Association 274, 131136.

K Yano , GG Rhoads & A Kagan (1977) Coffee, alcohol and risk of coronary heart disease among Japanese men living in Hawaii. New England Journal of Medicine 297, 405409.

LC Yong , CC Brown , A Schatzkin , CM Dresser , MJ Slesinski , CS Cox & PR Taylor (1997) Intake of vitamins E, C, and A and risk of lung cancer. The NHANES I epidemiologic follow up study. First National Health and Nutrition Examination Survey. American Journal of Epidemiology 146, 231243.

MP Zeegers , FE Tan , E Dorant & PA van Den Brandt (2000) The impact of characteristics of cigarette smoking on urinary tract cancer risk: a meta-analysis of epidemiologic studies. Cancer 89, 630639.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *