December 1, 2025, 7:19 pm | Read time: 5 minutes
A regular glass of wine or the occasional “pleasure cigarette”… Many enjoy it, but it’s not exactly healthy. But which is actually worse for the body: alcohol or smoking? Our FITBOOK author Nina Ponath asked three experts.
No beer before four, but after that, even more… like the drink to kick off the weekend, the Aperol before dinner with friends, or a shandy during a bike ride. The normalization of consuming a cell toxin is likely a result of the myth “alcohol in moderation is healthy.”
However, it’s now known that every glass and even every drop of alcohol is harmful. Yet many in my circle still enjoy drinking. And a lot. It’s different when you light a cigarette. You get critical looks, and some people even leave the room.
Don’t get me wrong: I’m not saying smoking is good, and I wouldn’t call myself a smoker. Admittedly, I occasionally enjoy a cigarette after work, just as I have a glass of wine every few weekends.
In my circle, I’m pretty much alone in this. While alcohol consumption continues to be normalized, smoking is on the blacklist. Rightly so?
Smoking or Alcohol: Is One Worse Than the Other?
Smoking or alcohol, plague or cholera? It’s clear that neither is really great. While it’s been known for years that smoking can cause lung cancer and other cancers of the mouth area, alcohol is now also linked to cancer.
Science Agrees: Alcohol Is Carcinogenic
The International Agency for Research on Cancer (IARC) of the WHO classifies alcohol and its metabolite acetaldehyde as a Group 1 human carcinogen, the highest risk category, which also includes tobacco.1 This means alcohol is considered carcinogenic. Scientific studies show that alcohol is involved in the development of at least seven types of cancer, including breast, colon, liver, and esophageal cancer.2 Research indicates there is no safe amount of alcohol, and the risk of cancer significantly increases even with “light” consumption.
I smoke at most one cigarette in the evening on vacation and drink a little sangria every few days. Am I going to die sooner because I occasionally smoke a cigarette in the evening? Or am I still better off than friends who invite acquaintances for a drink three times a week? Can you even compare the two? I wonder what is actually more harmful, if they can even be compared.
The Experts’ Assessment
I asked cardiologist Prof. Dr. med. Axel Preßler. In his Munich practice, he treats heart patients. The expert is certain: “Smoking is a vascular toxin.” He can immediately see a real smoker’s vice—especially on the skin. “However, you don’t see occasional pleasure smoking,” says the doctor.
How Nicotine Affects the Vessels
Nicotine is one of the strongest vascular spasm toxins. It causes an immediate narrowing of the peripheral blood vessels, leading to an accelerated heartbeat and increased blood pressure. In the long term, nicotine damages the inner walls of blood vessels, promotes plaque formation (atherosclerosis), and increases blood clotting. This significantly raises the risk of heart attacks and strokes.
Dr. Preßler also says: “Alcohol is harmful in any amount. People often try to justify it because they long believed they benefited from the polyphenols in wine.” Polyphenols are also found in grapes, which can be eaten without damaging organs like alcohol does. “There were probably some misinterpretations of studies,” says the cardiologist. It’s now known that older studies on alcohol consumption often included former drinkers and recovering alcoholics in the “abstainer” group. As a result, they showed the diseases of regular drinkers, skewing the abstainers’ results.3
“The fact that every drop of alcohol is harmful hasn’t reached everyone yet, as it’s only been known for a few years,” says Dr. Preßler. For many doctors, it’s now clear: Alcohol can indirectly lead to cancer. “Alcohol consumption is probably only really questioned in cases of liver cancer,” says Dr. Preßler. “But you can assume that alcohol also affects other types of cancer. Additionally, alcohol damages the heart and can lead to heart rhythm disorders, particularly atrial fibrillation.”
What Alcohol Does to the Bodies of Children and Adolescents
Red or White? One Type of Wine Increases the Risk of Skin Cancer
Studies Confirm: Alcohol Is a Cell Toxin
The German Cancer Research Center (DKFZ) confirms that acetaldehyde, produced during alcohol breakdown, can genetically alter body cells and thus cause cancer.4 Additionally, alcohol consumption can increase estrogen levels, significantly raising the risk of breast cancer in women—even with low consumption. Not to be overlooked are the social consequences of excessive alcohol consumption. “Alcohol also harms on a social level. There are people who lose themselves in alcohol. This is less common with nicotine.”
Also interesting: Early Signs of Alcohol Addiction and Types of Dependency
So, What Is More Harmful: Alcohol or Cigarettes?
As you can see, the question can’t be clearly answered, as both indulgences can have serious health consequences. Although both personally bring me some enjoyment. The key takeaways from this question?
There is no safe minimum for alcohol; even moderate drinking can cause cancer. Smoking remains one of the most dangerous single causes of cancer and cardiovascular diseases, while alcohol can indirectly promote cancer development. Consider carefully whether and how often you smoke and drink, and be honest with yourself. Even “a glass now and then” is not without risk, just like life itself. If we’re going to take a risk, we should honestly ask ourselves beforehand if the enjoyment is worth the potential consequences.