Triple threat of smoking, drinking and weight ‘puts a million in England at risk of early death’

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One in 50 people aged 16 or older in England are at risk of an early death because they smoke, drink too much and are overweight, research has found.

This “triple threat” increases the risk of diseases such as cancer and diabetes and in some cases means people dying 20 years earlier than they should, a senior doctor has said.

About 1 million people in England are living with that threat, an analysis of the Health Survey for England by the charity Action on Smoking and Health (Ash) has revealed. They are the 2.2% of the population who use tobacco, drink more than 14 units of alcohol a week and are overweight or obese, as judged by having a body mass index (BMI) of 25 or more.

However, 10 million – 22% of the population – exhibit two of the three risky behaviours, Ash found, while 33.9 million (73.6%) have at least one risk factor.

Prof Sir Ian Gilmore, the chair of the Alcohol Health Alliance, said: “It is staggering that as many as one in 50 adults in England are at a much higher risk of dying because of the combination of tobacco, alcohol and unhealthy food.

“Smoking, alcohol and excess weight each significantly increase the risk of serious health problems like cancer, heart disease and liver disease. When these risk factors are combined, the danger to people’s health is even greater, leading to higher chances of early death and more years in poor health.

“Together they create a toxic combination that can lead to long-term disability and early death.”

A lifelong smoking habit reduces someone’s life expectancy by about 10 years and grade three obesity – being severely obese with a BMI of more than 40 – does so by a similar amount. The UK’s four chief medical officers recommend that no one drinks more than 14 units of alcohol a week.

Gilmore, a former president of the Royal College of Physicians, added: “Although the risks of two or more risk factors are not purely additive, it is likely that smoking, grade three obesity and heavy drinking will reduce life expectancy by at least 20 years.”

Ash also found that:

  • 12.7% of people in England (5.9 million) are overweight and drink more than 14 units but do not smoke.

  • 5.5% (2.5 million) are overweight and smoke but drink less than 14 units.

  • 1.4% (600,000) smoke and drink more than 14 units but have a normal weight.

Caroline Cerny, the deputy chief executive of Ash, said: “The findings are extremely worrying. They provide an insight into the challenges facing the NHS both now and in the future.”

The burden of illness in England is rising due to the ageing and growing population and impact of lifestyle-related conditions linked to smoking, drinking and poor diet. Research by the Health Foundation has found that 9 million more people will be living with conditions such as cancer, diabetes, dementia, kidney disease and depression by 2040.

Cerny urged Wes Streeting, the health secretary, to include robust measures to improve public health in the government’s forthcoming 10-year plan for the NHS. They should include targets to cut smoking, alcohol consumption and excess weight, introducing minimum unit pricing of alcohol in England and extending the sugar tax to other unhealthy foods, she said.

The Department of Health and Social Care did not comment directly on the findings. A spokesperson said the 10-year health plan, due next Thursday, would shift the NHS from treatment to prevention.

Ministers were committed to tackling obesity through a ban on the advertising of junk food on TV before 9pm and a planned new food strategy, they said.

They also cited the tobacco and vapes bill, an increase in the public health grant and an extra £310m for treatment of drug and alcohol addiction as evidence of the government’s action on public health.

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