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Smoking and alcohol cause early damage to adolescents’ arteries


Cigarettes always lit and group drinking, often to the point of being frankly drunk and feeling sick. These are all too common behaviors among adolescents, engaged in more to feel included and appreciated by peers than out of real individual pleasure or goliardic spirit. In the general belief that challenging the limits of one’s body and having the “courage” to dare more than others serves to assert one’s worth.

But this is as risky a belief as ever, as well as completely wrong, because even a young, healthy body suffers greatly from the toxic effects of smoking and alcohol. And not only after years of immoderate consumption, but also in the immediate term and for modest amounts, especially when their intake occurs at the same time, multiplying the damage at multiple levels, often synergistically.

The harmful effects on the organism

Even when taken individually, smoking and alcohol are harmful to the body on several fronts. The former, promotes respiratory diseases and several types of cancers (first and foremost that of the lung, but also of the mouth and throat, stomach, colorectum, and breast), reduces fertility, increases cardiovascular and metabolic risk, and complicates acute and chronic diseases already present, especially inflammatory and autoimmune diseases.

Alcohol, on the other hand, is neurotoxic (centrally and peripherally), harmful to the liver (promotes fibrosis and cirrhosis of the liver), the kidneys and the gastrointestinal system, and, if taken in excess, the cardiovascular system as well (where “excess” means more than a couple of glasses of wine a day, a limit beyond which any hypothetical benefit is lost). Not to mention the risks consequent to the psychotropic and sensory effects of alcohol (euphoria, reduced reflexes, drowsiness, altered vision, etc.), often the cause of traffic accidents and borderline behavior.

When the cigarette is in one hand and the glass in the other, the problems quickly multiply, even if the hands in question are those of beardless (or nearly so) teenagers, seemingly immune to acute or chronic ailments and diseases and far removed from vascular degenerative phenomena typical of old age, such as atherosclerosis.

Young arteries at risk

A collaborative study between a number of prestigious clinical institutions in the United Kingdom (University College and King’s College London, St. Thomas’ Hospital and the University of Bristol) and Queen Silvia Children’s Hospital in Gothenburg, Sweden, indicated that smoking and alcohol promote the early onset of stiffness and thickening of the walls of the arteries already in 17-year-olds taking only one or both of the two, even from relatively short periods of time (1-5 years).

The extent of the vascular damage mentioned, measured indirectly as blood flow velocity between carotid and femoral artery with pulsed Doppler (Pulse Wave Velocity, PWV), appeared to be correlated with the number of cigarettes smoked and the amount of alcohol consumed, being in both cases increasing with increasing consumption of each substance and particularly marked when smoking and alcohol were combined.

But there is also good news: quitting smoking and drinking when the atherosclerotic process is just starting allows it to regress completely, restoring the arteries of ex-smoking and “ex-drinking” teens to a condition comparable to those of never-smoking and lifelong teetotal peers. An outcome that cannot, however, be hoped for later in life, and which should lead to strong disincentives to smoking and alcohol use in young people, partly to prevent the consolidation of two decidedly harmful habits.


  • Article: Charakida M et al. Early vascular damage from smoking and alcohol in teenage years: the ALSPAC study. European Heart Journal 2019;40:345-353
  • Editorial: Münzel T et al. Double hazard of smoking and alcohol on vascular function in adolescents. European Heart Journal 2019;40:354-356


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