In almost half of the United States, alcohol, tobacco, and marijuana are legal for individuals over the age of 21. However, each substance has its own set of rules, taxes, and health effects. We asked three doctors across the country to rank alcohol, weed, and cigarettes based on their impact on health.
While acknowledging that it is challenging to definitively rank the substances without head-to-head trials and that individual consumption levels greatly influence the risk of negative effects, Dr. Michael L. Glickman, a family medicine doctor and weight loss expert from Washington, D.C., asserted that alcohol poses the highest risks.
Dr. Anand Akhil, a behavioral health doctor at Cleveland Clinic, concurred that alcohol is the worst, closely followed by tobacco. Akhil highlighted alcohol’s association with over 200 health conditions and diseases, including depression, anxiety, dementia, cancers, and organ damage, while tobacco use is primarily linked to severe cancers, chronic obstructive pulmonary disease, and cardiovascular diseases.
Dr. Kevin Most, chief medical officer at Northwestern Central DuPage Hospital, shared this opinion in an interview with WGN Radio, stating, “I would certainly rank alcohol No. 1. I’m going to say that alcohol in moderation is OK, but too much alcohol is going to have an impact on many illnesses.”
Regarding tobacco, Dr. Most mentioned that most harms associated with its consumption can be reversed if individuals cease smoking at an early age. He explained, “If people understand the risk of lung cancer, based on how many years you’ve been smoking and how much you’ve been smoking, if you stop that smoking at an early age … your lungs can reinvigorate and get back almost to normal.” Contrarily, according to Dr. Glickman, tobacco ranks as the worst substance due to its lack of proven health benefits and its links to heart disease, cancers, and premature mortality.
As for alcohol, Dr. Glickman suggested that moderate amounts could have benefits, especially red wine, which contains antioxidants and has been shown to reduce inflammation in blood vessels.
All three doctors agreed that marijuana ranks as the least harmful substance for the average person’s health. Dr. Most mentioned the numerous medicinal uses of marijuana, particularly in aiding appetite for chemotherapy patients. Dr. Glickman acknowledged that while cannabis can be beneficial for certain conditions when medically supervised, it may worsen mental health issues and impair memory and concentration. Additionally, there is an increased risk for young adults with developing brains.
All three experts emphasized that every person is unique, and it is essential to consult a doctor for personalized advice and guidance.
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