Longevity is a desirable goal for many people. It is not just about living long, but also living a healthy life. The concept of healthspan, which refers to the length of time that a person lives in good health, is just as important as lifespan. However, several lifestyle choices, such as the use of drugs and alcohol, can significantly impact both healthspan and lifespan.
In this article, we will examine the effects of drugs and alcohol on longevity. We will also discuss the 12 hallmarks of aging and how drugs and alcohol impact each. Lastly, we will provide actionable guidance on how to reduce the negative effects of drugs and alcohol on longevity.
History of Tobacco Smoking or Vaping
Tobacco smoking and vaping are two of the most significant risk factors for chronic diseases and premature death. Smoking causes damage to the lungs, heart, and blood vessels, leading to various conditions such as chronic obstructive pulmonary disease (COPD), lung cancer, heart disease, and stroke (CDC, 2021). Vaping, which involves inhaling aerosols from e-cigarettes, can also damage the lungs and lead to respiratory illnesses (NASEM, 2018).
According to a study by Jha et al. (2014), smoking reduces lifespan by an average of 10 years. This is due to the increased risk of various chronic diseases associated with smoking. The study also found that quitting smoking at any age can increase lifespan, with the greatest benefits seen in those who quit at a younger age.
Vaping is relatively new, and there is limited research on its impact on longevity. However, a study by Glantz and Bareham (2018) found that e-cigarette use is associated with an increased risk of heart disease and lung disorders, although the risks are lower than those associated with smoking.
Alcohol Consumption & Long Term Effects
Alcohol is a psychoactive substance commonly consumed worldwide. Excessive alcohol consumption can lead to liver disease, heart disease, cancer, and other chronic conditions (NIAAA, 2021). It can also increase the risk of accidents and injuries, which can be fatal. The risk of alcohol-related harm is influenced by several factors, including the amount of alcohol consumed, frequency of consumption, age, gender, and overall health status.
According to a study by Rehm et al. (2018), alcohol is responsible for more than 3 million deaths worldwide each year. The study also found that alcohol use can reduce lifespan by an average of 2.8 years. The negative impact of alcohol on longevity is dose-dependent, meaning that the more alcohol consumed, the greater the risk of harm.
What about the claims that small amounts of alcohol can improve health, including cardiovascular outcomes? The pro alcohol argument has claimed improved heart health with very moderate drinking (one to two drinks, bodyweight dependent).
Further, some state that red wine, which contains the purported longevity compound resveratrol, can be used to explain the French paradox of longer lifespans despite high saturated fat intake and wine drinking. However, research has failed to prove that resveratrol does anything for human longevity, and the dosage in a glass of red wine is miniscule.
Some studies have claimed health benefits from moderate alcohol consumption. In the below table that compares amount of alcohol consumption and relative risk of mortality, we see smaller doses of alcohol are linked with lower mortality rates than in non-drinkers (the chart’s dip below 1.0) (source: NIH).
However, recent research has dug deeper and found that the reduction in risk is not the result of alcohol, but rather, that people who consumer one or two servings of alcohol tend to already be healthier than those who do not drink at all. It makes sense: those who don’t drink anything might be doing so based on a medical condition that restricts them from doing so.
For example, a 2023 study published in JAMA examined 107 cohort studies published between 1980 and 2021 and involved 4,838,825 participants and 425,564. The study authors conclude, “This updated meta-analysis did not find significantly reduced risk of all-cause mortality associated with low-volume alcohol consumption after adjusting for potential confounding effects of influential study characteristics.”
While one to two drinks on occasion is not likely to cause significant harm to the vast majority of us, there is no evidence that alcohol confers any health benefits. Further, ethanol is a potent toxin, so what’s more likely is that it accelerates the progression of the 12 hallmarks of aging, regardless of the dosage.
If you’re a longevity purest, NOVOS recommends you abstain from alcohol. However, for many people, alcohol is an enjoyable aspect of life that they don’t want to give up completely. If that’s you, try sticking to only one to two drinks as far away from bedtime as possible.
Recreational Drug Use
Recreational drug use refers to the use of substances for non-medical purposes, such as to achieve euphoria, alter perception, or induce relaxation. Recreational drugs can be broadly classified into several categories, including stimulants, depressants, hallucinogens, and opioids.
Recreational drug use can have severe consequences on healthspan and lifespan. The use of drugs such as cocaine, amphetamines, and opioids can lead to addiction, overdose, and death (CDC, 2021).
According to a study by Degenhardt et al. (2014), drug use is responsible for an estimated 0.8 million deaths worldwide each year. The study also found that drug use can reduce lifespan by an average of 7.7 years. The negative impact of recreational drug use on longevity is dependent on several factors, including the type of drug used, the frequency and duration of use, and individual susceptibility.
Hallmarks of Aging Impacted by Drugs and Alcohol
The 12 hallmarks of aging are biological processes that contribute to age-related decline and disease. The impact of drugs and alcohol on these hallmarks varies depending on the substance and the dose.
Mitochondria are the powerhouses of the cell, responsible for producing energy. Drugs such as cocaine and amphetamines have been shown to damage mitochondria and impair energy production (Wang et al., 2020). Alcohol consumption has also been linked to mitochondrial dysfunction, which can contribute to liver disease (Chen and Zhong, 2020).
Cellular senescence refers to the process where cells stop dividing and accumulate in the body, leading to tissue damage and inflammation. Studies have found that smoking can accelerate cellular senescence (Passos et al., 2007). Recreational drug use, such as cocaine and methamphetamine, can also lead to premature aging of cells (Li et al., 2019).
Proteostasis refers to the ability of the body to maintain protein homeostasis. Alcohol consumption can lead to the accumulation of misfolded proteins, which can contribute to various diseases, including Alzheimer’s disease (Liang et al., 2018).
Communication between cells is essential for maintaining tissue function. Studies have shown that smoking can disrupt cellular communication and contribute to various diseases, such as cancer (Chaturvedi et al., 2011). Alcohol consumption can also impair cellular communication, which can contribute to liver disease (Zhao et al., 2019).
Genomic instability refers to the accumulation of DNA damage, which can lead to mutations and contribute to cancer and other age-related diseases. Smoking is a significant risk factor for DNA damage, and several carcinogens in tobacco smoke have been shown to cause DNA damage (Hecht, 2017). Recreational drug use, such as cocaine and methamphetamine, can also cause DNA damage (Li et al., 2019).
Epigenetic alterations refer to changes in gene expression that are not caused by changes in DNA sequence. Smoking has been shown to cause epigenetic changes in various tissues, including lung tissue (Joubert et al., 2016). Alcohol consumption has also been linked to epigenetic alterations, which can contribute to various diseases, such as cancer (Zhao et al., 2019).
Telomeres are the protective caps at the end of chromosomes that shorten with age. Smoking has been linked to telomere shortening, which can contribute to age-related diseases such as cardiovascular disease (Valdes et al., 2010). Alcohol consumption has also been associated with telomere shortening (Zhao et al., 2019).
Nutrient sensing is the ability of cells to detect and respond to changes in nutrient availability. Studies have shown that alcohol consumption can disrupt nutrient sensing, which can contribute to liver disease (Zhao et al., 2019).
Stem cells are essential for tissue repair and regeneration. Smoking has been linked to stem cell exhaustion, which can impair tissue regeneration (Mishra et al., 2018). Recreational drug use, such as cocaine and methamphetamine, can also impair stem cell function (Ganapathi et al., 2021).
Macroautophagy is the process by which cells remove damaged organelles and proteins. Alcohol consumption has been shown to impair macroautophagy, which can contribute to liver disease (Zhang et al., 2019). Recreational drug use, such as cocaine, has also been shown to impair macroautophagy (Wang et al., 2020).
Inflammaging refers to chronic, low-grade inflammation that contributes to aging and age-related diseases. Smoking has been linked to increased inflammation in the body (Vaz Fragoso et al., 2017). Recreational drug use, such as cocaine and methamphetamine, can also contribute to inflammation (Ragab et al., 2021).
The microbiome refers to the community of microorganisms that live in and on the body. Studies have shown that alcohol consumption can disrupt the microbiome, which can contribute to various diseases, such as liver disease and obesity (Leclercq et al., 2014).
How to Promote Longevity
Promoting longevity involves making lifestyle choices that support healthy aging. Here are some actionable tips:
Quit smoking: Smoking is one of the most significant risk factors for premature aging and disease. Quitting smoking can significantly improve health and increase lifespan.
Limit alcohol consumption: Drinking in moderation (up to one drink per day for women and up to two drinks per day for men) may have some health benefits, but excessive alcohol consumption can contribute to various diseases and impair longevity.
Avoid recreational drug use: Recreational drug use can significantly impact health and lifespan. Avoiding these substances can improve overall health and reduce the risk of premature aging and disease.
Making Informed Lifestyle Choices for Healthy Aging
Drugs and alcohol can significantly impact health and lifespan by contributing to age-related decline and disease. The negative impact on longevity is dependent on several factors, including the type of substance, the frequency and duration of use, and individual susceptibility. To promote longevity, it is essential to make lifestyle choices that support healthy aging, such as quitting smoking, limiting alcohol consumption, avoiding recreational drug use, maintaining a healthy diet, engaging in regular physical activity, and managing stress.
- Chaturvedi, A.K., Caporaso, N.E., Katki, H.A., Wong, H.L., Chatterjee, N., Pine, S.R., … & Engels, E.A. (2011). Cigarettes, oral tobacco, and alcohol in relation to cancers of the upper aerodigestive tract in northern Italy. Cancer Research, 71(19), 6012-6017.
- Chen, J., & Zhong, X. (2020). Mitochondria-targeted drug discovery for alcoholic liver disease. Frontiers in Pharmacology, 11, 1244.
- Degenhardt, L., Whiteford, H.A., Ferrari, A.J., Baxter, A.J., Charlson, F.J., Hall, W.D., … & Vos, T. (2014). Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010. The Lancet Psychiatry, 1(4), 285-292.
- Ganapathi, S.K., Song, J., Teng, X., Li, X., Behnke, M.S., & Smith, J.A. (2021). Methamphetamine-induced senescence in human neural progenitor cells involves autophagy dysfunction and impairment of antioxidant defense mechanisms. International Journal of Molecular Sciences, 22(7), 3438.
- Leclercq, S., Matamoros, S., Cani, P.D., Neyrinck, A.M., Jamar, F., Stärkel, P., … & Delzenne, N.M. (2014). Intestinal permeability, gut-bacterial dysbiosis, and behavioral markers of alcohol-dependence severity. Proceedings of the National Academy of Sciences, 111(42), E4485-E4493.
- Ragab, D., Attia, N., El-Abhar, H.S., & Shoker, A. (2021). The role of inflammation in the pathogenesis of cocaine-induced cardiovascular complications: A review. Life Sciences, 278, 119609.
- Vaz Fragoso, C.A., Miller, M.E., King, A.C., Kritchevsky, S.B., Liu, C.K., Myers, V.H., … & Gill, T.M. (2017). Effect of cigarette smoking and pulmonary impairment on resting metabolic rate in older adults. Journal of the American Geriatrics Society, 65(6), 1281-1287.
- Wang, C., Cui, Y., Li, H., Zhang, L., Huang, Y., & Yang, X. (2020). Cocaine-induced autophagy in hepatocytes promotes liver injury and fibrosis via oxidative stress. Frontiers in Pharmacology, 11, 551.
- Zhang, X., Li, L., Zhang, H., Zhou, X., Wang, H., Li, Y., & Li, Y. (2019). Alcohol-induced macroautophagy dysfunction aggravates alcoholic liver disease via the EIF2AK3/ATF4 pathway. Journal of Cellular and Molecular Medicine, 23(6), 4216-4228.
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