Gender-specific effects of smoking and alcohol consumption on cardiometabolic diseases and multimorbidity

Gender-specific variations in hormonal profiles, adipose tissue distribution, and metabolic pathways may differentially modulate the health impacts of smoking and alcohol use. Current population-based studies on the impact of smoking and alcohol consumption on cardiometabolic diseases (CMD) and multimorbidity (CMM) often lack gender-stratified analyses, thereby limiting the evidence base for gender-tailored preventive strategies.
A population-based cross-sectional study used data from the 2020 China Health and Retirement Longitudinal Study (CHARLS). A total of 11,447 participants were included in the analysis. The researchers assessed behavioural risk factors, with interaction terms evaluating effect modification by gender.
The prevalence was 16.67% for CMD and 5.66% for CMM. Participants who smoked were more likely to report CMM than those who did not smoke (OR=2.70). Smoking was significantly associated with the prevalence of CMD in females (AOR=1.34), but not in males. Moreover, female smokers were more likely to report CMM compared to male smokers (AORfemales=3.53, AORmales=2.02). No significant associations were found between alcohol consumption and the prevalence of CMD or CMM, nor were any gender-specific differences observed.
The authors conclude that smoking, but not alcohol, may have a potential gender-specific effect on the risk of CMD and CMM, with female smokers exhibiting a higher prevalence of CMM than males. This highlights the need to integrate gender considerations into chronic disease prevention frameworks.
Source: Sun P, Gao J, Liang X, et al. Gender-specific effects of smoking and alcohol consumption on cardiometabolic diseases and multimorbidity: A cross-sectional study. Tobacco Induced Diseases. 2025;23(September):135.