Addictive drugs can have devastating effects on human life, but the worst of the lot are not the ones you might think. In fact, alcohol and tobacco are more damaging than other harder, illicit drugs, according to a new report.
Smoking and boozing excessively are causing humanity a quarter of a billion disability-adjusted life years, says the paper from the Society for the Study of Addiction in the UK. Illegal substances add on extra tens of millions.
That means years lost to premature death, or lived with the burden of diseases like cancer and cardiovascular problems.
Of course, that doesn't mean one beer is going to have more of a negative impact on your health than a line of coke in a one-off situation. But when you look at humanity as a whole, it's the stuff we use every day that's hitting us the hardest.
So, in terms of their knock-on effects on disease and mortality in the population, alcohol and tobacco are the worst kinds of drugs there are – and that should make us think again about what's acceptable for our bodies.
"Their health burden is accompanied by significant economic costs, namely expenditure on healthcare and law enforcement, lost productivity, and other direct and indirect costs, including harm to others," writes the team of researchers.
"Estimating the prevalence of use and associated burden of disease and mortality at the country, regional, and global level is critical in quantifying the extent and severity of the burden arising from substance use."
Of course alcohol and tobacco are more widely available and more commonly consumed than other types of drugs, but the increased damage they're doing to our health is laid bare by the newly revealed statistics.
On average, smoking accounts for 110.7 deaths per 100,000 people. In the same size sample, alcohol accounts for 33 deaths, and illicit drugs like cocaine account for 6.9 deaths.
This isn't an invitation to suddenly develop a hard drug habit – but it might make you think twice about how much you're smoking or drinking.
Nearly one in seven adults (15.2 percent) are regular tobacco smokers, the study shows, while more than one in five adults have reported at least one occasion of "heavy alcohol use" within the last 30 days.
Harder, usually outlawed drugs are used less frequently. Top of the list was cannabis, estimated to be used by less than one in twenty people on average.
And it's the Europeans who need to take the longest, hardest look at themselves – the report shows they're smoking and drinking more than everyone else.
The data was gathered together from various sources, including the World Health Organisation (WHO), the United Nations Office on Crime and Drugs (UNODC), and the Institute for Health Metrics and Evaluation (IHME).
Certain limitations are acknowledged by the study authors too: data isn't widely available in regions of Asia and Africa, for example, and there's always going to be some unrecorded consumption in every part of the world.
The quality of estimates can vary in these reports, the researchers note, particularly for illegal drugs where a lot of activity happens underground. Nevertheless, the report authors hope their findings will help inform health policy and education, even if some of the figures are not as precise as they might be.
They might not be super-specific statistics, but they're the best we've got to date.
And the ultimate takeaway isn't in doubt – just because tobacco and alcohol are culturally acceptable and legally available drugs, doesn't mean they can't do you some serious harm.
"Smoking and alcohol are always well ahead [of illicit drugs]," one of the researchers, Robert West from University College London in the UK, told The Independent. "There's nowhere that it even comes close."
"If we're going to make the impact we really want on death rates, we need to address the cultural normality of it all."
The research has been published in Addiction.