A questionnaire containing the Iowa Scale of Preoccupation with Alcohol and questions about cigarette smoking habits was completed by 927 hospitalized medical patients (mean age 47; 512 women). Approximately 18% of the sample were classified as problem drinkers, 32% as drinkers and 50% as nondrinkers. Heavy smokers made up 21% of the sample, smokers 40% and nonsmokers 39%. Problem drinking was positively associated with heavy smoking (more than 1 pack/day) and nondrinking was positively associated with nonsmoking. Proportionately more men than women were problem drinkers (80 vs. 20%) and heavy smokers (63 vs. 37%). Since heavy drinking is often associated with heavy smoking, an integrated approach to the study of medical problems associated with drinking and smoking is needed.