Parallels and contrasts between tobacco smoking and alcohol drinking are considered, in terms of harms, cultural positioning, and a dependence, which is social as well as physical and psychological. Evidence is briefly reviewed of two kinds of conjunction: of being a smoker and being a drinker, and of the smoking event and the drinking event. The complementary relation between smoking and drinking, it is argued, can be understood at physiological, psychological and social levels. Implications for prevention, intervention and policy are discussed, including the need for international agreement on alcohol as well as tobacco control.