동남보건대학교 임상병리과, 2 고려대학교 안산병원 신경과, 3 강원대학교 의학과대학원 진단검사의학전공This study examined the associations of smoking, alcohol drinking habits and both with the carotid intima-media thickness (CIMT) in university students. This study was performed using a CAGE (test for alcohol: cutting down, annoyance by criticism, guilty feeling, and eye-openers) questionnaire, FTND (the Fagerstrom test for nicotine dependence) questionnaire, and CIMT of university students. No statistically significant differences were observed among the CIMT results according to each CAGE level classified into 3 groups. The results of CIMT according to the FTND smoking categorization showed that the smoking group was higher than nonsmoking group (P<0.01). A statistically significant difference was observed between the left and right CIMT regarding smoking and drinking (P<0.01). In the only drink risk group, the left CIMT (19.84 rank) showed a low-ranking. The CIMT on the left (42.38 rank) and right (42.81 rank) showed high scores in the group with only the risk of smoking (P<0.01). These results suggested that there are distinct differences in CIMT and relevant risk factors between smokers and drinkers, particularly among those with a high smoking status. This study had several limitations: the study population was small; the relatively young age of the study subjects; and limited of focus on smoking, drinking and CIMT. In conclusion, cigarette smoking significantly exacerbates the adverse effects and higher CIMT on the subclinical atherosclerosis risk in young adults, which underscores the importance of prevention and cessation of cigarette smoking in young adults.