Combination of heavy drinking and smoking may increase risk of dying in house fires

People who drink heavily may increase their risk of dying in house fires that should otherwise have been escapable, a new study suggests.

The findings, reported in the September issue of the Journal of Studies on Alcohol and Drugs, highlight one of the less-recognized dangers of downing too much alcohol -- especially in combination with smoking.

Looking at coroners' records for 95 fire victims, Australian researchers found that 58% had positive results on blood alcohol tests, often with very high alcohol levels. And those intoxicated victims were less likely than sober ones to have had obstacles preventing their escape from the fire -- like barred windows or an exit route that was blocked by the fire.

The implication, the researchers say, is that at least some intoxicated victims might have survived had they been roused in time.

Most of the victims in the study were alone at the time of the fire, and many were asleep (including close to half of intoxicated victims). So it's possible that well-placed smoke detectors -- or having other, sober people in the house -- would have protected some, according to lead researcher Dorothy Bruck, Ph.D., of Victoria University in Melbourne.

But probably the biggest issue is the combination of heavy drinking and smoking. In this study, victims who had been drinking were about 4.5 times more likely to have died in fires that involved "smoking materials," like discarded cigarettes.

"A key message is that smoking and drinking together constitute a high-risk activity, even in your own home," Bruck says.

Aside from not combining drinking and smoking, people may be able to lessen their fire risks in other ways, according to Bruck.

One way would be to always have someone else in your home who stays sober, even if you're having a few drinks. Also, it's a good idea to have smoke detectors in bedrooms or living areas, rather than just hallways, Bruck says. In general, smoke alarms are less effective at rousing people who've been drinking heavily.

"Our research has also shown that certain changes to improve the sound that smoke alarms make, and better alarm locations, may arouse more sleeping intoxicated people in the case of a fire," Bruck says. But, she adds, experts don't know how loud smoke alarms, even with the improved signal, need to be to wake a person with very high blood alcohol levels.

Another potential way to prevent fire deaths is to use so-called fire-safe cigarettes, Bruck notes. The cigarettes self-extinguish if a smoker sets one down and forgets about it or falls asleep while smoking.

All of the fatalities in the current study were among adults who died in house fires in the Australian state of Victoria between 1998 and 2006. The high percentage of intoxicated victims (58%) is consistent with what's been seen in studies from the United States, Canada and Europe.

In recent U.S. studies, anywhere from 40% to 55% of people who died in fires were intoxicated, based on blood alcohol tests..