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BACKGROUND AND AIMS Many addictive substances, such as tobacco and alcohol, influence atherosclerosis development. Whether or not tobacco's pro-atherosclerotic effect is influenced by alcohol consumption is unknown. We aimed to estimate the impact of alcohol intake on the presence of subclinical atherosclerosis in femoral arteries in smoking and non-smoking middle-aged men. DESIGN, SETTING AND PARTICIPANTS Cross-sectional analysis of a subset of the Aragon Workers Health Study (AWHS), comprising 2099 men with mean age 50.9 years without