Histories of alcohol and tobacco consumption and other potential risk factors were obtained from 98 patients with pancreatitis and 451 comparison patients at 11 large hospitals in Eastern Massachusetts and Rhode Island between 1975 and 1979. The great majority of the patients with pancreatitis had chronic or recurrent disease. From the comparison patients were excluded patients with other diseases of the pancreas and biliary tract and those admitted for disorders known to be associated with smoking or alcohol use. A statistically significant association of pancreatitis with alcohol use was present in males, but not in females. Cigarette use was very strongly associated with pancreatitis in males and less so in females. The associations with alcohol and cigarette use were independent, each retaining significance after adjustment for the other. There was no significant association of risk with coffee consumption in either sex. A history of biliary tract disease was given by 45 per cent of the male and 60 per cent of the female cases. The associations with alcohol use and cigarette smoking did not appear to be restricted either to the patients with or those without a history of biliary tract disease. Chronic or recurrent pancreatitis appears to have different dominant etiologies in males and females.