In this study, 6,386 males and 5,990 females, with a mean age of 55 years, constituting a random sample, were administered questionnaires by interviewers relating to amount of self-regulation and drinking status. They were then followed up over a 20-yr. period, and health status (living well, chronically ill, or deceased) was ascertained. It was hypothesized that the deleterious effect of alcohol would be worse for those low on self-regulation; that health status would be worse for those in whom drinking diminished self-regulation, as compared with those for whom drinking improved self-regulation; and that smoking would have greater effects in lowering health status in those in whom drinking diminished self-regulation than in those in whom drinking improved self-regulation. All predictions were borne out by the data at high statistical significance. The results confirmed findings from an earlier study to the effect that psychological factors like self-regulation powerfully influence the kind of effects drinking has with respect to health.