Background: The aim of the study was to assess the effects of smoking and drinking alcohol on death rates in working-age urban inhabitants in Poland. Material and Methods: In 2001 randomly selected inhabitants of Łódź, aged 18-64 years, were included in the WHO Program Countrywide Integrated Noncommunicable Diseases Intervention (CINDI). The study sample comprised 1828 people (1002 men, 826 women). In 2009 for all participants of the 2001 study, information was obtained whether they were living or deceased, or moved out of Łódź. The Cox proportional hazard model was used for the evaluation of hazard ratios (HR). Results: The analysis revealed the increased risk of death among Łódź inhabitants of working age. An 8-year follow-up yielded the following values: for active smokers compared with people slightly addicted to nicotine, HR = 2.582 (95% CI: 1.381-4.825, p < 0.003); for people heavily addicted to nicotine, HR = 3.656 (95% CI: 1.544-8.654, p < 0.004); and for passive smokers (risk for persons staying in smoky rooms up to 5 h a day, compared to those not living in smoke-filled rooms), HR = 2.021 (95% CI: 1.111-3.672, p < 0.03). The variable that had a protective effect on the mortality risk of working-age population turned out to be a "reasonable" use of alcohol (HR = 0.411, 95% CI: 0.227-0.744, p < 0.004), compared to non-drinking alcohol at all. Conclusions: Addiction to smoking significantly increases the risk of premature death, and therefore appropriate prevention programs aimed at the reduction of smoking can contribute to closing the gap in the population health status. Med Pr 2014;65(2):251–260