Drinking habits and other characteristics were observed for 20 years in a cohort of 5,209 Framingham, Mass, men and women. During this period the average amount of alcohol consumed rose 63%. The percent increase was greater for women than men and greater for younger persons than older. Serum uric acid and phospholipid concentrations were higher at higher levels of alcohol consumption. Lipoprotein levels of 0 to 12 and 100 to 400 Svedberg units were positively associated with alcohol consumption in men but negatively associated with alcohol consumption in women. Blood pressure was higher in nondrinkers than light drinkers, but among drinkers BPs were higher at higher consumption levels. While cigarette smokers had lower BPs than nonsmokers, this seemed to be due to their lower weight. Persons who increased their alcohol consumption during follow-up had a small mean increase in serum phospholipid and uric acid levels, BP, and weight relative to the average changes for these variables.