Regular worship went with less drinking, drug use and suicide, and more porn went with less worship

Counting the studies

Do religious people drink and use drugs less? Koenig tried to answer that by counting. He gathered the studies he could find up to mid-2010 that looked at religion and alcohol, drugs or smoking, and scored each one for quality out of 10¹. Of 278 studies on alcohol, 240 found less drinking among the more religious¹. Among the 145 best-rated studies, the ones scoring 7 or more, 131 did¹.

Drugs and smoking looked the same. 84% of the drug studies and 90% of the smoking studies found less use among the more religious, and the best-rated studies agreed at 86% and 90%¹. Only 1% of the alcohol and drug studies found more use among the more religious, and none of the smoking studies did¹. None of them were about pornography. We start with them anyway, because they ask the question this whole article turns on, about habits people find hard to put down and what faith has to do with it.

A count has a weak spot. It says how often a link turned up, not how big it was¹. Most of the alcohol and drug studies were also of high school or college students¹. So the size of the link had to wait for a pooled result.

A 2026 review in JAMA Psychiatry gave one². Koh and colleagues pooled 55 long-term studies covering 540,712 people². People with more spiritual practice, worship included, had a 13% lower risk of harmful use of alcohol, tobacco or other drugs². Among weekly attenders the risk was 18% lower². That second number matters for the rest of this article. Turning up to worship every week went with what the authors call a possibly stronger link than other kinds of spirituality, and weekly attendance is the measure the later studies use.

Two limits come with it. 41 of the 55 studies were American². And among people already in recovery, the estimate was an 18% lower risk, which the authors call similar to prevention, but its 95% interval ran from 36% lower to 4% higher, so it was not statistically significant².

Deaths of despair

Less drinking is one thing. The harder question is whether the gap shows up at the far end, in deaths. Chen, Koh, Kawachi, Botticelli and VanderWeele looked at that in two large US studies of health professionals³. 66,492 female nurses were followed from 2001 to 2017, and 43,141 male health professionals from 1988 to 2014³. Each said once, at the start, how often they went to religious meetings or services³. The researchers then counted deaths from poisoning by drugs or alcohol, suicide and liver disease³.

Before any adjustment the gap is plain. Women who never went died of these causes at 14 per 100,000 years of follow-up, and weekly attenders at 3³. For men the rates were 44 and 19³. After adjusting for lifestyle, social ties and, for the women, depression, weekly attenders had a 68% lower risk among women and a 33% lower risk among men³.

An earlier study found the same with suicide on its own. In 2016 VanderWeele and colleagues looked at 89,708 US nurses, all women⁴. Women who attended weekly or more had a suicide hazard ratio of 0.16 against those who never went, about a sixth of the rate, though the authors' text calls it five-fold lower⁴. The result rests on 36 suicides⁴.

These are observational studies. Weekly attenders may differ in ways the adjustments missed, though the authors judge the results at least moderately robust to a hidden factor³. The people were US health professionals, mostly white, with relatively high socioeconomic status, and the women's result rests on 75 deaths³. About two thirds of the deaths were suicides, and for men, deaths from poisoning or liver disease alone showed no evidence of a link with worship³. Liver deaths could not be split into alcohol and other causes, and the study measures deaths, not recovery from addiction³. Even so, a gap of 33% for men and 68% for women after all those adjustments is hard to wave away³.

Starting in the teen years

If weekly worship goes with fewer of these deaths in middle age, when does the pattern start? Chen and VanderWeele went back to the teenage years⁵. They used the Growing Up Today Study, made up of the children of the nurses in one of the studies above. Worship and prayer were measured in 1999, at a mean age of 14.7⁵. Outcomes came from the 2010 survey, at ages 23 to 30, or from the 2007 or 2013 survey when 2010 answers were missing⁵. Depending on the outcome, that was about 5,700 to 7,500 young Americans followed for 8 to 14 years⁵.

Teenagers who attended services at least weekly had a 17% lower risk of using marijuana as young adults, and 33% lower odds of using any other illegal drug⁵. Daily prayer or meditation went with a wider gap, a 25% lower risk for marijuana and 44% lower odds for other drugs⁵. Weekly worship also went with a 35% lower risk of having sex at 15 or younger⁵. So the drug pattern Koenig counted in students shows up here too, 8 to 14 years after the teenagers were asked⁵. Frequent binge drinking was the exception, with no significant link to teenage worship or prayer⁵.

With 26 outcomes tested, the authors held each result to a strict cut-off of p below 0.0019⁵. Every result in the chart passed it except weekly worship and sexually transmitted infections⁵. The models allowed for age, sex, race, region, the mother's health, marital status and household income⁵. Weekly worship also went with more forgiveness, more volunteering and a stronger sense of mission. Its link with fewer depressive symptoms did not pass the strict cut-off, and it was not linked to anxiety⁵.

The weak spots are familiar by now. Worship and prayer were each measured with a single question, and prayer was asked together with meditation⁵. The parents' own religious practice was not measured, so it cannot be separated from the teenager's⁵. The group was mostly white, and every mother was a nurse⁵. That is the same narrow kind of sample as the deaths study. It makes the two fit together, and it also limits how far either one reaches.

Porn runs the other way

Every study so far asks what worship goes with. The last one asks the reverse, and it is the only one here about pornography. Perry and Hayward followed 2,561 young Americans through two or three surveys each, from ages 13 to 17 at the start to 18 to 24 at the end⁶. Viewing was the number of X-rated films, videos or cable programs watched in the past year, capped at 5⁶. Each person was compared with themselves over time, so traits that stay fixed, such as family background, cannot explain the links⁶.

When a person watched more porn than before, their attendance at worship, how often they prayed, their closeness to God and the importance of their faith all fell, and their religious doubts rose⁶. Each step up in viewing went with attendance 0.072 lower on a 0 to 6 scale and prayer 0.056 lower on the same scale⁶. Under 18, the links with importance of faith, closeness to God and doubts were stronger, while the links with attendance and prayer did not differ significantly by age⁶. For boys under 18 going from none to 5 or more a year, the authors predict attendance falls 0.40 on the 0 to 6 scale⁶. Among women 18 and over only the attendance link held, while among men 18 and over every link held except doubts⁶. The authors found no significant difference between the sexes⁶.

The changes are small. Going from none to 5 or more a year moved each measure by less than one step on its scale⁶. Viewing and faith were measured at the same times, so faith falling first cannot be ruled out, the authors note⁶. The question asked about X-rated movies, videos and cable programs, which the authors note leaves out magazines, and the data end in 2008⁶. About 13% of the sample came from minority religions, so the authors urge caution in applying the results outside Christian traditions⁶.

Read it next to the teenage study and the two line up. Weekly worship at 14 went with fewer drugs in the twenties and less early sex⁵. More porn went with less worship and prayer, with no significant difference by age, and its links with faith, closeness to God and doubt were strongest before 18⁶. Both studies put the weight on the same stretch of life. The habit of turning up to worship and the habit of watching porn seem to move in opposite directions, and the teenage years are where they start to pull apart.

How they found it

• Koenig counted the studies he found up to mid-2010 that looked at religion and alcohol, drugs or smoking, and scored each for quality out of 10. Best-rated means a score of 7 or more. One person scored every study. On a check of 75 studies, a second rater agreed on high or low quality for 56.
• A 2026 review in JAMA Psychiatry pooled 55 long-term studies of 540,712 people.
• 66,492 female nurses were followed from 2001 to 2017, and 43,141 male health professionals from 1988 to 2014. Each said once, at the start, how often they went to religious services. Deaths from poisoning by drugs or alcohol, suicide and liver disease were then counted. A 2016 study of 89,708 US women nurses looked at suicide alone, with 36 suicides.
• In the teenage study, worship and prayer were measured in 1999, at a mean age of 14.7. Outcomes came from the 2010 survey, at ages 23 to 30, or from the 2007 or 2013 survey when 2010 answers were missing.
• With 26 outcomes tested in the teenage study, the authors used a strict cut-off of p below 0.0019. Every result in its chart passed it except weekly worship and infections.
• In the porn study, the same young people were surveyed two or three times each, from ages 13 to 17 at the start to 18 to 24 at the end, and each was compared with themselves over time. Viewing was the number of X-rated films, videos or cable programs watched in the past year, capped at 5.

What it cannot tell you

• Every study here is observational. Worshippers may differ in ways the adjustments missed, though the authors of the deaths and teenage studies calculated how strong a hidden cause would need to be to explain each result away.
• Koenig counted studies rather than pooling them, and most of the alcohol and drug studies were of high school or college students. 41 of the 55 long-term studies were American.
• Among people already in recovery, the 2026 review estimated an 18% lower risk, which the authors call similar to prevention, but the result was not statistically significant.
• The deaths study was of US health professionals, mostly white, with relatively high socioeconomic status, and the women's result rests on 75 deaths. About two thirds of all its deaths were suicides. The teenage study was mostly white, and every mother was a nurse.
• Worship and prayer were each measured with a single question, prayer together with meditation, and the parents' own practice was not measured.
• Only the porn study is about pornography. Its viewing and faith were measured at the same times, so faith falling first cannot be ruled out, the changes are small, and the data end in 2008.

In P-Minus

P-Minus treats the habit as distance from God and recovery as coming closer to Him. It puts worship on the same daily list as the habit work.

Sources

1. Koenig HG. Religion, spirituality, and health: the research and clinical implications. ISRN Psychiatry. 2012;2012:278730.
2. Koh HK, Frederick DE, Balboni TA, et al. Spirituality and harmful or hazardous alcohol and other drug use. JAMA Psychiatry. 2026;83(4):363-78.
3. Chen Y, Koh HK, Kawachi I, Botticelli M, VanderWeele TJ. Religious service attendance and deaths related to drugs, alcohol, and suicide among US health care professionals. JAMA Psychiatry. 2020;77(7):737-44.
4. VanderWeele TJ, Li S, Tsai AC, Kawachi I. Association between religious service attendance and lower suicide rates among US women. JAMA Psychiatry. 2016;73(8):845-51.
5. Chen Y, VanderWeele TJ. Associations of religious upbringing with subsequent health and well-being from adolescence to young adulthood: an outcome-wide analysis. Am J Epidemiol. 2018;187(11):2355-64.
6. Perry SL, Hayward GM. Seeing is (not) believing: how viewing pornography shapes the religious lives of young Americans. Soc Forces. 2017;95(4):1757-88.

Sources checked October 2026.