Though the rate has significantly decreased, the United States continued into the late 90’s with one of the highest fire death rates in the industrialized world. Given the advancements in fire prevention, including public education, building design, consumer product safety, and sophisticated levels of the fire protection in this country, it is puzzling to many as to why this is so. In an effort to identify the underlying problem(s), researchers have been delving deeper into the extent to which human behavior affects our fire losses. The connection between alcohol and the ignition, detection, and escape from the fire has been broadly examined by numerous medical and fire protection organization studies. A series of landmark studies undertaken by the Johns Hopkins University and the National Bureau of Standards in the 1970’s were among the first to discover a definitive link between alcohol consumption and fire deaths. Many studies have now confirmed their general findings. Alcohol intoxication may increase the risk of initiating a fire by impairing one’s judgment and coordination. An intoxicated individual who is smoking may also succumb to the depressant effects of alcohol, fall asleep and drop a lit cigarette on upholstery or clothing. Intoxication also acutely diminishes one’s ability to detect a fire. Under the sedative effects of alcohol, an alcohol-impaired person may fail to notice the smell of smoke, or fail to hear a smoke alarm. Escape from a fire can be hampered by the loss of motor coordination and mental clarity caused by alcohol, even when warning signs are heeded. Furthermore, burns are more physiologically damaging in the presence of alcohol. Several researchers have found that about half of all adult fire fatalities were under the influence of alcohol at the time of the fire. Men have been found to consistently outnumber women among fire casualties and do so with even greater disparity for fire victims under the influence of alcohol. In addition, the younger adult population (ages 15 to 34) seems to incur the greatest number of alcohol-impaired fire casualties. Drinking behaviors that are characteristic of various age groups and sexes may explain these findings. Studies have also provided conclusive evidence supporting the deleterious effects of chronic and acute alcohol abuse on the occurrence and recovery from burn injuries. Burn injury victims have been found to be disproportionately likely to have been intoxicated at the time of injury or known to be heavy drinkers. From a physiological standpoint, burn victims with histories of alcoholism tend to have longer hospital stays, more complications, and higher mortality rates as a result of their burns. Questions still remain as to the extent that alcohol affects fire losses. How do we explain the fact that some industrialized countries with some of the highest alcohol consumption rates per capita, e.g. Germany and the Netherlands, have relatively low fire death rates? Researchers have suggested that alcohol-related unintentional injuries have more to do with alcohol drinking patterns than the total amount of alcohol consumed per capita. Who drinks, where they drink, what they drink, and under what social, cultural, and religious circumstances they drink are perhaps more significant factors than the amount of alcohol consumed. A lone drinker at home is probably at greater risk of a fire emergency than a group of people drinking at a bar or restaurant. Moreover, the number of drinks consumed in a single sitting seems to matter a great deal. Alcoholics have a disproportionately high rate of fire fatalities relative to their percentage of the total population. Non-intoxicated fire victims also may be affected by alcohol: they may have been entrusted to the care of an alcohol-impaired individual. These fire fatalities would not be reported as related to alcohol when blood alcohol levels (BALs) are taken of victims only. As a result, the estimated number of alcohol-related fire casualties as well as the magnitude of the problem may be underestimated. Smoking fires are the leading cause of fire fatalities. The incidence of such fatal fires is higher among those who are under the influence of alcohol and most smokingrelated fire fatalities have some connection to alcohol consumption. In summary, there is a clear connection of alcohol and fire fatalities. Unlike the connection between alcohol consumption and vehicle fatalities, the connection is not often referred to in prevention programs, nor has much been done to address the problem.