Worked solution
Smoking: tobacco smoke contains carcinogens and damages the lining of the arteries and lungs, substantially increasing the risk of lung cancer, chronic obstructive pulmonary disease (COPD), and coronary heart disease through accelerated atherosclerosis, all of which reduce both quality and length of life.
Alcohol misuse: excessive alcohol consumption places a chronic strain on the liver (increasing the risk of fatty liver disease, hepatitis and cirrhosis), raises blood pressure over time, and is linked to several cancers and to increased risk of accidents and injury, contributing both directly (organ damage) and indirectly (accidents) to reduced life expectancy.
Poor diet: a diet high in saturated fat, salt and sugar, and low in fruit, vegetables and fibre, increases the risk of obesity, high cholesterol, high blood pressure and Type II diabetes, all of which are major risk factors for coronary heart disease and stroke.
Physical inactivity: a sedentary lifestyle reduces cardiovascular fitness, contributes to weight gain and reduced insulin sensitivity, and is independently associated with a higher risk of CHD, Type II diabetes, certain cancers, and poorer mental health.
Taken together, these lifestyle risk factors frequently interact and compound one another (for example, physical inactivity and poor diet both contribute to obesity, which itself worsens the risk associated with the others), meaning individuals with multiple risk factors face a substantially greater cumulative risk of hypokinetic and other chronic disease, and, on average, a shorter life expectancy than those who address these factors through positive lifestyle change.
Marking scheme
Assessed against a 3-band QWC level of response grid. Level 3 (7–8): discusses at least three of the four named risk factors with an accurate physiological mechanism for each, and explicitly links these to reduced life expectancy (ideally noting how risk factors interact/compound); fluent, well-organised use of specialist terminology. Level 2 (4–6): discusses at least two risk factors with reasonable accuracy, with some link to ill health/life expectancy. Level 1 (1–3): discusses only one risk factor in any depth, or gives vague/generic health claims without accurate physiological mechanism.