The association between tobacco smoking, the consumption of coffee and alcohol and bladder cancer was investigated in a hospital-based case-control study in Brescia, northern Italy. A total of 172 incident cases (135 men and 37 women) and 578 controls (398 men and 180 women) were enrolled. As expected, cigarette smoking was strongly associated with bladder cancer. The odds ratios (OR) for coffee drinking adjusted for age, education, residence and cigarette smoking in current drinkers were 2.6 (95% confidence interval, CI: 1.1-6.1) in men and 5.2 (95% CI: 1.0-30.4) in women. A dose-response relationship was found in men, with the highest risk in the highest category of exposure: drinkers of more than 5 cups per day had an OR of 4.5 (95% CI: 1.2-16.8). The ORs for current alcohol drinkers were 2.1 (95% CI: 1.0-4.8) in men and 3.4 (95% CI: 1.2-9.7) in women; according to grams of ethanol drunk per day (grams/day, g/d) the ORs were: 1.7 (1-20 g/d), 1.6 (21-40 g/d), 4.3 (41-60 g/d) and 4.6 (61+ g/d) in men and 3.1 (1-20 g/d) and 3.9 (21+ g/d) in women. These results suggest that regular consumption of both coffee and alcohol can be independently associated with an increased bladder cancer risk.