Bulimia nervosa (bulimia) is often concomitant with alcohol and other substance abuse. To investigate the coprevalence of bulimia with alcohol abuse and smoking, we surveyed 2597 male and female Japanese high school students and obtained a group of bulimic students who fulfilled four of five DSM-III-R bulimia nervosa criteria and a control group who reported no binge-eating experience. Comparison of the groups showed significantly more alcohol abuse for both male and female bulimic students than for the non-bulimic control group. The male and female adolescents with symptoms of bulimia were similar in showing a high prevalence of alcohol abuse. The incidence of smoking was significantly higher among the bulimic females than among the female controls, but there was no significant difference between the male groups' smoking experiences.