OBJECTIVES: To establish the relationship between alcohol use and job stress among firemen, and to develop a comprehensive health promotion program including stress management and the prevention of problem drinking. METHODS: Data was collected from July to August, 2000. Study subjects included 97 rescue workers, 97 emergency medical personnel, 179 fire extinguishers, 116 administrators and 49 others. RESULTS: The firemen displayed higher scores of stress due to promotion-related pressures and salary. We found significant differences in job internal factors, job role, interpersonal relationship, organizational norm, work environment and stress outcome among the various jobs. Job internal factors, job stress factors, personal characteristics, coping skills, and stress outcome were higher in heavy drinkers compared with the light and moderate drinkers. Job internal factors and smoking habit showed a positive correlation with the amount of drinking, although coping skill, exercise frequency and monthly income showed a negative relation with the amount consumed. CONCLUSION: This study suggested that alcohol drinking is associated with job stress. This suggests that a comprehensive health promotion program including stress management and problem drinking prevention and control should be developed.