Background: The irregular routine of truck drivers favors the development of chronic noncommunicable diseases (NCDs), especially cardiovascular diseases (CVDs), which can be exacerbated by the use of illicit drugs. Methods: A cross-sectional study was carried out with data from 2,071 truck drivers who traveled through the state of São Paulo between 2010 and 2016. Socioeconomic and occupational variables, risk factors for CVD, use of illicit drugs were analyzed. Clinical and toxicological tests

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... ere also carried out. Results: The average age of the truck drivers was 42.27 ± 11.07 years, and the use of illicit drugs, at least once while working, was reported or detected in 388 (18.7%) drivers. Compared to non-users, drug users were younger (37.25 ± 9.45 vs. 43.43 ± 11.1 years; p <0.001) and single (43.3% vs. 28.4%; p <0.001). The independent variables age [OR = 0.93 (95% CI: 0.91 - 0.95; p<0.001)], smoking [OR = 2.18 (95% CI: 1.39 - 3.44; p = 0.001)], alcohol consumption [OR = 1.626 (95% CI: 1.06 - 2.49; p = 0.026)] and hours of driving per day [OR = 1.08 (95% CI: 1.01 - 1.15; p = 0.012)] were also associated with the use of illicit drugs. Conclusion: The use of illicit drugs was higher in young and single drivers and was associated with a higher prevalence of smoking, alcohol consumption and more driving hours, which are risk factors for NCDs, CVD and traffic accidents.