In many developing countries, there is wide inequality in the distribution of health, with those at the top end of the socioeconomic scale having better health outcomes. Mitigating the inequalities in health is the priority of most health care systems, including the National Health System in South Africa. In recent decades, many low- and middle-income countries have experienced an epidemiological transition from communicable to non-communicable diseases (NCDs). The prevalence of NCDs varies with socioeconomic status, and is driven by adopted lifestyle such as smoking, harmful alcohol use, and obesity among others. The idea is that the gradient in inequality in health between the poor and the rich is likely to depend on differences in their adopted lifestyle, and socioeconomic-related inequalities in health will widen if the negative effects unhealthy practices are concentrated among the poor. This has negative consequences on human capital development, and imposes a growing economic burden on society. Numerous studies that have attempted to examine the contribution of lifestyle factors on income-related inequality in health, have done so without considering health outcomes that are directly associated to these factors. We therefore examine the contribution of smoking and alcohol consumption to income-related inequality in health by incorporating measures of health that are directly associated to smoking and alcohol use.