That's a tough question, and without any kind of long term study and research you can't make an accurate conclusion on the topic.
Having said that, we have to remember we are not perfect human beings, we also are alive because we are this huge self sufficient chemical laboratory, but since we are not perfect many of us (in reality all of us) have different degrees of chemical imbalances, our bodies also have this huge ability to be very adaptable but also very dependent.
I have actually thought about this for a long time, I do a lot of extreme sport, that means injuries, therefore lots of prescriptions, at first you play terrible on this prescriptions, then your body becomes use to it so now you need to be on them to play good again, same goes with alcohol, everytime I have drank often for a considerable amount of time, then I need to have a drink or two to play good. I have randomly taken pills like tramadol and it worked great right away, but after a while it doesn't work as good anymore, or you need higher dose. I don't smoke, but some people absolutely have to go outside and smoke before a match.
Now I will tell you this, everytime my body has been absolutely healthy, no injuries, no alcohol for a couple of weeks, good sleep, really good food, no worries in life and a good workout regimen, I have played the absolute beat pool in my life, just as I have played great in certain ocations medicated. So if I have to pick, the healthy route is the toughest but in the long run is the most benefitial.