Alcohol, Tobacco, and Caffeine: Daily Pleasures, Daily Challenges

1. Alcohol, Tobacco, and Caffeine: Daily Pleasures, Daily Challenges

2. Alcohol • Overview • 65% of Americans consume alcohol • 10% are heavy drinkers • Alcohol and college students • 70% of college students consumed alcohol in the last year • 1/2 are classified as heavy drinkers • Many students have a misperception about “normal drinking” behavior, and believe their peers drink more than they actually do.

4. Binge Drinking and College Students • Binge drinking • On one single occasion: • 5 drinks in a row for a man • 4 drinks in a row for a woman • 1,700 students die annually due to preventable alcohol related injuries

6. Binge Drinking • Dangerous to yourself and others • Consuming a large quantity of alcohol in a short period of time increases the risk of unconsciousness, alcohol poisoning, and death • Linked to campus crime, including rape and assault • Many colleges and universities trying to address the problem • Implementing policies against drinking • Offering more programs to help students with alcohol problems

7. Chemical Make-Up of Alcohol • Ethyl alcohol or ethanol • Fermentation process • Yeast organisms break down sugar • Distillation • Alcohol vapors are released from the mash at high temperatures • Proof • Measure of the percent alcohol • 80 proof whiskey = 40% alcohol

8. Alcoholic Beverages and Their Alcohol Equivalencies Figure 8.1

9. Alcohol: Absorption and Metabolism • Absorption and metabolism • Absorption in stomach 20% • Absorption in small intestine 80% • Factors that influence absorption • Concentration of the drink • Amount consumed • Food in the stomach • Mood • Pylorospasm (spasm of valve)

10. Alcohol Absorption • Wine and beer • Absorbed more slowly than distilled beverages • Carbonated alcoholic beverages (champagne and sparkling wines) • Absorbed more quickly than non-carbonated • Carbonated beverages (soda and seltzer) and drinks with mixers • Relax the pyloric valve and empty stomach contents into intestines • Increases rate of alcohol absorption • The more alcohol you consume, the longer absorption takes

11. ABC News: Alcohol • Discussion Questions • How did each of the three men differ when considering body size, past alcohol drinking patterns, food intake on the day of the competition and during the drinking bout, performance on the roadside sobriety test, and eventual blood alcohol content? • What was each man’s perception or judgment of how drunk he was at the end of the drinking competition? • Discuss situations when you have been drinking and thought that you were in control but may have had a high blood alcohol content. Can you safely trust your own judgment? Play Video | Alcohol

12. Blood Alcohol Levels • Breathalyzers and urinalysis • Both measure a person’s blood alcohol concentration (BAC) • Ratio of alcohol to total blood volume

14. Behavioral and Physiological Effects of Alcohol • Alcohol and injuries • 13% of ER visits by undergrads are for alcohol-related injuries • Patients with a BAC >0.08 are 3.2 times more likely to have a violent injury than an unintentional injury • Most people admitted to ER are men 21 and over, most as a result of accidents or fights in which alcohol was a factor

15. Behavioral and Physiological Effects of Alcohol • Alcohol poisoning • Consuming large amounts of alcohol in short period of time can be lethal • Alcohol alone or mixed with another drug responsible for more deaths due to toxic overdose than any other substance • Death caused by either central nervous system and respiratory depression or by inhalation of vomit or fluid into the lungs • Signs include inibility to be roused, weak and rapid pulse, unusual breathing pattern, and cool, damp, pale or bluish skin • If wait to call for help until person is unconscious, risk of death increases tenfold

16. Behavioral and Physiological Effects of Alcohol • Decision making skills impaired • Alcohol lowers inhibitions, impairing ability to make wise decisions regarding sexual activity • 70% of college students admit to having engaged in sexual activity primarily as a result of being under influence of alcohol • Less likely to use safer sex practices • Risk of contracting STI or unplanned pregnancy increases among those who drink heavily

17. Behavioral and Physiological Effects of Alcohol • Alcohol affects men and women differently • Women have less body fat • Women have half as much alcohol dehydrogenase – enzyme that breaks down alcohol in the stomach • More vulnerable to impairment due to alcohol consumption • Hormonal differences and use of oral contraceptives likely to contribute to longer periods of initoxication

18. Physiological and Behavioral Effects of Alcohol • Immediate effects of alcohol • Reduces frequency of nerve transmissions • Dehydration • Water is lost from cerebrospinal fluid • Alcohol irritates the gastrointestinal system • Hangovers • Congeners – forms of alcohol metabolized more slowly • Be informed of drug and alcohol interactions • What are some symptoms experienced by someone with a hangover?

19. Physiological and Behavioral Effects of Alcohol • Long-term effects of alcohol • Effects on the Nervous System • Cardiovascular Effects • Liver disease • Cirrhosis • Alcoholic hepatitis • Cancer • Chronic inflammation of pancreas • Impairs ability to recognize and fight bacteria and viruses

20. A normal liver and a liver with cirrhosis

21. Alcohol and Pregnancy • Risks • Alcohol can harm fetal development • Even a single exposure to high levels can cause damage • Fetal Alcohol Syndrome (FAS) • Mental retardation, small head, tremors, and abnormalities of face, limbs, heart, and brain • FAS is the 3rd most common birth defect in the United States

22. Alcohol and Pregnancy • FAS behaviors include • Impaired learning • Poor memory • Impulsive behaviors • Reduced attention span • Poor problem solving • Some have Fetal Alcohol Effects (less severe)

23. Drinking and Driving • Facts • 39% of all traffic fatalities are alcohol related • Many college students drink and drive • In 2005, 16,885 alcohol related fatalities (ARTFs) • One ARTF every 30 minutes • At BAC 0.10, ten times more likely to be in an accident • Current limit for BAC in all 50 states: 0.08%

24. Percentage of Fatally Injured Passenger Vehicle Drivers with BACs >.08 Percent, by Driver Age Figure 8.2

25. Alcohol Abuse and Alcoholism • Identifying a problem drinker • Abuse interferes with • Work • School • Social/family relationships • Alcoholism = alcohol dependency • Tolerance • Psychological dependence • Withdrawal

26. Alcohol Abuse and Alcoholism • Causes • Biological and family factors • Social and cultural factors • Family attitudes • Weakening of family links • Combination of heredity and environment

27. Alcohol Abuse and Alcoholism • Effects of alcoholism on the family • 1 in 4 children live in an alcoholic situation • Dysfunctional families • Family rules: “Don’t talk, don’t trust, don’t feel.” • Children often assume at least one of the following roles: • Family hero • Scapegoat • Lost child • Mascot • Do you know someone who fits the description of one of these roles?

28. Alcohol Abuse and Alcoholism • Costs to society • Estimated alcohol directly or indirectly responsible for over 25% of U.S. medical expenses and lost earnings • Cost of underage drinking estimated at $61.9 billion annually • Includes crashes, violent crime, FAS, high-risk sex, poisoning, psychosis, treatment for alcohol dependence

29. Alcohol Abuse and Alcoholism • Women and Alcoholism • Female alcoholics approaching the rate of male alcoholics • Women get addicted faster • Risk factors include: • Family history • Pressure to drink from peers • Depression • Stress • Despite the growing problem only 10% receive treatment

30. Alcohol Abuse and Alcoholism • Ethnic or racial differences • Different minority groups have own problems related to alcohol consumption and abuse • Alcohol most widely used drug among Native American populations • Rate of alcoholism two or three times higher than national average, death rate eight times higher than national average • Generally African Americans drink less than white Americans, but more likely to be heavy drinkers • Latino men have higher-than-average rates of alcohol abuse and alcohol-related health problems • Asian Americans have low rate of alcoholism, but many have defect in the gene that manufacturs alcohol dehydrogenase, leading to unpleasant side-effects when drinking

31. Recovery • The family’s role • Intervention – planned confrontation • Express love and concern • Treatment programs • Psychologist and psychiatrists specializing in treatment • Alcoholics Anonymous (AA) • Private treatment centers • Family, individual and group therapy

32. Recovery • Relapse • 60% rate of relapse in first 3 months • Many say they are recovering their whole life • To be effective, must work on self esteem and personal growth

33. Smoking in the United States • Smoking facts • Single most preventable cause of death • 438,000 Americans die a year • 50 times that of illegal drug deaths • Teen smokers = 27.5% • Advertising • Spends $18 million per day • Children and teens constitute 90% of new smokers • Women, minorities and college students new targets

34. ABC News: Tobacco • Discussion Questions • Why do you think that the federal government heavily regulates nicotine replacement products but not the delivery of cigarettes? • Why does Phillip Morris want to have the federal government regulate their tobacco products? Play Video | Tobacco

35. Annual Deaths Attributable to Smoking in the United States Figure 8.3

36. Smoking in the United States • Financial costs to society • $167 billion in annual health related economic losses • $75.5 billion in medical expenditures • College students are smoking less • Estimated 18% reported having smoked in the past 30 days (2005) • Does tobacco appear to be a big problem on your campus? • What efforts are made to decrease smoking?

37. Tobacco and Its Effects • Physiological effects of nicotine • Nicotine is the main addictive substance in tobacco • Stimulates CNS • Stimulates adrenal glands • Increases production of adrenaline • Increases heart rate • Increases respiratory rate • Constricts vessels • Increases blood pressure

38. Tobacco and Its Effects • All tobacco products are harmful • Cigarettes • Clove cigarettes • Cigars • Pipes • Bidis (hand-rolled, flavored cigarettes) • Spit (smokeless) tobacco • Chewing tobacco • Dipping • Snuff

39. Health Hazards of Smoking • Cancers • Lung 85-90% associated with smoking • Pancreatic • Lip • Esophagus • Tongue • Cardiovascular disease • Smokers have 70% higher death rate • Stroke • Smokers are 2 times more likely to suffer

40. Health Hazards of Smoking • Respiratory disorders • Chronic bronchitis • Emphysema • Sexual dysfunction • Males are twice as likely to suffer impotence • Other problems • Gum disease • More likely to need medications • Metabolism of drugs is affected

41. How Cigarette Smoking Damages the Lungs Figure 8.4

42. Environmental Tobacco Smoke (ETS) • Risks from ETS • Mainstream • Sidestream • Sidestream smoke causes more deaths a year than any other environmental pollutant • Children exposed • Have you seen any anti-smoking public service announcements you thought were powerful?

44. Tobacco Use and Prevention Politics • Over 40 years since the government recognized the hazard • 46 states have sued • States have imposed extra taxes • Tobacco control initiatives are increasing

45. Quitting • Breaking the nicotine addiction • 70% attempt to quit a year • Fewer than 5% succeed • Many programs exist to help with quitting • Nicotine withdrawal is experienced • Nicotine replacement products • Nicotine chewing gum • Nicotine patch • Nicotine nasal spray • Nicotine inhaler

46. Quitting • Other means of breaking the habit • Aversion therapy • Operant strategies • Self-control • Benefits of quitting • According to the American Cancer Society many tissues will repair themselves

47. When Smokers Quit Figure 8.5

48. Caffeine • Caffeine facts • A drug derived from xanthines • Mild stimulant to CNS • Increases heart rate • Increases oxygen consumption • Increases urinary output • Increases wakefulness

49. Caffeine • Side effects • Insomnia • Irregular heartbeat • Dizziness • Nausea • Indigestion • Mild delirium • Involuntary muscle twitches