Chapter 8

1. Chapter 8 Alcohol, Caffeine, and Tobacco

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.

3. <<insert Table 8.1>> Table 8.1

4. Binge Drinking • Binge Drinking and College Students • What is binge drinking? • On one single occasion: • 5 drinks in a row for a man • 4 drinks in a row for a woman • 1700 students die annually due to preventable alcohol related injuries

5. Binge Drinking • Binge Drinking is 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. • Binge drinking is linked to campus crime including rape, and assault. • Many colleges and universities are implementing policies against drinking, and offering more programs to help students with alcohol problems.

6. Alcohol: Chemical Make-Up • Chemical Makeup • Ethyl alcohol, aka ethanol • Produced through fermentation process • produces beer or wine • Yeast breaks down plant sugars until solution reaches 14 % alcohol • Manufacturers then add ingredients to dilute drink • Distillation – further processing • Alcohol vapors are released from the solution at high temperatures • Vapors are condensed and mixed with water for the final product • Proof – measure of the percent alcohol • Example: 80 proof whiskey = 40% alcohol

7. Alcoholic Beverages and Their Alcohol Equivalencies <<Insert figure 8.1>> Figure 8.1

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

9. <<insert table 8.2>> Table 8.2

10. Alcohol Absorption • Wine and beer absorbed more slowly than distilled beverages • Carbonated alcoholic beverages (champagne & sparkling wines) absorbed more quickly than non-carbonated • Due to relaxation of pyloric valve • The more alcohol you consume, the longer absorption takes • Due to irritation of pyloric valve • Typical rate for metabolizing is consistent at .5 oz an hour • Translates to one 12oz beer or wine, 1.5 oz 80 proof liquor.

11. Alcohol Poisoning • Alcohol Poisoning • Death from alcohol • Large amount of alcohol in short amount of time. • Two ways this happens • 1) CNS and respiratory depression • 2) Inhalation of vomit or fluid into the lungs • Signs of alcohol poisoning • Inability to be rouses • Weak, rapid pulse • Irregular breathing pattern • Cool, pale, bluish skin • Call 911

12. 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 – result from decreased CSF and dehydration • Congeners – forms of alcohol metabolized more slowly, play role in hangovers • Be informed of drug and alcohol interactions

13. Physiological and Behavioral Effects of Alcohol • Long-Term Effects of Alcohol • Nervous system • Brain decrease in size • Loss in intelligence • Mostly left side of brain • Cardiovascular system • Increase Blood Pressure • Liver disease • Cirrhosis due to fat deposits • Alcoholic hepatitis • Cancer • Esophagus, stomach, mouth, tongue, liver. • Chronic inflammation of pancreas • Impairs ability to recognize and fight bacteria & viruses

14. A normal liver and a liver with cirrhosis

15. Alcohol and Pregnancy • 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

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

17. 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%

18. Alcohol Abuse and Alcoholism • Identifying a Problem Drinker • Abuse interferes with: • Work • School • Social/Family relationships • Alcoholism = alcohol dependency • Tolerance • Psychological dependence • Withdrawal

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

20. 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: Try to divert attention by being a good kid • Scapegoat: Draw attention away from problem by causing other problems • Lost child: Passive and withdrawing • Mascot: Comic releif

21. Alcohol Abuse and Alcoholism • Women and Alcoholism • More women are drinking • Female alcoholics approaching the rate of male alcoholics • Risk factors include: • Family history • Pressure to drink from peers • Depression • Stress

22. Recovery • The Family’s Role • Intervention – planned confrontation • Express love and concern • Treatment Programs • Detoxification: end physical dependence on drug • Treatment for psychological dependence • Takes 7 to 21 days • Up to 6 weeks • Relapse • 60% rate of relapse in first 3 months • Many say they are recovering their whole life

23. Our Smoking Society • Smoking Facts • Single most preventable cause of death • 440,000 Americans die a year • 50 times that of illegal drug deaths • Teen smokers = 21.8% • Advertising • Spends $18 million per day • Children and teens constitute 90% of new smokers • 18- to 24-year-olds new target

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

25. Our Smoking Society • Financial Costs to Society • $167 billion in annual health related economic losses • $75.5 billion in medical expenditures • College Students Are Smoking More • Estimated 60% have tried tobacco products • Does tobacco appear to be a big problem on your campus? • What efforts are made to decrease smoking?

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

27. Tobacco and Its Effects • All Tobacco Products are Equally Harmful • Cigarettes • Clove cigarettes (40% cloves, 60% tobacco) • Cigars: 23 poisons, 43 carcinogens • Pipes • Bidis (hand-rolled, flavored cigarettes) • Smokeless tobacco • Chewing tobacco • Dipping • Snuff

28. Tobacco and Its Effects • 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

29. Tobacco and Its Effects Health Hazards of Smoking (continued) • Respiratory Disorders • Chronic bronchitis • Emphysema • Sexual Dysfunction • Males are 2 times more likely to suffer impotence • Other Problems • Gum disease • More likely to need medications • Metabolism of drugs is affected

30. How Cigarette Smoking Damages the Lungs Figure 8.4

31. Environmental Tobacco Smoke (ETS) • Risks from ETS • Mainstream: inhaling from cigarette • Sidestream – more carcinogens • ETS is responsible for deaths • Sidestream smoke causes more deaths a year than any other environmental pollutant • Children exposed

32. Environmental Tobacco Smoke (ETS) • Tobacco and Politics • 40 years ago government recognized the hazard • States have imposed extra taxes • Tobacco control initiatives are increasing

33. Quitting • Breaking the Nicotine Addiction • 1/3 attempt to quit a year • 90% fail • Many programs exist to help with quitting • Nicotine withdrawal is experienced • Nicotine Replacement Products • Nicotine chewing gum • Nicotine patch • Nicotine nasal spray • Nicotine inhaler

34. Quitting • Other Means of Breaking the Habit • Operant strategies: pairing smoking with an external stimuli • Self-control: Teaching skills necessary for quitting • Benefits of Quitting • According to the American Cancer Society many tissues will repair themselves

35. When Smokers Quit <<insert Fig 8.5>> Figure 8.5

36. Caffeine • Caffeine Facts • A drug derived from xanthines • Mild stimulant to CNS • Increases heart rate • Increases oxygen consumption • Does not cause dehydration • Increases wakefulness

37. Caffeine • Side Effects of Caffeine • Insomnia in some • Irregular heart beat • Dizziness • Nausea • Indigestion • Mild delerium • Anxiety

38. <<insert table 8.4>> Table 8.4

39. Caffeine • Caffeine Addiction • Drink more when coming down • Caffeinism – jitters, muscle twitch • Withdrawing may produce headaches • No long-term damage is seen with moderate use in non-pregnant women