Chapter Eight

1. Chapter Eight The Responsible Use of Alcohol and Tobacco

2. Alcohol Use Patterns • 49% of Americans abstain from alcohol use • 22% are considered “light” drinkers • 29% are considered “risky” drinkers • Alcohol is responsible for more than 70,000 deaths per year among Americans

3. Nature of Alcoholic Beverages • Consumable form of alcohol – ethyl • Fermentation: process where sugars are converted into alcohol by yeast • Proof: alcohol concentration that is twice the percentage • Alcohol provides 7 calories per gram Alcohol is a depressant

4. Strength of the beverage Number of drinks consumed Speed of consumption Carbonation of the beverage Presence of food Body weight Body fat percentage Gender Factors that AffectAlcohol Absorption and Blood Alcohol Concentration Levels

5. Metabolism and Excretion • Once alcohol reaches the stomach, 20% is absorbed into the bloodstream • 75% is absorbed through the upper part of the small intestine • The liver is the main site for alcohol metabolism • 2-10% of ingested alcohol is not metabolized by the liver or other tissues, it is excreted by the lungs, kidneys, and sweat glands unchanged

6. Blood Alcohol Concentration • Percentage of alcohol in a measured amount of blood • Measured from exhaled breath or blood sample • Depends upon the balance between the rate of alcohol absorption and the rate of alcohol metabolism

7. The Immediate Effects of Alcohol • At .03 - .05% = relaxation and jovial • At .10% = physical impairment • At .20% = uncontrollable movement • At .35% = coma and possible death

8. Alcohol Hangover vs. Alcohol Poisonng • A hangover is probably due to a combination of toxic products of alcohol breakdown, dehydration, and hormonal effects • Symptoms of a hangover include: • Headaches • Fatigue • Impaired mental functioning • Alcohol poisoning is consuming large amounts of alcohol in a short amount of time, raising BAC to dangerous levels which could result in death due to: • CNS depression • Respiratory failure • Pulmonary edema

9. Other Dangerous Alcohol Use Combination • Using Alcohol with Other Drugs • Impaired judgment from Alcohol leading to: • Injuries • Violence • Suicide • Alcohol and Sexual Decision-making • Unplanned sexual activity • STD’s • Accidental pregnancies • Drinking and Driving • Dose-response function

10. The Effects of Chronic Use

11. Fetal Alcohol Syndrome • Fetus is exposed to alcohol in a slower manner than an adult via the placenta • Damage results in mental retardation • Other characteristics are low birth weight, facial abnormalities, widely spaced eyes, and a much smaller head. • Full expression rate: 1-2 out of 1000 births

12. Possible Health Benefits of Alcohol • Moderate drinking can benefit people who currently have or are at risk for Coronary Heart Disease by raising HDL levels and reducing inflammation • Some evidence suggests that moderate drinkers may reduce the onset of: • Diabetes • Stroke • Arterial blockages • Alzheimer’s Disease • Prostate enlargement

13. Alcohol Abuse and Dependence • Alcohol Abuse is recurrent use that has negative consequences that result in personal forms of difficulties • Alcohol Dependence (Alcoholism) is a result of needing alcohol on a regular basis to function, involving physical tolerance and withdrawal symptoms

14. Problem Drinking and Alcoholism • Problem drinking – alcohol pattern where the behavior creates personal difficulties or difficulties for others • Co-dependence – relationships that support an alcoholic

15. Health Effects of Alcoholism • Withdrawal symptoms can be acute (shakes or jitters) to more severe i.e. seizures, delirium tremens (DTs) • Alcoholism takes a heavy physical toll upon the body’s organs and tissues as well as causing psychological problems • Socially, it is a serious problem to families and friends • Economically, it effects employment and healthcare costs

16. Causes of Alcoholism • The precise causes are unknown, however the following factors are probably involved • Genetics • Personality • Social factors • Environment • Family structure

17. Binge Drinking • Defined as having 5 or more drinks in a row for men, 4 or more for women on at least one occasion in the last two weeks • A common form of alcohol abuse on college campuses • Binge drinking kills dozens of college students each year in this country • Fast, heavy drinking can easily raise BAC levels quickly, leading to unconsciousness and death

18. Treatment for Alcoholism • Rehab centers • Hospitals • Medication • Counseling • Support groups

19. Gender and Ethnic Differences on Alcoholism • Among White American men, drinking starts in the teenage years and progresses into late adulthood • Women tend to become alcoholics much later (40’s or 50’s) • African-Americans tend to have more health related problems with alcohol use • Drunk driving and cirrhosis tend to be common elements with Latino men • American Indians and Alaskans tend to abuse alcohol early in life

20. Why People Use Tobacco • Nicotine Addiction • Modulator of everyday emotions • Loss of Control • 3 of 4 smokers find they cannot quit, which is more difficult for smokeless users • Build up of Tolerance • Same effects build up over time, needing more cigarette to maintain the same original effects, which create dependence • Social and Psychological Factors • Habits are formed via ‘secondary reinforcers’ which keep the user dependent upon tobacco

21. A parent or sibling uses tobacco Peers use tobacco The child comes from a blue collar family The family is headed by a single parent The child comes from a low income home The child performs poorly in school The child drops out of school The child has positive attitudes about tobacco use Who Uses Tobacco? Research shows that children are vulnerable to smoking based upon the following

22. Other Demographic Factors Influencing Tobacco Use • Gender • Age groups • Region of the country • Education level • Ethnicity

23. The Source of Physiologically Active Compounds • Particulate phase (small particle compounds) • nicotine • water • tar (phenol, cresol, benzo pyrene, DDT) Many of these chemicals are considered carcinogens

24. Sources of Physiologically Active Compounds, cont’d • Gaseous phase (gas compounds) • carbon monoxide (CO) • carbon dioxide, ammonia, hydrogen cyanide, isopyrene, acetone, etc. Many of these chemicals are considered carcinogens

25. Acute Effects of Smoking • The effects of nicotine is dependent upon the smoker’s tolerance and previous consumption level • Once the cerebral cortex has been stimulated, arousal of nicotine allows norepinephrine, dopamine, acetylcholine, serotonin release • CNS is depressed within the brain which stimulates areas within the heart, lungs, blood flow

26. Relationship Between Cigarette Smoking and the Following Conditions • Cardiovascular Disease and Carbon Monoxide • Impairment of oxygen transport • Cardiovascular Disease and Nicotine • Myocardial infarction risk • Sudden cardiac death risk • Development of Angina Pectoralis • Increase of Platelet Adhesiveness

27. Relationship Between Cigarette Smoking and the Following Conditions, cont. • Cancers • Lung • Mouth • Throat * Evidence suggests that after one year without smoking, the risk of lung cancer decreases substantially

28. What are COLD’s? • Chronic Bronchitis (inflammation/infection of air passageways) • Pulmonary Emphysema (destruction of the alveoli) • Cilia destruction (hair-like projections which assist mucus movement) Chronic Obstructive Lung Disorders

29. Lung disease Cancer risk Heart disease Peripheral Vascular disease Skin changes Orthopedic problems Rheumatologic problems Male Infertility Depression Neurological disorders Endocrine system problems GI tract diseases Immune system Oral Health Complications in OB/GYN Selected Health Concerns from Cigarette Smoking

30. Other Forms of Tobacco Products • Smokeless Tobacco • Cigars and Pipes • Clove Cigarettes and Bidis

31. Second-hand Smoke • Mainstream (smoke exhaled by smoker) • Sidestream (smoke from the burning product) • Environmental smoke (diluted smoke in the air) 85% of the smoke in a room comes from sidestream smoke

32. ETS Effects • Up to 70% of nonsmokers subjected to Environmental Smoke develop some form of irritation or health ailment • It also causes 3000 lung cancer deaths annually • 60,000 deaths from heart disease is associated with ETS • Infants are 23 times more likely to die from SIDS when exposed to ETS • Children and infants becomes vulnerable to respiratory disorders and reduced lung function

33. Smoking and Pregnancy • Infertility • Problem pregnancies • Low birth weight • Premature labor/delivery • Miscarriage risk doubles

34. Benefits of Quitting • Taste returns back to normal • The concept of “smell” improves • Breathing becomes easier • Decrease risk of heart and lung disease • More energy and alertness

35. Options for Quitting • Strategies involving the benefits of behavioral and pharmacological interventions such as: • “Cold Turkey” method • Non-tobacco sources of nicotine products e.g. suckers, gums, straws, sprays, drops, etc. • Smoking cessation programs • Support groups • Regular exercise program

36. Chapter Eight The Responsible Use of Alcohol and Tobacco