1

Tobacco and Alcohol

Alcohol and Tobacco

Smoking cigarettes and drinking alcohol are behaviors that often begin in

adolescence.

Alcohol and tobacco are gateway drugs.

Alcohol

3

Use and Abuse

• 51.9% of Americans older than 12 years of age use alcohol

• Alcohol abuse occurs when the drinker’s harmful use of alcohol affects social interactions such as with one’s job, family, and friends.

Factors of Abuse

• Alcoholism has been shown to have a variety of origins, many of them biological. – Heredity

• People with a first-degree relative– Behavior and temperament

• More likely if impulsive, aggressive, and have short attention spans, slow ability to calm oneself, a thrill-seeking nature, and an inability to delay gratification.

– What Else contributes? (think Ch 1)

Effects

– Brain Effects: Intoxication is impaired functioning of the central nervous system.• Alcohol affects parts of the brain that control

drives, emotions, and skeletal muscle movements.

• At high doses, causes nausea and vomiting.• Over time, the drinker develops tolerance to

alcohol.• Chronic drinkers do not experience aversive

effects as quickly as occasional drinkers.

Alcohol

Factors Related to Alcohol Use and Dependence– Psychological, Social and Developmental

Factors• People expect positive effects from drinking• Peers• Parent who abuses alcohol

Alcohol and College Students– Alcohol abuse often appears or accelerates

during college years.– Alcohol is the most abused drug among

college students.– Moderate drinkers who do not abuse alcohol

cite a variety of reasons for drinking, such as social ease or stress relief. They are not goal-oriented drinkers (ex. getting drunk).

– Heavy drinkers who abuse alcohol usually drink for escapist and goal-oriented reasons.

Alcohol and College (2)

– Freshmen or sophomore status and low GPA also are associated with alcohol abuse.

– Binge Drinking and Drinking Games• Binge drinking often is accompanied by

drinking games. The danger of unconsciousness, coma, and death increases as alcohol consumption increases.

Alcohol and College (3)Alcohol and College Students

– Alcohol-related deaths in college students• 5,000 alcohol-related deaths occur each

year among those aged 18 to 24.• 1,600 are killed each year due to alcohol-

related injuries.• ¾ of these deaths are due to alcohol-related

car crashes and 1/4 to other alcohol-related causes, such as drownings, falls, gunshots, and alcohol/drug poisonings.

Processing Alcohol

– Alcohol absorbed into the bloodstream from the stomach and intestinal tract

– The blood transports alcohol to the “detoxification center” of the body—the liver.

– Alcohol is absorbed into the bloodstream more quickly than it can be broken down by the liver, and the excess alcohol stays in the blood.

– Thus, eating food, which keeps alcohol in the stomach longer allows more to be broken down before entering the bloodstream.

Measurement

• Blood Alcohol Content (BAC)–Related to Body weight, sex and amount of

food in the stomach, amount of alcohol consumed and how much time in between drinks

–2 hours to process 1oz (FAA)

13

Consequences

Diseases of the Liver

• Fatty Liver: Most liver cells die as a result of fat being stored in them.

• Cirrhosis: due to alcohol killing liver cells.–Usually after 10-20 years of heavy

drinking.• Alcoholic Hepatitis:- inflammation of the

liver that can result in death.

Alcoholic Hepatitis

• Acute or Chronic– Roughly 3.2 million cases in U.S.– 16,000 acute cases in 2009– immediate transmission (acute)– roughly 6 months for virus to do damage

(chronic)

16

Cardiovascular Disease and Cancer

• Heavier drinking is associated with increased risks of cardiomyopathy, hypertension, arrhythmias, and stroke.

• Alcohol use is associated with increased risks of cancers of the esophagus and liver.

Immune System

– Immune System Suppression• Chronic drinking suppresses the immune

system, predisposing the drinker to infectious diseases.

Impacts on Men

• Lower than normal testosterone levels• Shrinking testicles• Impotence• Loss of sex drive (libido).

–Yeast=estrogen production

Impact on Women

• Women - irregular menstrual periods or no periods, higher rate of premature menopause

• During pregnancy alcohol consumption can have a devastating effect on the fetus.

21

Detrimental Effects on the Brain

• Brain Disorders • Intoxication – the impairment of the central

nervous system• Withdrawal symptoms- mild agitation, shaking,

anxiety, loss of appetite, restless, insomnia.• Severe withdrawal symptoms –hyperactivity,

hallucinations, disorientation, and confusion.

The Brain (2)

• Hangover–Hangover also may be the result of drinking

certain toxic acidic compounds or formaldehyde, which is produced when the body cannot keep up with the breakdown of alcohol as it is being consumed.

–Dehydration–Only time cures a hangover.

Alcohol and Safety

• Serious and Fatal Injuries–Airplane Accidents

»8 hrs bottle to throttle (minimum)–Water-Related Accidents

»30-70% of drownings are associated with alcohol.

–Automobile Accidents (roughly a third)»Roughly 10,000 in 2011 (drop from

18,000 in 2006)»1.5M DUI arrests and climbing

Controlling Consumption

– Plan how much you will drink ahead of time– Drink slowly– Eat before and while drinking– Set a limit for yourself, how many drinks, how

long you will drink– Don’t drink to avoid problems– Know how to refuse a drink– Don’t drink daily

Tobacco

26

Types

– Cigarettes– Smokeless tobacco

• Snuff• Dipping

– Chewing Tobacco

Reasons for Use

– Most start in adolescence– Psychological Reasons for Using Tobacco

• Family/Friends• Peer influence is the most important factor.• Low self esteem, little knowledge, poor

academic achievement are most susceptible.• Those who think their parents don’t care about

them.

Addiction to Nicotine

• Nicotine becomes addicting during the first few years of use

• Withdrawal from nicotine causes unpleasant symptoms

• A smoker builds tolerance to the effects of nicotine during the day.

• The smoker smokes more cigarettes as the day wears on.

Tobacco

Health Effects of Tobacco Use– 1964:Tobacco use linked with lung cancer &

other diseases– Cigarette smoking is the leading cause of

preventable death in the United States.

Immediate Effects

Nicotine and Carbon Monoxide:• Increased the heart rate and blood pressure

increases.• Increases the metabolic rate.• The carbon monoxide in cigarette smoke

interferes with the red blood cells’ ability to carry oxygen.

Respiratory Illnesses

• Cilia damage (lining of respiratory tract)• Inability to expel foreign particles – smokers

cough• Acute Bronchitis: an inflammation of the

mucous membranes of the bronchi.• Chronic bronchitis: a persistent inflammation

and thickening of the lining of the bronchi caused by the constant irritation of smoke. Can result in death.

Respiratory Illness Cont’d

• Pneumonia: inflammation of the lungs• Emphysema: a condition in which the air sacs

of the lungs lose their normal elasticity.–Lungs normal capacity to allow air to enter

is decreased, making breathing a continual effort.

• Chronic Obstructive Pulmonary Disease (COPD): chronic bronchitis and emphysema,

34

Cardiovascular Disease

• Coronary Artery Disease, Hypertension, Stroke, Atherosclerosis

• Women + Oral Contraceptives = higher risk• Light Cigarettes = same risk• 3-9 years after quitting smoking the risk of

death returns to that of a non-smoker.

Cancer

• Cancer is the second biggest killer of Americans, and tobacco use is responsible for about 30% of cancer deaths and 87% of lung cancer deaths annually in the United States.

Periodontal Disease

• Use of tobacco products affects the oral cavity, creating problems such as bad breath, stained teeth, and even oral cancer

• Disease of the supporting tissues around the teeth including the gums, bone, and ligaments.

• Leukoplakia (lesions around the mouth that can turn into caner) is common in young people who use smokeless tobacco products.

Osteoporosis

• Smoking cigarettes can cause osteoporosis, or loss of bone density.

• This is a particular concern for women in their postmenopausal women because it increases the risk of bone fractures, back pain and other problems.

Second-Hand SmokeEnvironmental Tobacco Smoke:

– ETS can cause lung cancer in nonsmokers, have an increased risk of cardiovascular disease and respiratory problems.

– Children - increased respiratory symptoms such as coughing and wheezing and lower respiratory tract infections such as bronchitis, influenza, and pneumonia, and asthma

– Nonsmoking areas adjacent to smoking areas contain unacceptable levels of airborne pollutants unless the areas have separate ventilation systems.

•

Quitting

– Most smokers want to quit– Benefits of Quitting

• Lower risk of various diseases and conditions including certain cancers, heart attack, stroke, and chronic lung disease.

• In pregnant women, to reduce the risk of having a low--birth--weight baby.

• Stop exposing family and other people around to second-hand smoke.

Quitting Cont’d

– Withdrawal• Nicotine patches and other nicotine-containing

products can reduce these symptoms.• Electronic cigarettes are highly questioned by

the FDA.• Nicotine vaccine is in clinical trial.

Quitting (3)

– Process• 1st 6 months – quitting period• 6 month- 1 yr – maintenance • Relapse – can occur and can be overcome