2Alcohol: An Overview61 percent of Americans consume alcohol regularly.25 percent abstain from drinking.Alcohol and College StudentsApproximately 63 percent of students have consumed alcoholic beverages in the past 30 days.Almost half are classified as heavy drinkers.Many students have a misperception about “normal drinking” behavior, and believe their peers drink more than they actually do.
3Alcohol: An Overview Binge Drinking A pattern of drinking alcohol that brings blood alcohol concentration (BAC) to 0.08 gram-percent or aboveBinge drinking is defined as consuming within 2 hours:5 drinks in a row for a man4 drinks in a row for a womanMany colleges are trying to address the problem:Cognitive-behavioral skills training with motivational interviewingSocial norms approachWorking to change misperceptions
4Trends of Alcohol-Related Problems among College Students, Nonbinge Drinkers vs. Frequent Binge Drinkers
5Alcohol: An Overview High-Risk Drinking and College Students Why is binge drinking the number one cause of preventable death among undergraduate students?Alcohol exacerbates their already high risk for suicide, automobile crashes, and falls.Customs, norms, and traditions encourage dangerous drinking.Drinking is heavily advertised and promoted on campuses.Students are more likely to engage in drinking games.Students are more vulnerable to peer influences and peer pressure.College administrators often don’t admit to a problem on campus.
7Alcohol: An Overview Trends in Consumption In general, alcohol consumption levels among Americans have declined steadily since the late 1970s.In 2006, the estimated per capita consumption was the equivalent of 2.31 gallons of pure alcohol per person.The downward trend has been tied to growing attention to weight, personal health, and physical activity.
8Alcohol in the Body The Chemistry and Potency of Alcohol Ethyl alcohol or ethanol-only alcohol that can be consumedFermentation processYeast organisms break down sugar.DistillationAlcohol vapors are released from the mash at high temperatures.ProofMeasure of the percent alcohol80 proof whiskey = 40 percent alcoholStandard drink-14 g, 0.6 oz, 1.2 tablespoons
9Alcohol in the Body Absorption and Metabolism Absorption that occurs in stomach is about 20 percentAbsorption that occurs in small intestine is about 80 percentFactors that influence absorption:Concentration of the drinkAmount consumedFood in the stomach slows the absorptionCarbonation increases absorptionMood-absorbed rapidly
11Alcohol in the Body Blood Alcohol Levels Blood Alcohol Concentration (BAC)Ratio of alcohol to total blood volumeThe legal limit for BAC is 0.08 percent in all states.Both breath analysis (breathalyzer tests) and urinalysis are used to determine whether an individual is legally intoxicated, but blood tests are more accurate.Can not be effected byExerciseBreathing deeplyEatingDrinking coffeeTaking other drugsGenetic factorsMetabolism is the same if the person is awake or asleep
12Approximate Blood Alcohol Concentration (BAC) and the Physiological and Behavioral Effects
14Alcohol and Your Health Immediate and Short-Term Effects of AlcoholCNS depressant (pulse, BP, respiratory rate)DehydrationWater is lost from cerebrospinal fluid.Alcohol irritates the gastrointestinal system.HangoversBe informed of drug and alcohol interactionsLow Concentrations .03% -.05% (light-headedness, relaxation, mild euphoria, more sociable)Higher Concentrations 0.1% -0.2% (pleasant effects replaced by negatives: motor coordination, verbal performance, irritability, emotional stability)Concentration of .35% and higher = COMA
15Gender & Health Women and Alcohol Women have more body fat than men do = higher concentration of alcoholWomen have half as much alcohol dehydrogenase— enzyme that breaks down alcohol in the stomachMore vulnerable to impairment due to alcohol consumptionHormonal differences and use of oral contraceptives likely to contribute to longer periods of intoxication
16Alcohol and Your Health Alcohol and Injuries13 percent of emergency room visits by undergrads are for alcohol-related injuriesPatients with a BAC over 0.08% are 3.2 times more likely to have a violent injury than an unintentional injury.Most people admitted to the ER are men aged 21 and over, most as a result of accidents or fights in which alcohol was a factor.
17Alcohol and Your Health Alcohol and Sexual Decision MakingAlcohol lowers inhibitions, impairing the ability to make wise decisions regarding sexual activity70 percent of college students admit to having engaged in sexual activity primarily as a result of being under the influence of alcohol.Less likely to use safer sex practicesRisk of contracting sexually transmitted infections (STIs) or pregnancy increases among those who drink heavily
18Alcohol and Your Health Alcohol PoisoningConsuming large amounts of alcohol in a short period of time can be lethal.Alcohol alone or mixed with another drug is responsible for more toxic overdose deaths than any other substance.Deaths are caused by either central nervous system and respiratory depression or by inhalation of vomit or fluid into the lungsSigns include inability to be roused; weak and rapid pulse; unusual breathing pattern; cool, damp, pale, or bluish skin.Call immediately.
19Alcohol and Your Health Long-Term Effects of AlcoholEffects on the nervous system-brain damage, shrinkage in brain size, weight and loss of some degree of intellectual abilityCardiovascular effects – heart disease, high BPLiver diseaseCirrhosis – fatty liver stops functioningAlcoholic hepatitis – chronic inflammationCancer – esophagus, stomach, mouth, tongue, liver, breast cancerChronic inflammation of pancreasImpairs ability to recognize and fight bacteria and virusesBlock the absorption of calcium
20Comparison of a Healthy Liver with a Cirrhotic Liver
21Alcohol and Pregnancy Alcohol and Pregnancy Alcohol can harm fetal development.Even a single exposure can cause damage.Fetal alcohol syndrome (FAS)Mental retardation, small head, tremors, and abnormalities of face, limbs, heart, and brain,FAS is the third most common birth defect in the United States.
22Alcohol and Your Health Alcohol and PregnancyFAS Symptoms IncludeImpaired learningPoor memoryImpulsive behaviorsReduced attention spanPoor problem solvingFetal alcohol effects are less severe than FAS
23Drinking and Driving32 percent of all traffic fatalities in 2008 were alcohol related.Many college students drink and drive.In 2008, there were 11,773 alcohol-impaired driving fatalities in the United States.This represents one alcohol-related fatality every 45 minutesAt BAC 0.10 a person is approximately 10 times more likely to be in an accident.
24Percentage of Fatally Injured Passenger Vehicle Drivers with BACs > 0.08 Percent, by Driver Age
26Alcohol Abuse and Alcoholism Identifying a Problem DrinkerAbuse interferes with work, school, and relationships.Alcoholism (alcohol dependence) results when personal and health problems related to alcohol use are severe, and stopping alcohol consumption results in withdrawal symptoms.Characterized by craving, loss of control, physical dependence, and tolerance
27Alcohol Abuse and Alcoholism Alcohol and Prescription Drug AbuseYoung adults aged 18 to 24 are at most risk for concurrent or simultaneous abuse of both alcohol and drugs.Alcohol and prescription drugs taken together can causeAlcohol poisoningUnconsciousnessRespiratory depressionDeathOpiates, stimulants, sedatives, and sleeping aids are most often combined with alcohol.
28Alcohol Abuse and Alcoholism The Causes of Alcohol Abuse and AlcoholismBiological and family factorsAlcoholism is 4 to 5 times more common among children of alcoholicsHeredity accounts for two-thirds of the risk for becoming an alcoholic.Social and cultural factorsFamily attitudesWeakening of family linksCombination of heredity and environment
29Alcohol Abuse and Alcoholism Women and AlcoholismFemale alcoholics approaching the rate of male alcoholicsWomen are addicted faster than are men but laterRisk factors includeFamily historyPressure to drink from peersDepressionStress
30Alcohol Abuse and Alcoholism Alcohol and Ethnic or Racial DifferencesDifferent minority groups have unique problems related to alcohol consumption and abuse.Alcohol most widely used drug among Native American populationsGenerally, African Americans drink less than white Americans, but are more likely to be heavy drinkers when they do drink.Latino men have higher-than-average rates of alcohol abuse and alcohol-related health problems than other groups.Asian Americans have a defect in the gene that manufactures alcohol dehydrogenase, leading to unpleasant side effects of alcohol consumption.
31Recovery The Family’s Role in Recovery Intervention is a planned confrontation.Treatment ProgramsPsychologist and psychiatrists specializing in treatmentAlcoholics Anonymous (AA)Private treatment centersFamily, individual, and group therapy
32RecoveryRelapseThere is roughly a 60 percent rate of relapse (resuming drinking) in the first three monthsMany say they are recovering their whole life.To be effective, one must work on self-esteem and personal growth.
33Tobacco Use in the United States Tobacco and Social IssuesSingle most preventable cause of death438,000 Americans die a year50 times that of illegal drug deathsTeen smokers = 27.5 percent of all smokersAdvertising$36 million per day spent on tobacco-related advertising.Children and teens constitute 90 percent of new smokers.Women, minorities, and college students are new targets.
34Percentage of Population That Smokes (Aged 18 and Older) among Select Groups in the United States
35ABC News Video: Smash the Ash! Discussion QuestionsWhat are the biggest deterrents to smoking?Do antismoking ads reinforce smoking habits?Is seeing the different lungs (a healthy lung, a smoker’s long, and a lung with cancer) effective?Why do people quit smoking? Is there any way you can help a friend or family member quit?
36Tobacco Use in the United States Financial Costs to Society$193 billion in annual health-related economic losses$95 billion in medical expendituresCollege Students and Tobacco UseEstimated 19 percent reported having smoked in the past 30 days in a 2007 study“Social smokers” are those who smoke when they are with people, rather than alone.Does tobacco appear to be a big problem on your campus?
37Trends in Prevalence of Cigarette Smoking in the Past Month among College Students
38Tobacco and Its Effects NicotineIt 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.
39Tobacco and Its Effects Tar and Carbon MonoxideTar is a thick, brownish sludge, that contains various carcinogenic (cancer-causing) agents.Tar accounts for about 8 percent of tobacco smoke.92 percent of the remaining tobacco smoke consists of various gases.The most dangerous gas is carbon monoxide, which is 800 times higher than the level considered safe by the EPA.Carbon monoxide causes oxygen deprivation in many body tissues.
40Tobacco and Its Effects Tobacco AddictionBetween 60 and 80 percent of people have tried a cigarette.Smoking delivers the drug to the brain in just a few seconds.Nicotine poisoning—dizziness, light-headedness, rapid and erratic pulse, clammy skin, nausea, vomiting, and diarrheaWhen a person continues to smoke because stopping is too difficult, that person is addicted.Pairing—an environmental cue triggers a craving for nicotineTwo specific genes may influence smoking behavior by affecting dopamine.
41Tobacco and Its Effects Tobacco ProductsCigarettesCigarsPipeBides (hand-rolled, flavored cigarettes)Spit (smokeless) tobaccoChewing tobaccoDippingSnuff
42Health Hazards of Tobacco Products CancersLung 85 to 90 percent associated with smokingPancreaticLipEsophagusTongueCardiovascular diseaseSmokers have a 70 percent higher death rate than nonsmokers.StrokeSmokers are 2 times more likely to suffer a stroke than nonsmokers.
44Health Hazards of Tobacco Products Respiratory DisordersChronic bronchitisEmphysemaSexual Dysfunction and Fertility ProblemsMales are twice as likely to suffer impotence as are females.Women are likely to suffer infertility and problems with pregnancy.Other Health EffectsGum disease, macular degeneration, premature skin wrinkling, and risk of Alzheimer’s diseaseMetabolism of drugs affected
45Comparison of Cross Sections with a Healthy Lung and with the Lung of a Smoker
46Environmental Tobacco Smoke Risks from Environmental Tobacco Smoke (ETS)Mainstream—smoke drawn through tobacco while inhalingSidestream—smoke from the burning end of a cigarette or smoke exhaled by a smokerContains 2 times more tar and nicotine, 5 times more carbon monoxide, and 50 times more ammonia than mainstream smokeCauses more deaths a year than any other environmental pollutantEvery year, ETS is estimated to be responsible for 3,000 lung cancer deaths, 46,000 coronary and heart disease deaths, and 430 SIDs deaths in newborns.
47ABC News Video: Second-Hand Smoke Discussion QuestionsAccording to a 2006 Surgeon General’s report, are there any acceptable exposure levels of second-hand smoke? Do you agree with the report?Does your state have antismoking laws in place? Do you think there should be such laws, or are they unfair to people who wish to smoke?Are you exposed to second-hand smoke in your daily life? What can you do to limit your exposure?
48Clear the Air Efforts to Reduce the Hazards of ETS 17,059 municipalities across the United States are covered by a 100 percent smoke-free provision in workplaces, and/or restaurants, and/or bars.Hotels and motels set aside rooms for nonsmokers, and many hotels are now 100 percent smoke free.Car rental agencies designate certain vehicles for nonsmokers.Smoking is banned on all U.S. airlines.Many colleges have rules in effect banning smoking in all public places.
49Tobacco Use and Prevention Policies It has been over 40 years since the government recognized the hazard of tobacco use.In 1998, the tobacco industry reached a Master’s Settlement Agreement with 40 states.46 states have sued to recover health care costs related to treating smokers.States have imposed extra taxes on tobacco products.Tobacco control initiatives are increasing.Have you seen any antismoking public service announcements you thought were powerful?
50Quitting Breaking the Nicotine Addiction 70 percent attempt to quit a yearFewer than 5 percent succeedNicotine Replacement ProductsNicotine chewing gumNicotine patchNicotine nasal sprayNicotine inhalerNicotine lozenges
52Quitting Smoking Cessation Medications Buproprion (Zyban) works on dopamine and norepinephrine receptors in the brain.Chantix reduces nicotine cravings and it blocks the effects of nicotine at nicotine receptor sites in the brain.Both drugs are associated with changes in behavior such as hostility, agitation, depressed mood, and suicidal thoughts or actions.NicVAX, an antismoking vaccine, is due out on the market soon.Intended to prevent nicotine from reaching the brain, making smoking less pleasurable
53Quitting Breaking the Smoking Habit Operant conditioning Self-control therapyBenefits of QuittingMany tissues will repair themselves, according to the American Cancer Society.Gain more energy, sleep better, and feel more alertWomen less likely to bear babies with low birth weightCan save about $1, per year