1. Chapter 8 Lecture Drinking Alcohol Responsibly and Ending Tobacco Use © 2015 Pearson Education, Inc.

2. LEARNING OUTCOMES Explain the health risks and effects of alcohol consumption. Discuss the alcohol use patterns of college students and overall trends in consumption. Explain the physiological and behavioral effects of alcohol, including blood alcohol concentration, absorption, and metabolism. Identify the long-term effects of alcohol consumption. Describe the symptoms and causes of alcoholism, its cost to society, and effects on the family. Explore treatment options for alcohol dependence. © 2015 Pearson Education, Inc.

3. LEARNING OUTCOMES (cont.) Discuss the social and political issues involved in tobacco use. Explain the scope of tobacco use in the United States. Describe the health risks and physical impact associated with using tobacco products. Explain the dangers of environmental tobacco smoke. Assess the effectiveness of tobacco use and prevention policies. Describe methods and benefits of smoking cessation. © 2015 Pearson Education, Inc.

4. Alcohol: An Overview Very low levels of alcohol, particularly red wine, may lower some health risks in older adults. Half of all Americans consume alcoholic beverages regularly; about 21 percent abstain. Men typically drink more regularly and drink more than women. © 2015 Pearson Education, Inc.

5. Alcohol and College Students Approximately 62 percent of students report having consumed an alcoholic beverage in the past 30 days. Of college students, 39 percent engage in binge drinking. Binge drinking for men is consuming 5 or more drinks in about 2 hours; for women, consuming 4 or more. Alcohol use among college students disrupts sleep, decreases alertness, and may affect academic performance. © 2015 Pearson Education, Inc.

6. College Students' Patterns of Alcohol Use in the Past 30 Days © 2015 Pearson Education, Inc.

7. High-Risk Drinking and College Students Alcohol exacerbates risk for suicide, automobile crashes, and falls. Many college and university students' customs and celebrations encourage certain dangerous practices and patterns of alcohol use. Advertising and promotions from the alcoholic beverage industry heavily target university campuses. Beer and other drink specials enable students to consume large amounts of alcohol cheaply. College students are more likely to drink recklessly. College students are vulnerable to peer influence. Administrators often deny that a problem exists. © 2015 Pearson Education, Inc.

8. ABC News Video: Sloppy Spring Breaker Discussion Questions Who should be held responsible in a potentially dangerous situation that involves a visually intoxicated woman and a male who attempts to take advantage of her? (i.e., the bartender, her friends, herself)? Would you feel responsible for helping a visually intoxicated woman who is seemingly being taken advantage of by a male patron at the bar? How would you react in a similar situation to the ones in the video? Discuss ground rules or ways to keep friends safe while on spring break if one of your friends gets intoxicated. © 2015 Pearson Education, Inc.

9. Prevalence of Negative Consequences of Drinking among College Students, Past Year © 2015 Pearson Education, Inc.

10. Efforts to Reduce Student Drinking Brief Alcohol Screening and Intervention for College Students (BASICS) has been effective for heavy-drinking students with already existing or risk for problems related to alcohol. E-intervention, electronically based alcohol education interventions using text messages, e-mails, and podcasts, and Alcohol e-Check Up to Go (e-Chug) have shown promise in reducing alcohol problems in first-year students. A social norms approach to reduce alcohol consumption is also used. © 2015 Pearson Education, Inc.

11. Alcohol in the Body The Chemistry and Potency of Alcohol Ethyl Alcohol or Ethanol –The intoxicating substance in all alcoholic beverages 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 percent alcohol © 2015 Pearson Education, Inc.

12. What Is a Standard Drink? © 2015 Pearson Education, Inc.

13. Absorption and Metabolism About 20 percent of absorption occurs in the stomach. About 80 percent of absorption occurs in the small intestine. Factors that influence absorption –Concentration of the drink –Amount consumed –Food in the stomach –Mood –Pylorospasm (spasm of valve) © 2015 Pearson Education, Inc.

14. Absorption and Metabolism (cont.) Alcohol contains 7 calories per gram. The breakdown of alcohol is fairly constant at about 0.5 ounce per hour (about one standard drink.) Unmetabolized alcohol circulates in the bloodstream until enough time passes for the body to break it down. © 2015 Pearson Education, Inc.

15. Blood Alcohol Concentration (BAC) Ratio of alcohol to total blood volume The 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. Learned behavioral tolerance—even though BAC may be quite high, the individual has learned to modify his behavior to appear sober. © 2015 Pearson Education, Inc.

16. The Psychological and Physical Effects of Alcohol © 2015 Pearson Education, Inc.

17. Blood Alcohol Concentration (BAC) (cont.) A drinker's BAC depends on –Weight and body fat –The water content in the body tissues –The concentration of alcohol in the beverage consumed. –Alcohol concentration is higher in people with more body fat; women generally have more body fat than men. –Women have half as much alcohol dehydrogenase as men. © 2015 Pearson Education, Inc.

18. Approximate Blood Alcohol Concentration (BAC) and the Physiological and Behavioral Effects © 2015 Pearson Education, Inc.

19. Effects of Alcohol on the Body and Health © 2015 Pearson Education, Inc.

20. Alcohol and Your Health Immediate and Short-Term Effects of Alcohol Alcohol depresses central nervous system (CNS) functions. Vital functions become noticeably affected, and in extreme cases, coma and death can result. Alcohol is a diuretic, but water is pulled out of the cerebrospinal fluid, resulting in "morning- after" headaches. © 2015 Pearson Education, Inc.

21. Immediate and Short-Term Effects of Alcohol (cont.) Alcohol irritates the gastrointestinal system. Brief drinking sprees of high amounts increase risk for irregular heartbeat or total loss of heart rhythm. Hangovers kick in for more than half of drinkers when BAC reaches 0.11. But, 20–25 percent of those who drink enough to reach that level do not experience them. © 2015 Pearson Education, Inc.

22. Immediate and Short-Term Effects of Alcohol (cont.) Alcohol is involved in approximately 70 percent of fatal injuries during activities such as boating and swimming. Heavy drinking is associated with dating violence One drink can add 100 calories to your daily intake; adding 150 calories per day more than you need can result in weight gain of 12 pounds a year. © 2015 Pearson Education, Inc.

23. Alcohol Poisoning Acute alcohol intoxication can be fatal. The amount of alcohol that causes unconsciousness is dangerously close to a fatal dose. BAC continues to rise even after a drinker is unconscious. Signs include inability to be roused; weak, rapid pulse; cool, pale, or bluish skin. Call 9-1-1 immediately. © 2015 Pearson Education, Inc.

24. Long-Term Effects of Alcohol Effects on the nervous system Cardiovascular effects Liver disease Cancer Other effects –Chronic inflammation of the pancreas –Blocked absorption of calcium –Reduced ability of the body to fight bacteria and viruses. © 2015 Pearson Education, Inc.

25. Comparison of a Healthy Liver with a Cirrhotic Liver © 2015 Pearson Education, Inc.

26. Alcohol and Pregnancy Teratogenic substances cause birth defects; alcohol is one of the most dangerous and common. 7.6 percent of children have been exposed to alcohol in utero; 1.4 percent of pregnant women report binge drinking. Fetal alcohol syndrome (FAS) –Mental retardation, impaired learning, poor memory, small head, tremors, impulsive behaviors, reduced attention span, and abnormalities of face, limbs, heart, and brain. –FAS is the third most common birth defect in the United States. © 2015 Pearson Education, Inc.

27. Alcohol and Pregnancy © 2015 Pearson Education, Inc.

28. Drinking and Driving Thirty-one percent of all traffic fatalities in 2010 were alcohol related. Among college students, 15.1 percent drink and drive. In 2010, there were 10,228 alcohol-impaired driving fatalities in the United States. –This represents one alcohol-related fatality every 51 minutes. The likelihood of a driver being involved in a fatal crash rises significantly with a BAC of 0.05 percent and even more rapidly after 0.08 percent. © 2015 Pearson Education, Inc.

29. Percentage of Fatally Injured Drivers with BACs Greater Than 0.08 percent, by Driver Age, 1982–2011 © 2015 Pearson Education, Inc.

30. Abuse and Dependence Alcohol use becomes alcohol abuse when it interferes with work, school, or social and family relationships, or when it entails law violations, including DUI. Alcoholism or alcohol dependence occurs when alcohol use is so severe that stopping alcohol results in withdrawal symptoms. Identifying an Alcoholic –Craving, loss of control, tolerance, psychological dependence, and withdrawal symptoms must be present to qualify a drinker as an addict. –About 15 percent of people in the United States are problem drinkers. –One study shows that 25 percent of college students meet the criteria for alcohol abuse or dependence in the past year. © 2015 Pearson Education, Inc.

31. The Causes of Alcohol Abuse and Alcoholism Biological and Family Factors –Higher rates of alcoholism occur among children of alcoholics. –Scientists have not identified an alcoholism gene. Social and Cultural Factors –Family attitudes People raised in cultures in which alcohol is part of religious or ceremonial activities are less prone to dependence than people raised where purchase is controlled and alcohol use is regarded as a rite of passage. © 2015 Pearson Education, Inc.

32. Women and Alcoholism Women become alcoholic at later ages and after fewer years of heavy drinking than do male drinkers. Women get addicted faster. Women have greater risks for cirrhosis; excessive memory loss and shrinkage of the brain; heart disease; and cancers of the mouth, throat, esophagus, liver, and colon. Risk factors include being unmarried but living with a partner; being in 20s or 30s, with a husband or partner who drinks heavily; family history; pressure to drink; depression and stress. © 2015 Pearson Education, Inc.

33. Alcohol and Prescription Drug Abuse Alcohol and prescription drugs taken together can cause –Alcohol poisoning –Unconsciousness –Respiratory depression –Death Opioids, stimulants, sedatives, and sleeping aids are most often combined with alcohol. © 2015 Pearson Education, Inc.

34. Costs to Society Alcohol-related societal costs are estimated to be over $223.5 billion when health insurance, criminal justice costs, treatment costs, and lost productivity are factored in. Alcoholism is directly or indirectly responsible for over 25 percent of the nation's medical expenses and lost earnings. Underage drinking costs $61.9 billion annually. –Costs include violence, drunk driving, high- risk sex, property crime, and addiction treatment. © 2015 Pearson Education, Inc.

35. Treating Alcoholism Alcoholics who decide to quit will experience detoxification and may experience the following withdrawal symptoms: –Hyperexcitability –Confusion – Agitation – Sleep disorders – Convulsions – Hand tremors – Depression – Headache – Seizure – Possible delirium tremors (DTs) Treatment programs include –Private facilities –Therapy © 2015 Pearson Education, Inc.

36. Relapse Success rates vary, but over half of alcoholics relapse within the first 3 months of treatment. –Treatment requires more than drinking cessation. There must be a guard against relapse. Identifying situations that could result in relapse, such as becoming angry, frustrated, being around drinkers, being pressured to drink, must be identified. Joining a support group helps. Effective recovery programs help addicts create self-esteem and resume personal growth. © 2015 Pearson Education, Inc.

37. Tobacco Use in the United States Nearly 443,000 Americans die annually of tobacco-related diseases. Another 10 million suffer tobacco-induced health disorders. Tobacco causes about 20 diseases, and about half of all regular smokers die of smoking-related diseases. © 2015 Pearson Education, Inc.

38. Tobacco and Social Issues Advertising –$36 million is spent daily on advertising and promotion. –Ninety percent of adults who smoke started by age 21, and half became regular smokers by age 18. Financial Costs to Society –Tobacco use causes more than $193 billion in annual health-related economic issues. –For each smoker, the cost is about $3,100 per year. © 2015 Pearson Education, Inc.

39. Percentage of Population That Smokes (Age 18 and Older) among Select Groups in the United States © 2015 Pearson Education, Inc.

40. College Students and Tobacco Use Heavy tobacco marketing and advertising is aimed at students, but smoking among college students is declining. –Why do college students smoke? To relax or reduce stress To fit in/social pressure Because of addiction –Social smoking Many students identify themselves as social smokers: those that smoke only around other smokers. This can lead to dependence and all the same health risks as smoking regularly. © 2015 Pearson Education, Inc.

41. Tobacco and Its Effects Nicotine –Highly addictive, psychoactive substance –CNS stimulant Tar and Carbon Monoxide –Tar is the carcinogenic particulate matter. –Nicotine paralyzes cilia, which become unable to clear out tar. –Carbon monoxide is a deadly gas that reduces the oxygen-carrying capacity of red blood cells. Tobacco Addiction –Nicotine poisoning © 2015 Pearson Education, Inc.

42. Trends in Prevalence of Cigarette Smoking in the Past Month among College Students © 2015 Pearson Education, Inc.

43. Tobacco Products Cigarettes –Filtered cigarettes may deliver more hazardous gases. –Switching to low-tar or low-nicotine is self-defeating because the smoker may smoke more. –Clove cigarettes contain 60 percent tobacco. Cigars –Contain 23 poisons and 43 carcinogens. Bidis –Produce three times more carbon monoxide and nicotine and five times more tar than do cigarettes. © 2015 Pearson Education, Inc.

44. Tobacco Products (cont.) Pipes and Hookahs –Water pipes may cut down on throat irritation. –The main ingredient in hookahs is tobacco. –A hookah does not filter out harmful chemicals found in tobacco smoke. Smokeless tobacco –Chewing tobacco Dipping rapidly releases nicotine into the bloodstream. –Snuff Can be inhaled, chewed, or placed against the gums. Smokeless tobacco is just as addicting as cigarette smoking. © 2015 Pearson Education, Inc.

45. Health Hazards of Tobacco Products— Cancer Lung cancer is the leading cause of cancer death. –Of lung cancers, 85–90 percent are caused by smoking tobacco. It can take 10–30 years to develop, and most cases are not diagnosed until the cancer has spread. –Five-year survival rate is only 16 percent. Smoking just one cigar a day can double the risk of several cancers. Chewing tobacco is responsible for the majority of new oral cancers, which can begin as leukoplakia. –Warning signs include lumps in the jaw or neck, color changes or lumps inside the lips, white smooth or scaly patches in the mouth or neck, lips or tongue; a red spot or sore on the lips, gums, or inside the mouth that does not heal in 2 weeks. Other tobacco-induced cancers include pancreatic, kidney, bladder, lip, tongue, esophagus, and larynx © 2015 Pearson Education, Inc.

46. Effects of Smoking on the Body and Health © 2015 Pearson Education, Inc.

47. Health Hazards of Tobacco Products— Cardiovascular Disease Smokers have a 70 percent higher death rate from heart disease than do nonsmokers. Daily cigar smoking doubles the risk of heart attack and stroke. Smoking contributes to heart diseases by adding the equivalent of 10 years of aging to the arteries. Smokers are twice as likely to suffer strokes. © 2015 Pearson Education, Inc.

48. Lung Damage from Chemicals in Tobacco Smoke © 2015 Pearson Education, Inc.

49. Health Hazards of Tobacco Products (cont.) Respiratory Disorders –Chronic bronchitis –Emphysema Sexual Dysfunction and Fertility Problems –Males are more likely to suffer impotence than are nonsmokers. –Women are likely to suffer infertility, problems with pregnancy, and problems for the child after birth. Unique Risks for Women Smokers are 26 times more likely to die from lung cancer than are nonsmokers. © 2015 Pearson Education, Inc.

50. Health Hazards of Tobacco Products (cont.) Unique Risks for Women (cont.) –Higher rates of osteoporosis, depression, and thyroid-related diseases. –Increased risk for blood clots, especially in smoking women who take birth control pills. –Heavier menstrual bleeding, longer duration of cramps, less predictable length of menstrual cycle. © 2015 Pearson Education, Inc.

51. Health Hazards of Tobacco Products (cont.) Other Health Effects –Gum disease, macular degeneration, premature skin wrinkling, staining of the teeth, yellowing of fingernails, and bad breath. –Nicotine speeds up the process by which the body uses and eliminates drugs, making medication less effective. –Smoking significantly increases the risk for Alzheimer's disease. © 2015 Pearson Education, Inc.

52. Environmental Tobacco Smoke (ETS) Mainstream—smoke drawn through tobacco while inhaling. Sidestream—smoke from the burning end of a cigarette or smoke exhaled by a smoker –Contains twice as much tar and nicotine, 5 times more carbon monoxide, and 50 times more ammonia than mainstream smoke. –Causes more deaths a year than any other environmental pollutant. Every year, ETS is estimated to be responsible for 3,400 lung cancer deaths, 46,000 coronary and heart disease deaths, and higher risk of SIDs deaths in newborns. © 2015 Pearson Education, Inc.

53. Tobacco Use and Prevention Policies It has been over 40 years since the government recognized the hazards of tobacco use. In 1998, the tobacco industry reached a Master's Settlement Agreement with 40 states. The Family Smoking Prevention and Tobacco Control Act (2009) forbids advertising geared to children, forbids nicotine reduction, and bans sweetened cigarettes. Smokeless tobacco ads must have a warning that fills 20 percent of the advertising space. Cigarette packages were required to have bigger, stronger warnings, but lawsuits by tobacco companies prevented their implementation in 2012. © 2015 Pearson Education, Inc.

54. Quitting Smoking Breaking the Nicotine Addiction –Seventy percent attempt to quit each year. –Only between 4 and 7 percent succeed. –Options include going "cold turkey," gradual reduction, short-term programs based on behavior modification and a system of rewards, and treatment centers. –Combining several approaches has the most promise. © 2015 Pearson Education, Inc.

55. Coping Strategies for Common Smoking Withdrawal Problems © 2015 Pearson Education, Inc.

56. Quitting (cont.) Breaking the Nicotine Addiction Symptoms of withdrawal include irritability, restlessness, nausea, vomiting, and intense craving for tobacco. Nicotine Replacement Products –Nicotine chewing gum –Nicotine patches –Nasal spray –Nicotine inhaler –Smoking cessation medications © 2015 Pearson Education, Inc.

57. ABC News Video: Do Nicotine Patches and Gum Work? Discussion Questions What impacts have state and national laws had on rates of smoking? How involved should the state be in regulating smoking and/or making it difficult for people to smoke? New York is discussing increasing the age for people to purchase cigarettes to 21. Discuss reasons to support the increase in age, and discuss reasons why the state should not increase the age to 21. © 2015 Pearson Education, Inc.

58. When Smokers Quit © 2015 Pearson Education, Inc.

59. Quitting Smoking (cont.) Benefits of Quitting –Many tissues will repair themselves, according to the American Cancer Society. –Circulation and the senses of taste and smell improve within weeks. –Risk of heart attack falls by half after only 1 year without smoking. –Can save about $2,184 per year. © 2015 Pearson Education, Inc.