1. Chapter 8 Alcohol, Caffeine, and Tobacco Alcohol, Caffeine, and Tobacco

2. Alcohol Overview Overview 65% of Americans consume alcohol65% of Americans consume alcohol 10% are heavy drinkers10% are heavy drinkers Alcohol and college students Alcohol and college students 70% of college students consumed alcohol in the last year70% of college students consumed alcohol in the last year 1/2 are classified as heavy drinkers1/2 are classified as heavy drinkers Many students have a misperception about “normal drinking” behavior, and believe their peers drink more than they actually do.Many students have a misperception about “normal drinking” behavior, and believe their peers drink more than they actually do.

3. > Table 8.1

4. Binge Drinking Binge Drinking and College Students Binge Drinking and College Students What is binge drinking?What is binge drinking? On one single occasion:On one single occasion: 5 drinks in a row for a man 5 drinks in a row for a man 4 drinks in a row for a woman 4 drinks in a row for a woman 1700 students die annually due to preventable alcohol related injuries1700 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. 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. 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. 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 Chemical Makeup Ethyl alcohol, aka ethanolEthyl alcohol, aka ethanol Produced through fermentation processProduced through fermentation process produces beer or wineproduces beer or wine Yeast breaks down plant sugars until solution reaches 14 % alcoholYeast breaks down plant sugars until solution reaches 14 % alcohol Manufacturers then add ingredients to dilute drinkManufacturers then add ingredients to dilute drink Distillation – further processingDistillation – further processing Alcohol vapors are released from the solution at high temperaturesAlcohol vapors are released from the solution at high temperatures Vapors are condensed and mixed with water for the final productVapors are condensed and mixed with water for the final product Proof – measure of the percent alcoholProof – measure of the percent alcohol Example: 80 proof whiskey = 40% alcohol Example: 80 proof whiskey = 40% alcohol

7. Alcoholic Beverages and Their Alcohol Equivalencies > > Figure 8.1

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

9. > Table 8.2

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

11. Alcohol Poisoning Alcohol Poisoning Alcohol Poisoning Death from alcohol Death from alcohol Large amount of alcohol in short amount of time.Large amount of alcohol in short amount of time. Two ways this happens Two ways this happens 1) CNS and respiratory depression1) CNS and respiratory depression 2) Inhalation of vomit or fluid into the lungs2) Inhalation of vomit or fluid into the lungs Signs of alcohol poisoning Signs of alcohol poisoning Inability to be rouses Inability to be rouses Weak, rapid pulse Weak, rapid pulse Irregular breathing pattern Irregular breathing pattern Cool, pale, bluish skin Cool, pale, bluish skin Call 911 Call 911

12. Physiological and Behavioral Effects of Alcohol Immediate Effects of Alcohol Immediate Effects of Alcohol Reduces frequency of nerve transmissionsReduces frequency of nerve transmissions DehydrationDehydration Water is lost from cerebrospinal fluidWater is lost from cerebrospinal fluid Alcohol irritates the gastrointestinal systemAlcohol irritates the gastrointestinal system Hangovers – result from decreased CSF and dehydrationHangovers – result from decreased CSF and dehydration Congeners – forms of alcohol metabolized more slowly, play role in hangoversCongeners – forms of alcohol metabolized more slowly, play role in hangovers Be informed of drug and alcohol interactionsBe informed of drug and alcohol interactions

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

14. A normal liver and a liver with cirrhosis

15. Alcohol and Pregnancy Alcohol can harm fetal developmentAlcohol can harm fetal development Even a single exposure to high levels can cause damageEven a single exposure to high levels can cause damage Fetal Alcohol Syndrome (FAS)Fetal Alcohol Syndrome (FAS) Mental retardation, small head, tremors, and abnormalities of face, limbs, heart, and brain Mental retardation, small head, tremors, and abnormalities of face, limbs, heart, and brain FAS is the 3 rd most common birth defect in the United States FAS is the 3 rd most common birth defect in the United States

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

17. Drinking and Driving Facts Facts 39% of all traffic fatalities are alcohol related39% of all traffic fatalities are alcohol related Many college students drink and driveMany college students drink and drive In 2005, 16,885 alcohol related fatalities (ARTFs)In 2005, 16,885 alcohol related fatalities (ARTFs) One ARTF every 30 minutes One ARTF every 30 minutes At BAC 0.10, ten times more likely to be in an accidentAt BAC 0.10, ten times more likely to be in an accident Current limit for BAC in all 50 states: 0.08%Current limit for BAC in all 50 states: 0.08%

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

19. Alcohol Abuse and Alcoholism Causes Causes Biological and family factorsBiological and family factors Social and cultural factorsSocial and cultural factors Family attitudesFamily attitudes UrbanizationUrbanization Weakening of family linksWeakening of family links Combination of heredity and environmentCombination of heredity and environment

20. Alcohol Abuse and Alcoholism Effects of Alcoholism on the Family Effects of Alcoholism on the Family 1 in 4 children live in an alcoholic situation1 in 4 children live in an alcoholic situation Dysfunctional familiesDysfunctional families Family rules: “Don’t talk, don’t trust, don’t feel.” Family rules: “Don’t talk, don’t trust, don’t feel.” Children often assume at least one of the following roles:Children often assume at least one of the following roles: Family hero: Try to divert attention by being a good kid Family hero: Try to divert attention by being a good kid Scapegoat: Draw attention away from problem by causing other problems Scapegoat: Draw attention away from problem by causing other problems Lost child: Passive and withdrawing Lost child: Passive and withdrawing Mascot: Comic releif Mascot: Comic releif

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

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

23. Our Smoking Society Smoking Facts Smoking Facts Single most preventable cause of deathSingle most preventable cause of death 440,000 Americans die a year440,000 Americans die a year 50 times that of illegal drug deaths50 times that of illegal drug deaths Teen smokers = 21.8%Teen smokers = 21.8% Advertising Advertising Spends $18 million per daySpends $18 million per day Children and teens constitute 90% of new smokersChildren and teens constitute 90% of new smokers 18- to 24-year-olds new target18- to 24-year-olds new target

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

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

26. Tobacco and Its Effects Physiological Effects of Nicotine Physiological Effects of Nicotine Stimulates CNSStimulates CNS Stimulates adrenal glandsStimulates adrenal glands Increases production of adrenalineIncreases production of adrenaline Increases heart rateIncreases heart rate Increases respiratory rateIncreases respiratory rate Constricts vesselsConstricts vessels Increases blood pressureIncreases blood pressure Nicotine is the main addictive substance in tobaccoNicotine is the main addictive substance in tobacco

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

28. Tobacco and Its Effects Health Hazards of Smoking Health Hazards of Smoking CancersCancers Lung 85-90% associated with smoking Lung 85-90% associated with smoking Pancreatic Pancreatic Lip Lip Esophagus Esophagus Tongue Tongue Cardiovascular DiseaseCardiovascular Disease Smokers have 70% higher death rate Smokers have 70% higher death rate StrokeStroke Smokers are 2 times more likely to suffer Smokers are 2 times more likely to suffer

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

30. Figure 8.4 How Cigarette Smoking Damages the Lungs

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

32. Environmental Tobacco Smoke (ETS) Tobacco and Politics Tobacco and Politics 40 years ago government recognized the hazard40 years ago government recognized the hazard States have imposed extra taxesStates have imposed extra taxes Tobacco control initiatives are increasingTobacco control initiatives are increasing

33. Quitting Breaking the Nicotine Addiction Breaking the Nicotine Addiction 1/3 attempt to quit a year1/3 attempt to quit a year 90% fail90% fail Many programs exist to help with quittingMany programs exist to help with quitting Nicotine withdrawal is experiencedNicotine withdrawal is experienced Nicotine Replacement Products Nicotine Replacement Products Nicotine chewing gumNicotine chewing gum Nicotine patchNicotine patch Nicotine nasal sprayNicotine nasal spray Nicotine inhalerNicotine inhaler

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

35. When Smokers Quit > Figure 8.5

36. Caffeine Caffeine Facts Caffeine Facts A drug derived from xanthinesA drug derived from xanthines Mild stimulant to CNSMild stimulant to CNS Increases heart rateIncreases heart rate Increases oxygen consumptionIncreases oxygen consumption Does not cause dehydrationDoes not cause dehydration Increases wakefulnessIncreases wakefulness

37. Caffeine Side Effects of Caffeine Side Effects of Caffeine Insomnia in someInsomnia in some Irregular heart beatIrregular heart beat DizzinessDizziness NauseaNausea IndigestionIndigestion Mild deleriumMild delerium AnxietyAnxiety

38. > Table 8.4

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