Alcohol and Tobacco
Learning Objectives 1) Describe the patterns of alcohol use, and the health risks and social problems that can result from alcohol use, abuse, and dependence 2) Explain treatment approaches for alcohol abuse and dependence 3) Discuss the patterns of tobacco use in the U.S. and the substances in forms of tobacco products 4) Understand the physical and psychological reasons for tobacco use 5) Describe various treatment options available for quitting tobacco 6) Give examples of current strategies to confront tobacco use
Patterns of Alcohol Use Ø About 65% of American adults drink at least occasionally Ø 35% of the adult U.S. population are abstainers Ø Of the two-thirds who do consume alcohol, 28% are atrisk drinkers Ø Low-risk drinkers are men who drink no more than 14 drinks per week or women who drink no more than 7 drinks per week*
One drink is defined by the NIAAA as 0.5 ounce (or 15 grams) of alcohol
Why Do Some People Have Problems with Alcohol? Psychosocial factors Ø Family history of alcoholism Ø Family dysfunction in general Sociocultural/environmental factors Ø Cultural attitudes Ø Economic factors Ø Laws Ø Stresses
Drinking on the College Campus 79% of college students drink alcoholic beverages Binge drinking or heavy episodic drinking Extreme drinking Alcohol consumption beyond binge drinking 10 to 15 drinks a day for men and 8 to 12 for women
Possible Consequences of Binge Drinking Ø Physical injury Ø Assault Ø Sexual assault Ø Unsafe sex Ø Academic problems Ø Health problems Ø Jeopardizing career ambitions
Why Do College Students Binge Drink? Ø Ease of social inhibitions Ø Fit in with peers Ø Imitate role models Ø Reduce stress Ø Soothe negative emotions Ø Cope with academic pressure Ø Mistaken belief of increased sexual arousal and performance
Drinking on College Campuses Pre-gaming is the excessive consumption of alcohol prior to attending an event or activity in which alcohol will be served Ø Freshmen more likely to pre-game Spring break environment made to be conducive to excessive drinking Ø Collapse, sexual assaults, and unprotected sex are common
Addressing the Problem Ø Screening interviews to identify high-risk students Ø Enforcing college alcohol policies Ø Punishing students who violate policies or break the law Ø Mandating treatment for substance-related offenses Ø Educating students to resist peer pressure Ø Helping students cope with stress and time management issues Ø Targeting prevention messages to high-risk events
The District policy states that all use of alcoholic beverages or any other illicit drugs or controlled substances is prohibited on District property and at any college sponsored or related activity regardless of its location. These include activities in which school funds are used and/or the club or organization is representing Riverside Community College District. See Board Policies 3560 Alcoholic Beverages and 3550 Drug Free Environment.
The Path of Alcohol
Alcohol Absorption Ø Food in the stomach Ø Gender Ø Age Ø Body fat Ø Drug interaction Ø Cigarette smoke Ø Mood and physical condition Ø Alcohol concentration Ø Carbonation Ø Diet soda Ø Tolerance
Alcohol Metabolism Ø A small amount of alcohol is metabolized in the stomach; however, 90% is metabolized by the liver Ø Between 2% and 10% is not metabolized at all but is excreted unchanged through the skin, urine, or breath Ø The liver allows conversion of alcohol to acetaldehyde by an enzyme, alcohol dehydrogenase (ADH)
Alcohol Metabolism Blood alcohol concentration (BAC): the amount of alcohol in grams in 100 milliliters of blood, expressed as a percentage (DUI: driving over.08%) Ø Alcohol concentrations in the breath correspond well to levels of alcohol in the blood/ Breath analyzers Ø The amount of body water and body fat a person has influences the BAC levels in the body
Gender Differences in Alcohol Absorption and Metabolism Women are generally more susceptible to the effects of alcohol and have a higher BAC than men do based on the following: Ø Ø Ø Generally smaller than men Higher body fat percentage Metabolize alcohol less efficiently More vulnerable to health consequences such as: Ø Liver disease Ø Heart disease Ø Brain damage
Effects of Alcohol on the Body
Effects of Alcohol on the Body Ø Alcohol is quickly distributed to all the cells of the body Ø Once it reaches the brain, alcohol alters brain chemistry and neurotransmitter functions Ø Alcohol is a central nervous system depressant that impairs thinking, balance, and motor functions Ø As alcohol concentrations increase, more functions are depressed, and greater impairment occurs
Medical Problems Associated with Alcohol Use Fetal alcohol syndrome (FAS): set of birth defects associated with use of alcohol during pregnancy Heart disease and stroke Ø Alcoholic cardiomyopathy Ø Coronary heart disease Liver disease Ø Fatty liver: liver swells with fat globules Ø Alcoholic hepatitis: inflammation of the liver Ø Cirrhosis: scarring of the liver
Ø Alcohol is associated with several types of cancer, particularly cancers of the head and neck, cancers of the digestive tract, and breast cancer Ø Heavy alcohol consumption causes anatomical changes in the brain and directly damages brain cells Ø Recent studies suggest that alcohol abuse causes dysfunction in lung cells Ø Long-term heavy drinkers are at risk for weight loss and malnutrition Ø Drunkorexia: excessive alcohol consumption, excessive exercising, and disordered eating
Acute alcohol intoxication Life-threatening blood alcohol concentration which can produce collapse of vital body functions Blackout Period of time during which a drinker is conscious but has partial or complete amnesia for events Hangover Result of a common reaction to alcohol toxicity characterized by headache, stomach upset, thirst, and fatigue
Social Problems Associated with Alcohol Use Ø Reduction of inhibitions, which may lead to high-risk sexual activity and a lowered likelihood of practicing safe sex Ø Violence, including robbery, assault, rape, domestic violence, and homicide Ø Risk of injury Ø Drunk driving Ø Alcoholism Ø Suicide risk
Another View: Health Benefits The Dietary Guidelines for Americans notes that moderate alcohol consumption can be beneficial Ø Anticlotting effect on the blood Ø Enhances body s sensitivity to insulin Ø Stress reduction Ø Diuretic effect of high water content in beer Ø Increase in HDL In younger adults, alcohol appears to have fewer if any health benefits and is associated with more deaths, injuries, and accidents
Alcohol Misuse, Abuse, and Dependence Problem drinking: pattern of alcohol use that impairs the drinker s life, causing difficulties for the drinker and for others Alcohol abuse: pattern of alcohol use that leads to distress or impairment, increases the risk of health and/or social problems, and continues despite awareness of effects Alcohol dependence or Alcoholism: disorder characterized by a strong craving for alcohol, development of tolerance for alcohol, and withdrawal symptoms
Brief interventions/ Counseling sessions Focus on skills and knowledge development Aware of consequences of alcohol Develop strategies for change Inpatient and outpatient treatment Residential facilities specializing in alcohol recovery Ø Detoxification and withdrawal Ø Medications Ø Counseling Treatment Options Self-help programs Support groups (Alcoholics Anonymous, AA)
The harm reduction approach to treatment focuses on reducing the harm associated with drinking, both to the individual and to society Controlled drinking, which emphasizes moderation rather than abstinence, is an example of harm reduction