© 2012 McGraw-Hill Companies, Inc. All rights reserved.McGraw-Hill/Irwin © 2012 McGraw-Hill Companies, Inc. All rights reserved.

Health Psychology 8th edition

Shelley E. Taylor

Chapter Five:

Health-Compromising Behaviors: Alcoholism and

Smoking

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Characteristics of Health-Compromising Behaviors

Many of these behaviors share a window of vulnerability in adolescence:- drinking to excess

- smoking

- using illicit drugs

- having unsafe sex

- using risk-taking behaviors

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Health-Compromising Behavior (cont.)

- behaviors are tied to the peer culture- image of these behaviors as “cool”- behaviors, though dangerous, are pleasurable- behaviors develop gradually- substance abuse of all kinds is predicted by

some of the same factors- most problem behaviors more common in

lower SEC individuals

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Substance DependencePhysical dependence:

- body adjusts to substance and incorporates its use into normal functioning of the body’s tissues

Tolerance:

- larger doses needed to produce same effects

Craving:

- conditioning process is involved so that environmental cues trigger intense desire

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Substance Dependence (cont.)

Addiction:- person has become physically or psychologically

dependent on a substance following use over a period of time

Withdrawal:- unpleasant symptoms, both physical and

psychological, that people experience when

they stop using a substance on which theyhave become dependent

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Alcoholism and Problem Drinking

Scope of the problem:- third leading cause of preventable death- more than 20% of Americans drink at levels that

exceed government recommendations- alcohol consumption is linked to high blood

pressure, stroke, cirrhosis of the liver, fetalalcohol syndrome and some cancers

- 41% of traffic-related deaths related to alcohol- many drinkers keep their problem hidden

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Alcoholism and Problem Drinking (cont.)

Alcoholism:- physical addition to alcohol

- withdrawal symptoms when abstaining from alcohol

- high tolerance for alcohol

- little ability to control drinking

Problem drinking:- may not have all symptoms listed above, but do have

substantial social, psychological and medical

problems resulting from alcohol

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Alcoholism and Problem Drinking (cont.)

Origins of alcoholism and problem drinking:- genetic, gender, physiological, behavioral

and sociocultural factors are involvedDrinking and stress:

- drinking buffers stress, reduces negative emotions, lowers anxiety

Social origins of drinking:- two windows of vulnerability:

- dependence starting between 12 and 21 years

- late middle age

- depression and alcoholism may be linked

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Alcoholism and Problem Drinking (cont.)

Treatment of alcohol abuse:- 10 to 20% of alcoholics stop drinking on their

own

- 32% of alcoholics can stop with minimal help

- some use of cognitive-behavioral modification

- without employment or social support, prospects

for recovery are dim

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Alcoholism and Problem Drinking (cont.)

Treatment programs:- self-help groups such as AA (Alcoholics

Anonymous)

- inpatient/outpatient programs:

- detoxification

- short-term, inpatient therapy

- continuing outpatient treatment

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Alcoholism and Problem Drinking (cont.)

Treatment programs (cont.):- cognitive-behavioral treatments:

- self-monitoring

- contingency contracting

- motivational enhancement

- medications

- stress management techniques

- family therapy and group counseling

- relapse prevention

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Alcoholism and Problem Drinking (cont.)

Evaluation of alcohol treatment programs:- success involves environmental factors,

outpatient services, family/social support

- minimal interventions:

- can make a dent in drinking-related problems

- social engineering

- banning alcohol advertising

- raising the legal drinking age

- strictly penalizing drunk driving

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Alcoholism and Problem Drinking (cont.)

Can recovered alcoholics ever drink again?

- Alcoholics Anonymous philosophy:

An alcoholic is an alcoholic for life

- Drinking in moderation seems possible for:

- young, employed problem drinkers

- those who have not been drinking for long

- those who live in supportive environments

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Alcoholism and Problem Drinking (cont.)

Preventive approaches to alcohol abuse:- appealing to adolescents to avoid drinking- social engineering programs

Drinking and driving:- pressure state and local governments for tougher alcohol control measures- hosts/hostesses/friends intervening to recognize those too drunk to drive- need for stiffer penalties- designated drivers

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Alcoholism and Problem Drinking (cont.)

Is modest alcohol consumption a health behavior?- modest alcohol intake (1-2 drinks/day) may add to

a long life- coronary artery disease may be reduced

- HDL (“good” cholesterol) may increase- fewer strokes

- moderate drinking among younger adults may enhance risks of death, probably due to alcohol-related injuries

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Smoking- single greatest cause of preventable death- in the U.S., accounts for about 1 in 5 deaths- increases the risk of many diseases and disorders- smokers are generally less health-conscious than

non-smokers- dangers not confined to the smoker; hazards of

secondhand smoke- may lower cognitive performance in adolescents

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Smoking (cont.)Synergistic effects of smoking:

- smoking enhances the impact of other risk factors in compromising health:

- smoking and stress can interact in dangerous ways- weight and smoking can interact to increase

mortality- smokers engage in less physical activity- smoking is considered a potential cause of

depression, especially among youth- smoking is related to an increase in anxiety among

adolescents

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Smoking (cont.)A brief history of the smoking problem:

- considered sophisticated and a “manly” habit- 1940s

- large numbers of women smoke- 1955 – 53% of the adult male population was smoking - 1964

- first U.S. Surgeon General’s warning is issued- 2008 – 20% of adults smoke

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Smoking (cont.)Why do people smoke?

- genetics: smoking runs in families

- Factors associated with smoking in adolescents:- 22% of high school students already

smoke- peer and family influences- self-identity and smoking- Nicotine addiction and smoking

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Smoking (cont.)Interventions to reduce smoking:

- changing attitudes toward smoking

- the therapeutic approach to the smoking problem:

- Nicotine replacement therapy

- multimodal interventions

- social support and stress management

- interventions with adolescents

- maintenance

- relapse prevention

- evaluation of interventions

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Smoking (cont.)

Brief interventions:

- work-site

- commercial programs and self-help

- public health approach

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Smoking (cont.)

Smoking prevention:- advantages of smoking prevention programs:

- potentially effective, cost-effective and

easily implemented

- social influence interventions:

- modeling

- McGuire’s behavioral inoculation

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Smoking (cont.)Evaluation of social influence programs:

- can reduce smoking rates for as long as 4years

The life-skills training approach:- encourage self-esteem and coping

enhancement as well as social skills in adolescents

- has shown success in the reduction of smoking onset over time

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Smoking (cont.)

Social engineering and smoking:

- liability litigation

- regulation of access of tobacco by the Food and Drug Administration

- heavy taxation

- restricting smoking to particular places

- the perils of secondhand smoke