Alcohol and Tobacco
Chapter 8
Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 2
Chemistry of Alcohol Psychoactive ingredient Depressant Ethyl Alcohol – only alcohol that can be consumed
Beer 3-6% alcohol by volume Malt Liquors 6-8% alcohol by volume Table wines 9-14% alcohol by volume
Fermenting Fortified wines 20% alcohol by volume
Sugar added Hard liquors 35-50% alcohol by volume
Distilling or fermented Proof Value
Two times the percentage concentration Ingestion
7 calories per gram 1 drink 14-17 grams or 100-120 calories
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Absorption
20% is rapidly absorbed from the stomach 75% is absorbed in the upper small
intestines Remain is absorbed along the GI track Absorption
Carbonation Food in the stomach slows the absorption Drink of high concentration slows absorption Eventually all the alcohol ingested will be
absorbed
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Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 5
Metabolism and Excretion
Transported throughout the body via the bloodstream.
Easily moves through most biological membranes
Main site for metabolism is the Liver. 2-20% of ingested alcohol is not
metabolized.
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Alcohol Intake and Blood Alcohol Concentration A measure of intoxication
Body weight Percentage of body fat Difference between women & men
Balance of alcohol absorbed and rate of metabolism Genetic factors Drinking Behavior Can not be effected by
Exercise Breathing deeply Eating Drinking coffee Taking other drugs
Metabolism is the same if the person is awake or asleep
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The Immediate Effects of Alcohol on Health
Dependant on the individual. Low Concentrations .03% -.05%. Higher Concentrations 0.1% -0.2%.
Concentration of .35%. Alcohol hangover Alcohol poisoning Using Alcohol with other drugs Alcohol-related injuries and violence Alcohol and sexual decision making
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Drinking and Driving
In 2004 250,000 were injured in alcohol related
automobile crashes 42,000 people are killed in alcohol related
accidents Dose-response function
Driving with a BAC of 0.14% is more than 40 times more likely to be involved in a crash.
Greater than 0.14% the risk of fatal crash is estimated to be 380 times higher
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Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 10
Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 11
The Effects of Chronic Use Diseases of the digestive, cardiovascular systems and some
cancers Digestive system
Liver function liver cell damage and destruction (cirrhosis) Cirrhosis causes drinker to lose Tolerance
Pancreas inflammation Cardiovascular system
moderate doses may reduce the risk of HD Higher doses elevates BP, may weaken heart muscle or cardiac
myopathy. Cancer Brain Damage Mortality
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Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 13
The Effects of Alcohol use During Pregnancy
Effects are dose-related. FAS Fetal Alcohol Syndrome
Occurs in 1 or 2 out of every 1000 live births in the U.S.
Under weight, flat nasal bridge, and long upper lip. Small and have heart defects. Physical and mental growth is slow.Remain mentally
impaired. Fine motor skill problems, coordination, learning and behavioral problems (ADS).
ARND Alcohol-related neurodevelopment disorder.
Heavier drinking early in pregnancy.
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Possible Health Benefits of Alcohol
Abstainers and light to moderate drinkers live longer than heavy users.
35 years old and younger, your odds of dying increase in proportion to the amount consumed
Moderate drinking = one drink per day for women and two drinks per day for men. May lower coronary heart disease. Raising blood levels of HDL. May lower risks of; diabetes, arterial blockages,
Alzheimer’s
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Alcohol Abuse and Dependence Alcohol abuse is recurrent use that has
negative consequences. Alcohol dependence or Alcoholism more
extensive problems, tolerance and withdrawal Warning signs of alcohol abuse
Drinking alone Using deliberately and repeatedly Feeling uncomfortable on certain occasions Escalating consumption Getting drunk regularly Drinking in the morning or unusual times
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Alcohol Abuse and Dependence
Binge Drinking Having five drinks in row for a man or four
in a row for a women. Frequent binge drinking in college were
three to seven times more likely than non-binge drinkers to engage in unplanned or unprotected sex
Healthy People 2010 Reduce the rate of binge drinking to 20%
among college students
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Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 18
Alcoholism
Patterns and Prevalence Regular daily intake of large amounts Regular heavy drinking limited to weekends Long periods of sobriety interspersed with binges or daily
heavy drinking Heavy drinking limited to periods of stress
Health Effects DTs (delirium tremens) paranoia
Social and Psychological effects Causes of Alcoholism
Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 19
Treatment Programs
Not one program works for everyone. AA.
12-step program Al-Anon. Employee Assistance. Inpatient hospital rehabilitation Pharmacological treatments.
Disulfiram (Antabuse) Naltrexone Acamprosate (Campral)
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Gender and Ethnic Differences
Men White American men “Other men”
Women African Americans Latinos Asian Americans American Indians and Alaska Natives
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Promote Responsible Drinking In Others
Encourage responsible attitudes Be a responsible host Hold the drinker responsible Learn about prevention programs Take community action
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Why People use Tobacco
70 Million Americans, nearly 4 million adolescents Nicotine Addiction
Powerful psychoactive drug Reaches Brain via bloodstream in seconds Most physically addictive of the psychoactive
drugs. Loss of control Tolerance and Withdrawal
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Why Start in the First Place?
Between 2001-2005 high school use has declined. 28.5% to 23%
Children and teenagers make-up 90% of all new smokers in this country.
Estimated 4000 children and adolescents (12-17) start smoking.
Average age 13 for smoking 10 for spit tobacco
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Listening to Advertising
2003, Tobacco spends nearly $15 billion per year. Most heavily advertised brands
Marlboro Camel Newport
90% of teens prefer the top three most advertised brands.
Joe Camel is more familiar than Mickey Mouse. More than 90% of 6-year-olds recognized the character
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Who Uses Tobacco?
Characteristics which could increase the potential for use. A parent or sibling uses tobacco Peers use tobacco Child comes from blue-collar family Child comes from low-income home Single parent. Performs poorly in school Child drops out of school Has positive attitudes towards tobacco
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Health Hazards
Contains hundreds of damaging chemical substances
Unfiltered cigarettes = 5 billion particles per cubic MM
50,000 times more than polluted urban air Condensed particles in the cigarette produce
the tar
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Health Hazards (cont)
Carcinogens and Poisons 43 chemicals are linked to cancer (Carcinogen)
Benzo(a)pyrene Urethane
Cocarcinogens Combine with other chemicals to cause cancer
Poisonous substances Arsenic Hydorgen cyanide
Carbon monoxide 400 times greater than is considered safe in industrial workplaces Displaces oxygen in red blood cells
Additives Nearly 600 chemicals
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Health Hazards (cont) Cardiovascular Disease
Coronary Heart Disease (CHD)AtherosclerosisAngina pectorisMyocardial infarctionStrokeAortic aneurysmPulmonary heart disease
Lung and other cancers Chronic Obstructive Lung Disease
EmphysemaChronic Bronchitis
Other Respiratory Damage
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Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 31
Additional Health, Cosmetic, and Economic Concerns
Ulcers Impotence Reproductive health problems Dental diseases Diminished physical senses Injuries Cosmetic concerns Economic costs
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Cumulative Effects
Males before 15 yrs. old are half as likely to live to 75 versus those who did not smoke
Females with similar habits reduce life expectancy by more than 10 years
Female smokers spend 17% more sick days in bed than nonsmokers
Both men and women show a greater rate of acute and chronic diseases
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Other Forms of Tobacco
Spit (Smokeless) Tobacco More than 6.5 million adults
Cigar and Pipes Cigar smoking has increased by 50% since 1993
Clover cigarettes and Bidis Twice the tar, nicotine, and carbon monoxide
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The Effects of Smoking on the Nonsmoker
Environmental Tobacco smoke (ETS) EPA - 1993 – Class A Carcinogen Department of Health and Human Services’
National Toxicology Program - 2000 - “known human carcinogen”
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Environmental Tobacco Smoke
Second hand smoke Mainstream smoke Sidestream smoke Twice the tar and nicotine Three times the benzo(a)pyrene Three times the ammonia 85% of smoke in a room is second hand Smoke from a cigar can be even more dangerous
30 times more carbon monoxide
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ETS Effects
Develop cough, headaches, nasal discomfort, eye irritation, breathlessness and sinus problems
Allergies will be exacerbated 24-50% increase in lung cancer risk Causes 3,000 deaths due to lung cancer Contributes to about 35,000 overall deaths Contributes to increased Asthma attacks
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Infants, Children, and ETS
More likely to developBronchitis, pneumonia,& respiratory infections
More complications from asthma
Increased chance of SIDS
Low-birth weight
Bronchitis
Chemicals from smoking show up in breast milk Children inhale three times more pollutants per unit
of body weight than adults.
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Avoiding ETS
Speak up tactfully Display reminders Don’t allow smoking in your home or room Open a window Sit in the nonsmoking section Fight for a smoke-free environment Discuss quitting strategies
Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 39
Smoking and Pregnancy
Estimated 4600 infant deaths in the U.S. Miscarriage, premature birth, low birth
weight, long term impairments in growth and intellectual development
Possible higher risks of getting cancer 11% of pregnant women smoke 14% of female smokers quit while pregnant
Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 40
Cost of Tobacco Use to Society
Health care costs exceed $75 billion per year. Lost productivity from sickness, disability, and
premature death makes it closer to $157 Billion per year.
1998 Master Settlement Agreement (MSA) Tobacco companies have to pay $206 billion over
25 years
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What Can Be Done?
Local laws State and Federal laws International Action Private sector Individual Action
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Quitting
Since 1964 - 50% of all adults who have smoked have quit.
Benefits of quitting Options for quitting
Smoking cessation programs Smoking cessation products
Chantix (Varinicline) Zyban (Bupropion)
Nicotine replacement products Patches, gums, lozenges, nasal sprays, and inhalers
Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 43
Alcohol and Tobacco
Chapter 8