Insel10ebrup Ppt Ch08

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  • Insel10ebrup Ppt Ch08

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

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