Chapter 8 Alcohol and Tobacco Use and Abuse

What's in a Cigarette?

- *50%* shredded tobacco leaf. - *30%* reconstituted tobacco (made from other parts of the tobacco plant, such as the stem). - *20%* expanded tobacco (tobacco that has been "puffed up" like popcorn and functions as "filler"). - Nearly *600 additives* with a wide range of functions. - Some additives are used to hide the taste of tobacco. - Ammonia boosts the delivery of nicotine into the lungs and bloodstream - *Nicotine* is an alkaloid derived from the tobacco plant that is responsible for smoking's psychoactive and addictive effects. - When a cigarette is smoked: -- It releases more than 60 *carcinogenic* (cancer-causing) chemicals. -- It releases arsenic, formaldehyde, hydrogen cyanide, benzene, and carbon monoxide. -- *Tar*—a sticky, thick brown residue—forms when tobacco is burned and its chemical particles condense.

Alcohol Absorption and Metabolism

- *Absorption*: The process by which alcohol passes from the stomach or small intestine into the bloodstream. - *Metabolism*: The breakdown of food and beverages in the body to transform them into energy.

Alcohol Abuse

- *Alcohol abuse*: Drinking alcohol to excess, either regularly or on individual occasions, resulting in disruption of work, school, or home life and causing interpersonal, social, or legal problems. - *Alcoholism* (alcohol dependence): A physical dependence on alcohol to the extent that stopping drinking brings on withdrawal symptoms.

Alcohol

- *Alcohol* is a chemical substance that is toxic to the body. - *Ethyl alcohol* (ethanol) is the intoxicating ingredient in beer, wine, and distilled liquor. - Proof value is a measurement of alcoholic strength, corresponding to twice the alcohol percentage (13% alcohol equals 26 proof)

Binge Drinking

- *Binge drinking*: A pattern of drinking alcohol that results in a blood alcohol concentration of 0.08 or greater. - 5 or more alcoholic drinks within 2 hours for men. - 4 or more alcoholic drinks within 2 hours for women. - The binge drinking rate is highest among young adults aged 18-24. - is considered one of the most significant health risk behaviors among college students. - It is most common in athletes, sports fans, fraternity and sorority members, and extremely social students. - Alcohol is a factor in about 60% of fatal burn injuries, drowning, and homicides; 40% of fatal motor vehicle crashes; and 50% of severe trauma injuries and sexual assault. - Binge drinking can lead to drunk driving, violence, vandalism, risky sex, forced sex, and poor academic performance

Other Forms of Tobacco

- *Cigars*: Contain the same addictive, toxic, cancer-causing substances that cigarettes do. - *Clove cigarettes*: No evidence that they are any safer than cigarettes. - *Bidis*: Not safer than cigarettes. - *Smokeless spit tobacco*: Associated with an increased risk of cancer and leukoplakia. -- Leukoplakia: White spots on the mucous membranes in the mouth that may become cancerous. -- Frequently found in snuff and chew users in their 20s. - *Electronic/e-cigarettes*: Battery-operated devices that deliver nicotine in vapor form.

Intoxication

- Alcohol intoxication is the state of physical and/or mental impairment brought on by excessive alcohol consumption (BAC of 0.08% or greater). - In a basic sense, it is another term for being drunk. - Symptoms of intoxication vary depending on the individual - Symptoms of intoxication progress with increased BAC: - Relaxation and exhilaration (0.03%). - Decreased fine motor skills (0.06%). - Slowed reaction time, poor muscle control, slurred speech, and wobbly legs (0.09%). - Loss of self-restraint and impaired ability to reason (0.12%). - Blurred vision and unclear speech (0.15%). - Difficulty staying awake (0.18%). - Deep sleep or stupor (0.30%). - Deep coma and danger of death (0.50%).

Alcoholism

- At least three of the following symptoms during a one-year period: - Tolerance - Withdrawal symptoms - Loss of control - Desire or inability to quit - Overwhelming time commitment - Interference with life - Continued use Risk Factors for Alcoholism - Self-medicating is using alcohol or drugs to cope with sadness, grief, pain, or mental health problems. - Genetic, physiological, psychological, and social factors play a part in determining susceptibility: -- Having a parent who abused alcohol -- Low self-esteem -- Impulsiveness -- A need for approval -- Peer Pressure -- Chronic Stress

Alcohol Poisoning

- Dangerously high level of alcohol consumption, resulting in depression in the central nervous system, slowed breathing and heart rate, and compromised gag reflex. - Signs include mental confusion, vomiting, seizures, slow or irregular breathing, low body temperature, pale or bluish skin, and inability to rouse. - Call 911 immediately if a person you suspect of having alcohol poisoning: -- Is unconscious and you cannot rouse him or her. -- Has consumed other drugs. -- Is experiencing seizures. -- Is injured. -- Has a respiration rate of fewer than 8 breaths per minute. -- Is experiencing shallow or irregular breathing (10 seconds or more between breaths).

Alcohol and Sexual Activity

- Engaging in sexual intercourse while intoxicated can lead to: - Unplanned sexual activities (reported by 21% of college students who had too much to drink). - Lack of protection while having sex, leading to possible exposure to STDs such as AIDS or hepatitis B and unplanned pregnancy. -Heavy drinking increases a woman's likelihood of becoming a victim of sexual assault or date rape.

Why Do Some Students Smoke?

- Genetics. - Family and peer exposure. - Age at initiating smoking. - Psychosocial factors. - Desire to lose weight. - Role of media and advertising

Immediate Effects of Alcohol on the Body

- In addition to the effects of intoxication, other short-term effects can include: - Dehydration. - Gastrointestinal problems. - Sleep disturbances. - Alterations in the metabolic state of the liver and other organs. - *Hangover*: Withdrawal symptoms including headache and nausea caused by an earlier bout of heavy drinking

Alcohol and Pregnancy

- Ingesting alcohol during the first trimester of pregnancy can cause miscarriage. - *Fetal alcohol syndrome*: A pattern of mental and physical birth defects found in some children of mothers who drank excessively during pregnancy. -- Facial abnormalities -- Retarded growth -- Permanent intellectual and behavioral problems

Treatment Options and Dealing with Relapse

- Medications - Alcohol counseling or "talk therapy" - Self-help groups - Intensive treatment programs - Returning to drinking after a period of sobriety. - Experienced by up to 90% of drinkers when they first try to quit.

Treatments Options for Smoking

- Nicotine replacement therapies: Gum, inhalers, nasal sprays, lozenges, and patches. - Prescription drugs: Chantix and Zyban. - Residential, individual, or group therapy and education and support groups.

Blood Alcohol Concentration (BAC)

- The amount of alcohol present in blood, measured in grams of alcohol per deciliter of blood. - BAC can be affected by several factors: -- How much and how quickly you drink. -- What you drink. -- Sex, age, weight, and physical condition. -- Food intake. -- Medications

Secondhand Smoke (Environmental Tobacco Smoke)

- The smoke to which nonsmokers are exposed when someone has been smoking nearby. - It contains more than *250* chemicals known to be toxic or capable of causing cancer. - Some chemicals are present in higher concentrations in secondhand smoke than in the smoke inhaled by the smoker - A combination of sidestream smoke and mainstream smoke: - *Sidestream smoke* is smoke emanating from the burning end of a cigarette or pipe. - *Mainstream smoke* is exhaled smoke. Irritation of the eyes, nose, throat, and lungs. Chest pain, coughing, and production of excessive phlegm. Premature death and disease. Among nonsmokers, a 25-30% increased risk of heart disease. Lung cancer. Respiratory illness, including asthma, in children. Ear infections in children. Sudden infant death syndrome in some babies.

Smoking and Pregnancy

- When a pregnant woman smokes, so does her unborn baby. - Babies born to women who smoke are 2-3 times more likely to die of *sudden infant death syndrome* than babies born to women who don't smoke. - They are more likely to be born prematurely. - They are more likely to weigh less than 5.5 pounds at birth, increasing their risk for illness or death. - Smoking while pregnant has been linked to miscarriages and stillbirths

Long-Term Effects of Alcohol on the Body

Chronic, heavy use of alcohol has been linked to: - Cancer of the liver, breast, esophagus, mouth, larynx, and throat. - Neurological effects: Learning, memory, and brain damage. - Cardiovascular disease. -- Liver disease: -- Fatty liver -- Alcoholic hepatitis -- Alcoholic cirrhosis