Chapter 8 Lecture
Drinking Alcohol
Responsibly and
Ending Tobacco
Use
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LEARNING OUTCOMES (cont.)
•  Discuss the social and political issues involved in
tobacco use.
•  Explain the scope of tobacco use in the United
States.
•  Describe the health risks and physical impact
associated with using tobacco products.
•  Explain the dangers of environmental tobacco
smoke.
•  Assess the effectiveness of tobacco use and
prevention policies.
•  Describe methods and benefits of smoking
cessation.
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Alcohol: An Overview
•  Very low levels of alcohol, particularly red wine,
may lower some health risks in older adults.
•  Half of all Americans consume alcoholic
beverages regularly; about 21 percent abstain.
•  Men typically drink more regularly and drink
more than women.
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Alcohol and College Students
•  Approximately 62 percent of students report
having consumed an alcoholic beverage in the
past 30 days.
•  Of college students, 39 percent engage in binge
drinking. Binge drinking for men is consuming 5
or more drinks in about 2 hours; for women,
consuming 4 or more.
•  Alcohol use among college students disrupts
sleep, decreases alertness, and may affect
academic performance.
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College Students' Patterns of Alcohol Use in
the Past 30 Days
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High-Risk Drinking and College Students
•  Alcohol exacerbates risk for suicide, automobile crashes,
and falls.
•  Many college and university students' customs and
celebrations encourage certain dangerous practices and
patterns of alcohol use.
•  Advertising and promotions from the alcoholic beverage
industry heavily target university campuses.
•  Beer and other drink specials enable students to
consume large amounts of alcohol cheaply.
•  College students are more likely to drink recklessly.
•  College students are vulnerable to peer influence.
•  Administrators often deny that a problem exists.
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ABC News Video: Sloppy Spring
Breaker
Discussion Questions
•  Who should be held responsible in a potentially
dangerous situation that involves a visually intoxicated
woman and a male who attempts to take advantage of
her? (i.e., the bartender, her friends, herself)?
•  Would you feel responsible for helping a visually
intoxicated woman who is seemingly being taken
advantage of by a male patron at the bar? How would
you react in a similar situation to the ones in the video?
•  Discuss ground rules or ways to keep friends safe while
on spring break if one of your friends gets intoxicated.
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Prevalence of Negative Consequences of
Drinking among College Students, Past
Year
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Efforts to Reduce Student Drinking
•  Brief Alcohol Screening and Intervention for
College Students (BASICS) has been effective
for heavy-drinking students with already existing
or risk for problems related to alcohol.
•  E-intervention, electronically based alcohol
education interventions using text messages,
e-mails, and podcasts, and Alcohol e-Check Up
to Go (e-Chug) have shown promise in reducing
alcohol problems in first-year students.
•  A social norms approach to reduce alcohol
consumption is also used.
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Alcohol in the Body
The Chemistry and Potency of Alcohol
•  Ethyl Alcohol or Ethanol
–  The intoxicating substance in all alcoholic
beverages
•  Fermentation Process
–  Yeast organisms break down sugar.
•  Distillation
–  Alcohol vapors are released from the mash at
high temperatures.
•  Proof
–  Measure of the percent alcohol
•  80 proof whiskey = 40 percent alcohol
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What Is a Standard Drink?
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Absorption and Metabolism
•  About 20 percent of absorption occurs in the
stomach.
•  About 80 percent of absorption occurs in the
small intestine.
•  Factors that influence absorption
–  Concentration of the drink
–  Amount consumed
–  Food in the stomach
–  Mood
–  Pylorospasm (spasm of valve)
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Absorption and Metabolism (cont.)
•  Alcohol contains 7 calories per gram.
•  The breakdown of alcohol is fairly constant at
about 0.5 ounce per hour (about one standard
drink.)
•  Unmetabolized alcohol circulates in the
bloodstream until enough time passes for the
body to break it down.
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Blood Alcohol Concentration (BAC)
•  Ratio of alcohol to total blood volume
•  The legal limit for BAC is 0.08 percent in all
states.
•  Both breath analysis (breathalyzer tests) and
urinalysis are used to determine whether an
individual is legally intoxicated, but blood tests
are more accurate.
•  Learned behavioral tolerance—even though
BAC may be quite high, the individual has
learned to modify his behavior to appear sober.
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The Psychological and Physical Effects of
Alcohol
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Blood Alcohol Concentration (BAC) (cont.)
•  A drinker's BAC depends on
–  Weight and body fat
–  The water content in the body tissues
–  The concentration of alcohol in the beverage
consumed.
–  Alcohol concentration is higher in people with
more body fat; women generally have more
body fat than men.
–  Women have half as much alcohol
dehydrogenase as men.
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Approximate Blood Alcohol Concentration
(BAC) and the Physiological and Behavioral
Effects
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Effects of Alcohol on the Body and Health
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Alcohol and Your Health Immediate and
Short-Term Effects of Alcohol
•  Alcohol depresses central nervous system
(CNS) functions.
•  Vital functions become noticeably affected, and
in extreme cases, coma and death can result.
•  Alcohol is a diuretic, but water is pulled out of
the cerebrospinal fluid, resulting in "morningafter" headaches.
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Immediate and Short-Term Effects of
Alcohol (cont.)
•  Alcohol irritates the gastrointestinal system.
•  Brief drinking sprees of high amounts increase
risk for irregular heartbeat or total loss of heart
rhythm.
•  Hangovers kick in for more than half of drinkers
when BAC reaches 0.11. But, 20–25 percent of
those who drink enough to reach that level do
not experience them.
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Immediate and Short-Term Effects of
Alcohol (cont.)
•  Alcohol is involved in approximately 70 percent
of fatal injuries during activities such as boating
and swimming.
•  Heavy drinking is associated with dating violence
•  One drink can add 100 calories to your daily
intake; adding 150 calories per day more than
you need can result in weight gain of 12 pounds
a year.
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Alcohol Poisoning
•  Acute alcohol intoxication can be fatal.
•  The amount of alcohol that causes
unconsciousness is dangerously close to a fatal
dose.
•  BAC continues to rise even after a drinker is
unconscious.
•  Signs include inability to be roused; weak, rapid
pulse; cool, pale, or bluish skin.
•  Call 9-1-1 immediately.
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Long-Term Effects of Alcohol
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Effects on the nervous system
Cardiovascular effects
Liver disease
Cancer
Other effects
–  Chronic inflammation of the pancreas
–  Blocked absorption of calcium
–  Reduced ability of the body to fight bacteria
and viruses.
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Comparison of a Healthy Liver with a
Cirrhotic Liver
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Alcohol and Pregnancy
•  Teratogenic substances cause birth defects; alcohol is
one of the most dangerous and common.
•  7.6 percent of children have been exposed to alcohol in
utero; 1.4 percent of pregnant women report binge
drinking.
•  Fetal alcohol syndrome (FAS)
–  Mental retardation, impaired learning, poor memory,
small head, tremors, impulsive behaviors, reduced
attention span, and abnormalities of face, limbs,
heart, and brain.
–  FAS is the third most common birth defect in the
United States.
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Alcohol and Pregnancy
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Drinking and Driving
•  Thirty-one percent of all traffic fatalities in 2010
were alcohol related.
•  Among college students, 15.1 percent drink and
drive.
•  In 2010, there were 10,228 alcohol-impaired
driving fatalities in the United States.
–  This represents one alcohol-related fatality
every 51 minutes.
•  The likelihood of a driver being involved in a fatal
crash rises significantly with a BAC of 0.05
percent and even more rapidly after 0.08
percent.
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Percentage of Fatally Injured Drivers with
BACs Greater Than 0.08 percent, by Driver
Age, 1982–2011
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Abuse and Dependence
•  Alcohol use becomes alcohol abuse when it interferes
with work, school, or social and family relationships, or
when it entails law violations, including DUI.
•  Alcoholism or alcohol dependence occurs when
alcohol use is so severe that stopping alcohol results in
withdrawal symptoms.
•  Identifying an Alcoholic
–  Craving, loss of control, tolerance, psychological
dependence, and withdrawal symptoms must be
present to qualify a drinker as an addict.
–  About 15 percent of people in the United States are
problem drinkers.
–  One study shows that 25 percent of college students
meet the criteria for alcohol abuse or dependence in
the past year.
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The Causes of Alcohol Abuse and
Alcoholism
•  Biological and Family Factors
–  Higher rates of alcoholism occur among
children of alcoholics.
–  Scientists have not identified an alcoholism
gene.
•  Social and Cultural Factors
–  Family attitudes
•  People raised in cultures in which alcohol is part of
religious or ceremonial activities are less prone to
dependence than people raised where purchase is
controlled and alcohol use is regarded as a rite of
passage.
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Women and Alcoholism
•  Women become alcoholic at later ages and after
fewer years of heavy drinking than do male
drinkers.
•  Women get addicted faster.
•  Women have greater risks for cirrhosis;
excessive memory loss and shrinkage of the
brain; heart disease; and cancers of the mouth,
throat, esophagus, liver, and colon.
•  Risk factors include being unmarried but living
with a partner; being in 20s or 30s, with a
husband or partner who drinks heavily; family
history; pressure to drink; depression and stress.
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Alcohol and Prescription Drug Abuse
•  Alcohol and prescription drugs taken together
can cause
–  Alcohol poisoning
–  Unconsciousness
–  Respiratory depression
–  Death
•  Opioids, stimulants, sedatives, and sleeping aids
are most often combined with alcohol.
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Costs to Society
•  Alcohol-related societal costs are estimated to
be over $223.5 billion when health insurance,
criminal justice costs, treatment costs, and lost
productivity are factored in.
•  Alcoholism is directly or indirectly responsible for
over 25 percent of the nation's medical
expenses and lost earnings.
•  Underage drinking costs $61.9 billion annually.
–  Costs include violence, drunk driving, highrisk sex, property crime, and addiction
treatment.
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Treating Alcoholism
•  Alcoholics who decide to quit will experience detoxification and may
experience the following withdrawal symptoms:
–  Hyperexcitability
–  Confusion
–  Agitation
–  Sleep disorders
–  Convulsions
–  Hand tremors
–  Depression
–  Headache
–  Seizure
–  Possible delirium tremors (DTs)
•  Treatment programs include
–  Private facilities
–  Therapy
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Relapse
•  Success rates vary, but over half of alcoholics
relapse within the first 3 months of treatment.
–  Treatment requires more than drinking
cessation.
•  There must be a guard against relapse.
•  Identifying situations that could result in relapse,
such as becoming angry, frustrated, being around
drinkers, being pressured to drink, must be
identified.
•  Joining a support group helps.
•  Effective recovery programs help addicts create
self-esteem and resume personal growth.
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Tobacco Use in the United States
•  Nearly 443,000 Americans die annually of
tobacco-related diseases.
•  Another 10 million suffer tobacco-induced health
disorders.
•  Tobacco causes about 20 diseases, and about
half of all regular smokers die of smoking-related
diseases.
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Tobacco and Social Issues
•  Advertising
–  $36 million is spent daily on advertising and
promotion.
–  Ninety percent of adults who smoke started
by age 21, and half became regular smokers
by age 18.
•  Financial Costs to Society
–  Tobacco use causes more than $193 billion in
annual health-related economic issues.
–  For each smoker, the cost is about $3,100
per year.
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Percentage of Population That Smokes (Age
18 and Older) among Select Groups in the
United States
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College Students and Tobacco Use
•  Heavy tobacco marketing and advertising is
aimed at students, but smoking among college
students is declining.
–  Why do college students smoke?
•  To relax or reduce stress
•  To fit in/social pressure
•  Because of addiction
–  Social smoking
•  Many students identify themselves as social
smokers: those that smoke only around other
smokers.
•  This can lead to dependence and all the same
health risks as smoking regularly.
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Tobacco and Its Effects
•  Nicotine
–  Highly addictive, psychoactive substance
–  CNS stimulant
•  Tar and Carbon Monoxide
–  Tar is the carcinogenic particulate matter.
–  Nicotine paralyzes cilia, which become
unable to clear out tar.
–  Carbon monoxide is a deadly gas that
reduces the oxygen-carrying capacity of red
blood cells.
•  Tobacco Addiction
–  Nicotine poisoning
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Trends in Prevalence of Cigarette Smoking
in the Past Month among College Students
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Tobacco Products
•  Cigarettes
–  Filtered cigarettes may deliver more hazardous
gases.
–  Switching to low-tar or low-nicotine is self-defeating
because the smoker may smoke more.
–  Clove cigarettes contain 60 percent tobacco.
•  Cigars
–  Contain 23 poisons and 43 carcinogens.
•  Bidis
–  Produce three times more carbon monoxide and
nicotine and five times more tar than do cigarettes.
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Tobacco Products (cont.)
•  Pipes and Hookahs
–  Water pipes may cut down on throat irritation.
–  The main ingredient in hookahs is tobacco.
–  A hookah does not filter out harmful chemicals found
in tobacco smoke.
•  Smokeless tobacco
–  Chewing tobacco
•  Dipping rapidly releases nicotine into the
bloodstream.
–  Snuff
•  Can be inhaled, chewed, or placed against the
gums.
•  Smokeless tobacco is just as addicting as cigarette
smoking.
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Health Hazards of Tobacco Products—
Cancer
•  Lung cancer is the leading cause of cancer death.
–  Of lung cancers, 85–90 percent are caused by smoking
tobacco.
•  It can take 10–30 years to develop, and most cases are not
diagnosed until the cancer has spread.
–  Five-year survival rate is only 16 percent.
•  Smoking just one cigar a day can double the risk of several cancers.
•  Chewing tobacco is responsible for the majority of new oral cancers,
which can begin as leukoplakia.
–  Warning signs include lumps in the jaw or neck, color changes
or lumps inside the lips, white smooth or scaly patches in the
mouth or neck, lips or tongue; a red spot or sore on the lips,
gums, or inside the mouth that does not heal in 2 weeks.
•  Other tobacco-induced cancers include pancreatic, kidney, bladder,
lip, tongue, esophagus, and larynx
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Effects of Smoking on the Body and Health
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Health Hazards of Tobacco Products—
Cardiovascular Disease
•  Smokers have a 70 percent higher death rate
from heart disease than do nonsmokers.
•  Daily cigar smoking doubles the risk of heart
attack and stroke.
•  Smoking contributes to heart diseases by adding
the equivalent of 10 years of aging to the
arteries.
•  Smokers are twice as likely to suffer strokes.
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Lung Damage from Chemicals in Tobacco
Smoke
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Health Hazards of Tobacco Products (cont.)
•  Respiratory Disorders
–  Chronic bronchitis
–  Emphysema
•  Sexual Dysfunction and Fertility Problems
–  Males are more likely to suffer impotence
than are nonsmokers.
–  Women are likely to suffer infertility, problems
with pregnancy, and problems for the child
after birth.
•  Unique Risks for Women
•  Smokers are 26 times more likely to die from lung
cancer than are nonsmokers.
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Health Hazards of Tobacco Products (cont.)
•  Unique Risks for Women (cont.)
–  Higher rates of osteoporosis, depression, and
thyroid-related diseases.
–  Increased risk for blood clots, especially in
smoking women who take birth control pills.
–  Heavier menstrual bleeding, longer duration
of cramps, less predictable length of
menstrual cycle.
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Health Hazards of Tobacco Products (cont.)
•  Other Health Effects
–  Gum disease, macular degeneration,
premature skin wrinkling, staining of the teeth,
yellowing of fingernails, and bad breath.
–  Nicotine speeds up the process by which the
body uses and eliminates drugs, making
medication less effective.
–  Smoking significantly increases the risk for
Alzheimer's disease.
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Environmental Tobacco Smoke (ETS)
•  Mainstream—smoke drawn through tobacco while
inhaling.
•  Sidestream—smoke from the burning end of a cigarette
or smoke exhaled by a smoker
–  Contains twice as much tar and nicotine, 5 times
more carbon monoxide, and 50 times more ammonia
than mainstream smoke.
–  Causes more deaths a year than any other
environmental pollutant.
•  Every year, ETS is estimated to be responsible for 3,400
lung cancer deaths, 46,000 coronary and heart disease
deaths, and higher risk of SIDs deaths in newborns.
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Tobacco Use and Prevention Policies
•  It has been over 40 years since the government
recognized the hazards of tobacco use.
•  In 1998, the tobacco industry reached a Master's
Settlement Agreement with 40 states.
•  The Family Smoking Prevention and Tobacco Control
Act (2009) forbids advertising geared to children, forbids
nicotine reduction, and bans sweetened cigarettes.
•  Smokeless tobacco ads must have a warning that fills 20
percent of the advertising space.
•  Cigarette packages were required to have bigger,
stronger warnings, but lawsuits by tobacco companies
prevented their implementation in 2012.
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Quitting Smoking
•  Breaking the Nicotine Addiction
–  Seventy percent attempt to quit each year.
–  Only between 4 and 7 percent succeed.
–  Options include going "cold turkey," gradual
reduction, short-term programs based on
behavior modification and a system of
rewards, and treatment centers.
–  Combining several approaches has the most
promise.
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Coping Strategies for Common Smoking
Withdrawal Problems
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Quitting (cont.)
•  Breaking the Nicotine Addiction
•  Symptoms of withdrawal include irritability,
restlessness, nausea, vomiting, and intense
craving for tobacco.
•  Nicotine Replacement Products
–  Nicotine chewing gum
–  Nicotine patches
–  Nasal spray
–  Nicotine inhaler
–  Smoking cessation medications
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ABC News Video: Do Nicotine
Patches and Gum Work?
Discussion Questions
•  What impacts have state and national laws had
on rates of smoking?
•  How involved should the state be in regulating
smoking and/or making it difficult for people to
smoke?
•  New York is discussing increasing the age for
people to purchase cigarettes to 21. Discuss
reasons to support the increase in age, and
discuss reasons why the state should not
increase the age to 21.
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When Smokers Quit
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Quitting Smoking (cont.)
•  Benefits of Quitting
–  Many tissues will repair themselves,
according to the American Cancer Society.
–  Circulation and the senses of taste and smell
improve within weeks.
–  Risk of heart attack falls by half after only 1
year without smoking.
–  Can save about $2,184 per year.
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Study Guide - Quiz
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Relationship of alcohol and non-consensual sex
Alcohol, tobacco, and illicit drug death rates
Second hand smoke
Smoking and perceived stress by college
students
•  Smoking = increased risk heart disease
•  Cigarette advertising towards children
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Study Guide - Final
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Definition of binge drinking
College drinking – males vs females
How long to metabolize beer for adults
Consuming alcohol when pregnant
Detoxification – definition
Smoking and lung cancer
Smoking and heart disease
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