Chapter 8Chapter 8

Alcohol, Caffeine, and TobaccoAlcohol, Caffeine, and Tobacco

AlcoholAlcohol OverviewOverview

• 65% of Americans consume alcohol65% of Americans consume alcohol• 10% are heavy drinkers10% are heavy drinkers

Alcohol and college studentsAlcohol and college students• 70% of college students consumed 70% of college students consumed

alcohol in the last yearalcohol in the last year• 1/2 are classified as heavy drinkers1/2 are classified as heavy drinkers• Many students have a misperception Many students have a misperception

about “normal drinking” behavior, and about “normal drinking” behavior, and believe their peers drink more than they believe their peers drink more than they actually do.actually do.

<<insert Table 8.1>>

Table 8.1

Binge DrinkingBinge Drinking Binge Drinking and College StudentsBinge Drinking and College Students

• What is binge drinking?What is binge drinking?• On one single occasion:On one single occasion:

5 drinks in a row for a man5 drinks in a row for a man 4 drinks in a row for a woman4 drinks in a row for a woman

• 1700 students die annually due to preventable 1700 students die annually due to preventable alcohol related injuriesalcohol related injuries

Binge DrinkingBinge Drinking

Binge Drinking is Dangerous to Yourself Binge Drinking is Dangerous to Yourself and Othersand Others

Consuming a large quantity of alcohol in a short period Consuming a large quantity of alcohol in a short period of time increases the risk of unconsciousness, alcohol of time increases the risk of unconsciousness, alcohol poisoning, and death.poisoning, and death.

Binge drinking is linked to campus crime including rape, Binge drinking is linked to campus crime including rape, and assault.and assault.

Many colleges and universities are implementing Many colleges and universities are implementing policies against drinking, and offering more programs to policies against drinking, and offering more programs to help students with alcohol problems.help students with alcohol problems.

Alcohol: Chemical Make-UpAlcohol: Chemical Make-Up Chemical MakeupChemical Makeup

• Ethyl alcohol, aka ethanolEthyl alcohol, aka ethanol• Produced through fermentation process Produced through fermentation process

• produces beer or wineproduces beer or wine• Yeast breaks down plant sugars until solution reaches 14 % alcoholYeast breaks down plant sugars until solution reaches 14 % alcohol• Manufacturers then add ingredients to dilute drinkManufacturers then add ingredients to dilute drink

• Distillation – further processingDistillation – further processing• Alcohol vapors are released from the solution at high temperaturesAlcohol vapors are released from the solution at high temperatures• Vapors are condensed and mixed with water for the final productVapors are condensed and mixed with water for the final product• Proof – measure of the percent alcoholProof – measure of the percent alcohol

Example: 80 proof whiskey = 40% alcoholExample: 80 proof whiskey = 40% alcohol

Alcoholic Beverages and Their Alcohol Alcoholic Beverages and Their Alcohol EquivalenciesEquivalencies

<<Insert figure 8.1>><<Insert figure 8.1>>

Figure 8.1

Alcohol: Absorption & Alcohol: Absorption & MetabolismMetabolism

Absorption and MetabolismAbsorption and Metabolism• Absorption in stomach 20%Absorption in stomach 20%• Absorption in small intestine 80%Absorption in small intestine 80%• Factors that influence absorption:Factors that influence absorption:

Concentration of the drinkConcentration of the drink CarbonationCarbonation Amount consumedAmount consumed Food in the stomachFood in the stomach Pylorospasm (spasm of valve)Pylorospasm (spasm of valve)

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Table 8.2

Alcohol AbsorptionAlcohol Absorption Wine and beer absorbed more slowly than distilled Wine and beer absorbed more slowly than distilled

beveragesbeverages Carbonated alcoholic beverages (champagne & sparkling Carbonated alcoholic beverages (champagne & sparkling

wines) absorbed more quickly than non-carbonatedwines) absorbed more quickly than non-carbonated Due to relaxation of pyloric valveDue to relaxation of pyloric valve

The more alcohol you consume, the longer absorption The more alcohol you consume, the longer absorption takestakes

Due to irritation of pyloric valveDue to irritation of pyloric valve

Typical rate for metabolizing is consistent at .5 oz an Typical rate for metabolizing is consistent at .5 oz an hourhour• Translates to one 12oz beer or wine, 1.5 oz 80 proof liquor.Translates to one 12oz beer or wine, 1.5 oz 80 proof liquor.

Alcohol PoisoningAlcohol Poisoning

Alcohol PoisoningAlcohol Poisoning Death from alcoholDeath from alcohol

• Large amount of alcohol in short amount of time.Large amount of alcohol in short amount of time. Two ways this happensTwo ways this happens

• 1) CNS and respiratory depression1) CNS and respiratory depression• 2) Inhalation of vomit or fluid into the lungs2) Inhalation of vomit or fluid into the lungs

Signs of alcohol poisoningSigns of alcohol poisoning Inability to be rousesInability to be rouses Weak, rapid pulseWeak, rapid pulse Irregular breathing patternIrregular breathing pattern Cool, pale, bluish skinCool, pale, bluish skin

• Call 911Call 911

Physiological and Behavioral Physiological and Behavioral Effects of AlcoholEffects of Alcohol

Immediate Effects of AlcoholImmediate Effects of Alcohol• Reduces frequency of nerve transmissionsReduces frequency of nerve transmissions• DehydrationDehydration• Water is lost from cerebrospinal fluidWater is lost from cerebrospinal fluid• Alcohol irritates the gastrointestinal systemAlcohol irritates the gastrointestinal system• Hangovers – result from decreased CSF and dehydrationHangovers – result from decreased CSF and dehydration• Congeners – forms of alcohol metabolized more slowly, play Congeners – forms of alcohol metabolized more slowly, play

role in hangoversrole in hangovers• Be informed of drug and alcohol interactionsBe informed of drug and alcohol interactions

Physiological and Behavioral Effects of Physiological and Behavioral Effects of AlcoholAlcohol

Long-Term Effects of AlcoholLong-Term Effects of Alcohol• Nervous systemNervous system

Brain decrease in sizeBrain decrease in size Loss in intelligenceLoss in intelligence Mostly left side of brainMostly left side of brain

• Cardiovascular systemCardiovascular system Increase Blood PressureIncrease Blood Pressure

• Liver diseaseLiver disease Cirrhosis due to fat depositsCirrhosis due to fat deposits Alcoholic hepatitisAlcoholic hepatitis

• CancerCancer Esophagus, stomach, mouth, Esophagus, stomach, mouth,

tongue, liver.tongue, liver.

• Chronic inflammation of Chronic inflammation of pancreaspancreas

• Impairs ability to recognize and Impairs ability to recognize and fight bacteria & virusesfight bacteria & viruses

A normal liver and a liver with A normal liver and a liver with cirrhosiscirrhosis

Alcohol and PregnancyAlcohol and Pregnancy

• Alcohol can harm fetal developmentAlcohol can harm fetal development• Even a single exposure to high levels can Even a single exposure to high levels can

cause damagecause damage• Fetal Alcohol Syndrome (FAS)Fetal Alcohol Syndrome (FAS)

Mental retardation, small head, tremors, and Mental retardation, small head, tremors, and abnormalities of face, limbs, heart, and brainabnormalities of face, limbs, heart, and brain

FAS is the 3FAS is the 3rdrd most common birth defect in the most common birth defect in the United StatesUnited States

Alcohol and Pregnancy Alcohol and Pregnancy (continued)(continued)

• FAS behaviors include:FAS behaviors include: Impaired learning Impaired learning Poor memoryPoor memory Impulsive behaviorsImpulsive behaviors Reduced attention spanReduced attention span Poor problem solvingPoor problem solving Some have Fetal Alcohol Effects Some have Fetal Alcohol Effects

(less severe)(less severe)

Drinking and DrivingDrinking and Driving FactsFacts

• 39% of all traffic fatalities are alcohol related39% of all traffic fatalities are alcohol related• Many college students drink and driveMany college students drink and drive• In 2005, 16,885 alcohol related fatalities (ARTFs)In 2005, 16,885 alcohol related fatalities (ARTFs)

One ARTF every 30 minutesOne ARTF every 30 minutes

• At BAC 0.10, ten times more likely to be in an At BAC 0.10, ten times more likely to be in an accidentaccident

• Current limit for BAC in all 50 states: 0.08%Current limit for BAC in all 50 states: 0.08%

Alcohol Abuse and AlcoholismAlcohol Abuse and Alcoholism Identifying a Problem DrinkerIdentifying a Problem Drinker

• Abuse interferes with:Abuse interferes with: WorkWork SchoolSchool Social/Family relationshipsSocial/Family relationships

• Alcoholism = alcohol dependency Alcoholism = alcohol dependency ToleranceTolerance Psychological dependencePsychological dependence WithdrawalWithdrawal

Alcohol Abuse and AlcoholismAlcohol Abuse and Alcoholism

CausesCauses• Biological and family factorsBiological and family factors• Social and cultural factorsSocial and cultural factors• Family attitudesFamily attitudes• UrbanizationUrbanization• Weakening of family linksWeakening of family links• Combination of heredity and environmentCombination of heredity and environment

Alcohol Abuse and AlcoholismAlcohol Abuse and Alcoholism

Effects of Alcoholism on the FamilyEffects of Alcoholism on the Family• 1 in 4 children live in an alcoholic situation1 in 4 children live in an alcoholic situation• Dysfunctional familiesDysfunctional families

Family rules: Family rules: “Don’t talk, don’t trust, don’t feel.”“Don’t talk, don’t trust, don’t feel.”• Children often assume at least one of the following roles:Children often assume at least one of the following roles:

Family hero: Try to divert attention by being a good kidFamily hero: Try to divert attention by being a good kid Scapegoat: Draw attention away from problem by Scapegoat: Draw attention away from problem by

causing other problemscausing other problems Lost child: Passive and withdrawingLost child: Passive and withdrawing Mascot: Comic releifMascot: Comic releif

Alcohol Abuse and AlcoholismAlcohol Abuse and Alcoholism Women and AlcoholismWomen and Alcoholism

• More women are drinkingMore women are drinking• Female alcoholics approaching the rate of Female alcoholics approaching the rate of

male alcoholicsmale alcoholics• Risk factors include:Risk factors include:

Family historyFamily history Pressure to drink from peersPressure to drink from peers DepressionDepression StressStress

RecoveryRecovery The Family’s RoleThe Family’s Role

Intervention – planned confrontationIntervention – planned confrontation Express love and concernExpress love and concern

Treatment ProgramsTreatment Programs Detoxification: end physical dependence on drugDetoxification: end physical dependence on drug Treatment for psychological dependenceTreatment for psychological dependence

• Takes 7 to 21 daysTakes 7 to 21 days• Up to 6 weeksUp to 6 weeks

RelapseRelapse 60% rate of relapse in first 3 months60% rate of relapse in first 3 months Many say they are recovering their whole lifeMany say they are recovering their whole life

Our Smoking SocietyOur Smoking Society Smoking FactsSmoking Facts

• Single most preventable cause of deathSingle most preventable cause of death• 440,000 Americans die a year440,000 Americans die a year• 50 times that of illegal drug deaths50 times that of illegal drug deaths• Teen smokers = 21.8%Teen smokers = 21.8%

AdvertisingAdvertising• Spends $18 million per daySpends $18 million per day• Children and teens constitute 90% of new Children and teens constitute 90% of new

smokerssmokers• 18- to 24-year-olds new target18- to 24-year-olds new target

Figure 8.3

Annual Deaths Attributable to Annual Deaths Attributable to Smoking in Smoking in

the United Statesthe United States

Our Smoking SocietyOur Smoking Society Financial Costs to SocietyFinancial Costs to Society

• $167 billion in annual health related economic $167 billion in annual health related economic losseslosses

• $75.5 billion in medical expenditures$75.5 billion in medical expenditures

College Students Are Smoking MoreCollege Students Are Smoking More• Estimated 60% have tried tobacco productsEstimated 60% have tried tobacco products

Does tobacco appear to be a big problem on Does tobacco appear to be a big problem on your campus?your campus?

What efforts are made to decrease smoking?What efforts are made to decrease smoking?

Tobacco and Its EffectsTobacco and Its Effects Physiological Effects of NicotinePhysiological Effects of Nicotine

• Stimulates CNSStimulates CNS• Stimulates adrenal glandsStimulates adrenal glands• Increases production of adrenalineIncreases production of adrenaline• Increases heart rateIncreases heart rate• Increases respiratory rateIncreases respiratory rate• Constricts vesselsConstricts vessels• Increases blood pressureIncreases blood pressure• Nicotine is the main addictive substance in Nicotine is the main addictive substance in

tobaccotobacco

Tobacco and Its EffectsTobacco and Its Effects

All Tobacco Products are Equally HarmfulAll Tobacco Products are Equally Harmful

• CigarettesCigarettes• Clove cigarettes (40% cloves, 60% tobacco)Clove cigarettes (40% cloves, 60% tobacco)• Cigars: 23 poisons, 43 carcinogensCigars: 23 poisons, 43 carcinogens• PipesPipes• Bidis (hand-rolled, flavored cigarettes)Bidis (hand-rolled, flavored cigarettes)• Smokeless tobaccoSmokeless tobacco

Chewing tobaccoChewing tobacco DippingDipping SnuffSnuff

Tobacco and Its EffectsTobacco and Its Effects Health Hazards of SmokingHealth Hazards of Smoking

• CancersCancers Lung 85-90% associated with smokingLung 85-90% associated with smoking PancreaticPancreatic LipLip EsophagusEsophagus Tongue Tongue

• Cardiovascular DiseaseCardiovascular Disease Smokers have 70% higher death rateSmokers have 70% higher death rate

• StrokeStroke Smokers are 2 times more likely to sufferSmokers are 2 times more likely to suffer

Tobacco and Its EffectsTobacco and Its EffectsHealth Hazards of Smoking (continued)Health Hazards of Smoking (continued) Respiratory DisordersRespiratory Disorders

• Chronic bronchitisChronic bronchitis• EmphysemaEmphysema

Sexual DysfunctionSexual Dysfunction• Males are 2 times more likely to suffer impotenceMales are 2 times more likely to suffer impotence

Other ProblemsOther Problems• Gum diseaseGum disease• More likely to need medicationsMore likely to need medications• Metabolism of drugs is affectedMetabolism of drugs is affected

Figure 8.4

How Cigarette Smoking How Cigarette Smoking Damages the LungsDamages the Lungs

Environmental Tobacco Smoke (ETS)Environmental Tobacco Smoke (ETS)

Risks from ETSRisks from ETS• Mainstream: inhaling from cigaretteMainstream: inhaling from cigarette• Sidestream – more carcinogensSidestream – more carcinogens• ETS is responsible for deathsETS is responsible for deaths• Sidestream smoke causes more deaths a year Sidestream smoke causes more deaths a year

than any other environmental pollutantthan any other environmental pollutant• Children exposedChildren exposed

Environmental Tobacco Smoke Environmental Tobacco Smoke (ETS)(ETS)

Tobacco and PoliticsTobacco and Politics• 40 years ago government recognized the 40 years ago government recognized the

hazardhazard• States have imposed extra taxesStates have imposed extra taxes• Tobacco control initiatives are increasingTobacco control initiatives are increasing

QuittingQuitting Breaking the Nicotine AddictionBreaking the Nicotine Addiction

• 1/3 attempt to quit a year1/3 attempt to quit a year• 90% fail90% fail• Many programs exist to help with quittingMany programs exist to help with quitting• Nicotine withdrawal is experiencedNicotine withdrawal is experienced

Nicotine Replacement ProductsNicotine Replacement Products• Nicotine chewing gumNicotine chewing gum• Nicotine patchNicotine patch• Nicotine nasal sprayNicotine nasal spray• Nicotine inhalerNicotine inhaler

QuittingQuitting

Other Means of Breaking the HabitOther Means of Breaking the Habit• Operant strategies: pairing smoking with an external stimuliOperant strategies: pairing smoking with an external stimuli• Self-control: Teaching skills necessary for quittingSelf-control: Teaching skills necessary for quitting

Benefits of QuittingBenefits of Quitting• According to the American Cancer Society According to the American Cancer Society

many tissues will repair themselvesmany tissues will repair themselves

When Smokers QuitWhen Smokers Quit

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Figure 8.5

CaffeineCaffeine Caffeine FactsCaffeine Facts

• A drug derived from xanthinesA drug derived from xanthines• Mild stimulant to CNSMild stimulant to CNS• Increases heart rateIncreases heart rate• Increases oxygen consumptionIncreases oxygen consumption• Does not cause dehydrationDoes not cause dehydration• Increases wakefulnessIncreases wakefulness

CaffeineCaffeine Side Effects of CaffeineSide Effects of Caffeine

• Insomnia in someInsomnia in some• Irregular heart beatIrregular heart beat• DizzinessDizziness• NauseaNausea• IndigestionIndigestion• Mild deleriumMild delerium• AnxietyAnxiety

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Table 8.4

CaffeineCaffeine Caffeine AddictionCaffeine Addiction

• Drink more when coming downDrink more when coming down• Caffeinism – jitters, muscle twitchCaffeinism – jitters, muscle twitch• Withdrawing may produce headachesWithdrawing may produce headaches• No long-term damage is seen with No long-term damage is seen with

moderate use in non-pregnant womenmoderate use in non-pregnant women