first, remember all of this informatrion:

Page
6
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Because learning changes everything. ®
9: Alcohol and Tobacco
Your Health Today, 9th Edition
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ALCOHOL
2
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Understanding Alcohol Use
Alcohol is a psychoactive drug, which means it causes
changes in brain chemistry and alters consciousness.
• Intoxication: altered state of consciousness as a result of
drinking alcohol or ingesting other substances.
It can have wide-ranging effects on all aspects of our
thinking, emotions, and behavior.
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4
The Nature 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 and extra alcohol is added
 Hard liquors 35-50% (or more) alcohol by volume
 Distilling or fermented
 Proof Value
 Two times the percentage concentration
 Ingestion
 7 calories per gram
 1 drink contains 14-17 grams, or 100-120 calories
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Patterns of Alcohol Use
Low-risk drinking: Fourteen drinks a week for men and
no more than four one day; seven drinks a week for
women and no more than three on one day.
• Alcohol above theses levels is considered heavy or at-risk
drinking.
The USDA’s 2015–2020 Dietary Guidelines for
Americans advises alcohol only in moderation.
• One drink a day for women.
• Up to two drinks a day for men.
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Figure 9.1 What is “one drink”?
Each drink contains about 0.5 ounce of alcohol.
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((Beer): Bjorn Heller/Getty Images; (Wine): Clark Robertson/Stockphoto; (Shot): C Squared Studios/Getty Images; (Mixed Drink): Comstock Images/Alamy Stock Photo) 6
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Who Drinks? 1
People are more likely to drink at certain stages
in the lifespan.
• Adolescence and early adulthood; threshold of middle age;
and following retirement.
Older adults drink less than younger adults.
Women drink less and start later than men.
Adults who had at least one heavy drinking day in the
past month by ethnicity: non-Hispanic white 7.4%,
Hispanic/Latino 5.7%, Black 5.2%, Asian 2.1%.
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Who Drinks? 2
Differences in consumption among ethnic groups are
strongly influenced by sociocultural, environmental,
and economic factors.
• Alcohol use is generally lower among African Americans.
• Among Native Americans, alcoholism is recognized as the
number-one health problem.
• Asian Americans have lower consumption rates than white
Americans, possibly due to genetic biological reactions
referred to as the flushing effect.
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Binge Drinking and Extreme Drinking
Binge drinking, or heavy episodic drinking: within 2
hours, 5 or more drinks for men, 4 or more for women,
at least once in a 2-week period.
• Survey from the National Institute on Alcohol Abuse and
Alcoholism found that almost 57% of college students aged
18 to 22 binge drank in the previous 30 days.
Extreme drinking is now used to describe alcohol
consumption that goes well beyond binge drinking.
• For men, 10 to 15 drinks a day; for women, 8 to 12.
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Consequences of Binge Drinking
in College
Consequences can be serious.
• Injury.
• Commission of a crime or falling victim to crime.
• Driving while intoxicated.
• Unintended and unprotected sexual activity.
• Decreased academic performance.
• Increased risk of alcohol abuse and dependence 10 years
after college.
• “Secondhand effects” for other students, such as arguments,
assault, property damage, interrupted sleep or studying,
unwanted sexual advances, etc.
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Pregaming Drinking
• Pregaming is the
excessive consumption
of alcohol prior to
attending an event or
activity in which alcohol
will be served.
– High-risk because it
involves heavy
consumption in a
short period of time.
– Freshmen are more
likely to pregame.
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Pot-Infused Alcohol
Beer companies are lacing beer with
tetrahydrocannabinol (THC), the primary ingredient in
cannabis that produces a “high.”
Cannabbidiol (CBC) is legally served as cocktail drinks.
Mixing alcohol and CBD may have negative effects.
Mixing alcohol with THC is of even greater concern,
because it increases THC levels in the blood eightfold.
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Effects of Alcohol on the Body
• Alcohol is quickly distributed
to all the cells of the body.
• Once it reaches the brain,
alcohol alters brain chemistry
and neurotransmitter
functions.
• Alcohol is a central nervous
system depressant that
impairs thinking, balance, and
motor functions.
• As alcohol concentrations
increase, more functions are
depressed, and greater
impairment occurs.
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Alcohol Absorption
• Many factors affect alcohol
absorption:
– Food in the stomach.
– Gender and age.
– Body fat.
– Drug interactions.
– Cigarette smoke.
– Mood and physical
condition.
– Alcohol concentration.
– Carbonation.
– Artificial sugars from
diet soda.
– Individual tolerance
level.
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Alcohol Metabolism
A small amount of alcohol is metabolized in the
stomach; but 90% is metabolized by the liver.
• Between 2% and 10% is not metabolized at all but
is excreted unchanged through the skin, urine, or breath.
The liver allows conversion of alcohol to acetaldehyde
by an enzyme, alcohol dehydrogenase (ADH).
If more alcohol arrives than can be processed, it
circulates through the brain, liver, and other organs
until enzymes are available.
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liver
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Gender Differences in Alcohol
Absorption and Metabolism
Women are generally more susceptible to the effects of
alcohol and have a higher BAC than men.
• Generally smaller than men.
• Higher body fat percentage.
• Metabolize alcohol less efficiently.
As a result, women are more vulnerable to health
consequences.
• Breast cancer.
• Alcohol hepatitis.
• Heart problems.
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Blood Alcohol Concentration
Blood alcohol concentration (BAC): the amount of
alcohol in grams in 100 milliliters (ml) of blood,
expressed as a percentage.
• For example, 100 milligrams of alcohol in 100 milliliters of
blood is equivalent to a BAC of 0.10%.
• The amount of body water and body fat influences the
BAC levels in the body.
• Breath analyzers are valid based upon alcohol concentrations
in the breath that correspond well to levels of alcohol in the
brain.
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Rates and Effects of
Alcohol Metabolism 1
Because alcohol is metabolized more slowly than it is
absorbed, the concentration of alcohol builds when
additional drinks are consumed.
A person with a BAC of 0.08% is considered legally
drunk in all states, but people experience impairment
at different BAC levels.
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Table 9.1 Stages of Effects of Alcohol
BAC (%) Effects Impaired Functions
0.01 to 0.05 Relaxation; sense of
well being; loss of
inhibition
Decreased alertness; impaired
concentration, judgment, and
coordination (especially fine motor skills)
0.06 to 0.10 Euphoria; blunted
feelings; nausea;
sleepiness
Slower reflexes; impaired reasoning;
impaired visual tracking; reduced depth
perception
0.11 to 0.20 Emotional arousal;
mood swings; anger or
sadness; boisterousness
Slowed reaction time; staggering gait;
slurred speech; impaired balance
0.21 to 0.30 Aggression; reduced
sensations; depression;
stupor
Lethargy; increased pain threshold;
severe motor impairment; memory
blackout
0.31 to 0.40 Unconsciousness;
coma; death possible
Loss of bladder control; impaired
temperature regulation; slowed
breathing; slowed heart rate
0.41 and greater Death Respiratory arrest
Source: B.R.A.D.21. (n.d.). Effects at specific B.A.C. levels. Retrieved from www.brad21.org/effects_at_specific_bac.html. 21
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Rates and Effects of
Alcohol Metabolism 2
Visible effects of alcohol consumption include deeper
wrinkles, red cheeks, and weight gain.
Acute alcohol intoxication: life-threatening blood
alcohol concentration that can produce a collapse of
vital body functions.
Blackout: period of time during which a drinker is
conscious but has partial or complete amnesia about
events.
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Effects of Alcohol Ingestion Fads 1
Up to 28% of college students mix alcohol and energy
drinks, despite it being dangerous.
• Three times more likely to leave a bar drunk.
• Four times more likely to drive drunk.
• Increased risk of sexual assaults.
Two alcohol ingestion fads that bypass the digestive
tract are vaporizing and the alcohol enema.
• Alcohol is absorbed through the lungs or the intestines,
bypassing the buffering effect of the digestive tract.
• Poses a serious risk of alcohol poisoning.
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Effects of Alcohol Ingestion Fads 2
Hand sanitizer that contains 62% ethyl alcohol can be
distilled into a 120-proof alcohol beverage.
• Some users ingest hand sanitizer straight from the bottle.
• Side effects can be serious.
Other ingestion fads:
• Vodka tampons.
• Vodka eyeballing.
• Syringe alcohol injection.
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Hangovers
Hangovers are a result of a common reaction to alcohol
toxicity, characterized by headache, stomach upset,
thirst, and fatigue.
Be cautious of using analgesics to treat hangovers.
• Acetaminophen (Tylenol, Anacin-3) can damage your liver
when alcohol is in your body.
• Aspirin, either 6 hours before or after alcohol consumption,
may lead to a higher BAC and gastrointestinal distress.
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© McGraw Hill LLC
Table 9.2 What Happens When You Stop Drinking Alcohol?
Time Line Body Effects
1 hour Liver in overdrive to metabolize remaining alcohol. Pancreas
releases insulin, which leads to intense carbohydrate craving.
12 to 24 hours Blood sugar normalizes. Body still dehydrated. Sleep stages still
disturbed.
48 Hours Body completes alcohol detoxification. Minor hangover symptoms
may remain.
7 Days Sleep stages normalized. Skin takes on more even texture. Body no
longer dehydrated.
1 Month Liver fat decreased by 15 percent, which filtering out alcohol
improves. Cures fatty liver.
1 Year On average lose 13 pounds, most of which is belly fat. Decreased
risk of mouth, liver, and breast cancers.
Source: Montell, A. (2016). 7 things that happen to your body when you stop drinking alcohol. Retrieved from http://www.byrdie.com/what-does-alcohol-do-to-your-body/. 26
© McGraw Hill LLC
Medical Problems Associated with
Alcohol Use 1
Fetal alcohol syndrome (FAS): set of birth defects
associated with use of alcohol during pregnancy.
Heart disease and stroke:
• Alcoholic cardiomyopathy: disease of the heart muscle.
• Heart arrhythmias (irregular heartbeat) and coronary heart
disease.
Liver disease:
• Fatty liver: liver swells with fat globules.
• Alcoholic hepatitis: inflammation of the liver.
• Cirrhosis: scarring of the liver tissue.
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© McGraw Hill LLC
Medical Problems Associated with
Alcohol Use 2
Cancer:
• Several types of cancer, particularly cancers of the head and
neck, cancers of the digestive tract, and breast cancer.
Brain damage:
• Heavy alcohol consumption causes anatomical changes in the
brain and directly damages brain cells.
Lung damage:
• Recent studies suggest that alcohol abuse causes dysfunction
in lung cells.
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Figure 9.4 Effects of alcohol on the body.
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(Andersen Ross/Getty Images) 29
© McGraw Hill LLC
Social Problems Associated With
Alcohol Use
Alcohol can lead to many kinds of social difficulties.
• Reduction of inhibitions, which may lead to high-risk sexual
activity and a lowered likelihood of practicing safe sex.
• Violence, including robbery, assault, rape, domestic violence,
and homicide.
• Risk of injury.
• Drunk driving.
• Suicide risk.
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Alcohol Misuse, Abuse,
and Dependence
Alcohol misuse: consumption to the point of physical,
social, and moral harm to the drinker.
• Problem drinking: pattern of use that impairs the drinker’s
life, causing personal difficulties and difficulties for others.
• Alcohol abuse: continued use of alcohol despite negative
consequences.
Alcohol dependence: a strong craving for alcohol,
the development of tolerance, and symptoms of
withdrawal if alcohol consumption stops abruptly—
also known as alcoholism.
• Chronic, progressive, and often fatal disease.
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Another View: Health Benefits
Moderate alcohol consumption may have some
health benefits.
• Anticlotting effect on the blood.
• Enhances body’s sensitivity to insulin.
• Stress reduction.
• Diuretic effect of beer may help prevent kidney stones.
• Increase in HDL cholesterol.
The pattern of drinking is key.
• Binge drinking has no protective benefits and can increase the
risk for heart disease.
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Treatment Options 1
Brief interventions:
• Alcohol Skills Training Program;
• Internet-based programs.
• CDC’s alcohol screening and brief intervention (SBI).
Inpatient and outpatient treatment:
• Residential facilities—detoxification and withdrawal;
medications; and counseling.
Self-help programs:
• Support groups (AA, Al-Anon, Alateen, Adult Children of
Alcoholics, others).
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Treatment Options 2
Harm reduction—approach, policies, and laws:
• Focuses on reducing the harm associated with drinking, both
to the individual and to society.
• One example is controlled drinking, which emphasizes
moderation rather than abstinence.
• Minimum drinking age laws, drunk driving laws, ankle bracelet
breathalyzers, ignition interlock device, restrictions on liquor
sales and outlets, taxes on alcohol.
Fake IDs:
• Using a fake ID is now classified as a serious crime.
• IDs are now more difficult and costly to counterfeit.
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Are You at Risk?
“Yes” to one or more questions on the CAGE
questionnaire suggests you may be at risk.
• C for cut down: Have you ever tried to cut down on your
drinking?
• A for annoyed: Have you ever been annoyed by criticism
of your drinking?
• G for guilty: Have you ever felt guilty about your drinking?
• E for eye-opener: Have you ever had a morning
“eye-opener”?
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Developing a Behavior Change Plan
• Following a behavior
change plan can assist
you with reducing alcohol
consumption.
– Record behavior
patterns.
– Analyze your drinking
diary.
– Establish goals.
– Implement your plan.
– Evaluate your results.
© McGraw Hill LLC
Be an Advocate
You can also be an advocate for both abstinence and
responsible drinking.
Boost Alcohol Consciousness Concerning the Health of
University Students (BACCHUS Network).
• Run by student volunteers.
• Promotes both abstinence and responsible drinking.
Greeks Advocating the Mature Management of Alcohol
(GAMMA) .
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TOBACCO
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© McGraw Hill LLC
Understanding Tobacco Use
The use of tobacco causes an array of health problems,
both for users and for those around them.
Tobacco is the leading preventable cause of death in
the United States.
Almost 1 in 7 adult Americans smokes.
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Who Smokes?
Patterns of Tobacco Use
About 14% of the adult population in
the United States are smokers, down
from nearly 42% in 1965.
• Decline is largely because of public health
campaigns about the hazards of smoking.
• Rate of decline has slowed since 1990.
Cigarette smoking is negatively
correlated with educational
attainment.
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© McGraw Hill LLC
Substances in Tobacco
Tar is a thick, sticky residue formed when tobacco
leaves burn, containing hundreds of chemical
compounds and carcinogenic substances.
One of the most hazardous gaseous compounds in
burning tobacco is carbon monoxide, an odorless gas
that interferes with the ability of red blood cells to
carry oxygen to vital body organs.
Nicotine is the primary addictive ingredient; it is both a
poison and a powerful psychoactive drug.
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Cigarettes
Cigarettes are by far the most popular tobacco product
and account for nearly 95% of the tobacco market.
In 2009, the U.S. Congress passed the Family Smoking
Prevention and Tobacco Control Act.
• Gave the FDA power to regulate tobaccos.
• Fruit- and candy-flavored cigarettes are now prohibited.
• Also banned are clove cigarettes and bidis.
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E-cigarettes
Sales of e-cigarettes may surpass those of regular
cigarettes by 2025.
• Although marketed as a safe cigarette, they still contain
nicotine and have other health risks.
• Secondhand heath effects, especially on children, are of
particular concern.
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Vaping
• A vape is an electronic device
that simulates tobacco
smoking by heating a liquid to
an aerosol called vapor.
• The user inhales the vapor into
the lungs.
• The vapor is chemically similar
to cigarette smoke.
– Some people vape THC or
synthetic drugs in place of
nicotine.
• There is growing empirical
evidence that vaping is
dangerous.
© McGraw Hill LLC
Hookahs
• Hookahs are a potentially greater risk than
cigarettes because of the frequency and
number of puffs.
– About 17% of college students smoke a
hookah.
– African Americans have higher rates of
hookah-only and dual hookah and
cigarette smoking.
– The World Health Organization and the
CDC warn, however, that hookah use
can pose even greater dangers than
cigarette smoking.
© McGraw Hill LLC
Cigars
• Cigars have more tobacco and
nicotine than cigarettes, take longer
to smoke, and generate more smoke
and harmful combustion products.
– Nicotine absorbed in the mucus
membranes of the mouth
presents a higher risk for oral
cancers.
– Cigar smokers who do not inhale
have lower mortality rates than
cigar smokers who do.
– Black & Mild cigarillos are
popular among teens, young
adults, and African Americans.
© McGraw Hill LLC
Pipes
Pipe smoke has more toxins than cigarette smoke.
Pipe smokers who do not inhale are at less risk for lung
cancer and heart disease than are cigarette smokers.
Pipe smokers are just as likely as cigarette smokers to
develop cancer of the mouth, larynx, throat, and
esophagus.
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Smokeless Tobacco
Smokeless tobacco is also called snuff, chewing or spit
tobacco, and snus.
The use of spit tobacco is believed to cause about
10 to 15% of oral cancers.
Spit tobacco also causes gum disease, tooth decay and
discoloration, and bad breath.
The amount of nicotine absorbed from smokeless
tobacco is two to three times greater than that
delivered by cigarettes.
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Why Do People Smoke? 1
Nicotine is a highly addictive psychoactive drug.
• Some health experts believe it is the most addictive of all the
psychoactive drugs.
• Increases in release of the neurotransmitter dopamine
produce feelings of pleasure and a desire to repeat the
experience.
Behavioral dependence develops.
• Many smokers have a harder time imagining their future life
without cigarettes than they do dealing with the physiological
symptoms of withdrawal.
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Why Do People Smoke? 2
Weight control is one of the major reasons young
women give for smoking.
• Nicotine suppresses appetite and slightly increases basal
metabolic rate.
• People who start smoking often lose weight, and continuing
smokers gain weight less rapidly than nonsmokers.
Tobacco marketing and advertising has an effect.
• Because most smokers get hooked in adolescence, children
and teenagers are prime targets of tobacco advertising.
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© McGraw Hill LLC
Short-Term Effects
Nicotine effects can reach the brain within 7 to 10
seconds, producing stimulation and sedation.
Smoke quickly affects heart rate, blood pressure, and
body temperature.
Tar and toxins damage cilia, the hair-like structures
that prevent toxins and debris from reaching delicate
lung tissue.
The cardiovascular system cannot effectively deliver
oxygen to muscle cells.
51
© McGraw Hill LLC
Figure 9.6 Effects of smoking on the body.
Access the text alternative for slide images.
(Tim Large - Youth Social Issues/Alamy Stock Photo) 52
© McGraw Hill LLC
Long-Term Effects
Cardiovascular disease and cancer.
Chronic obstructive pulmonary disease.
• Emphysema: abnormal condition of the lungs that enlarges
the alveoli (air sacs) and decreases elasticity.
• Chronic bronchitis: mucus secretion, cough, and increasing
difficulty breathing.
• Asthma: respiratory disorder characterized by difficulty
breathing, wheezing, coughing, and thick mucus.
Premature skin wrinkling, increased risk during surgery,
and other health problems.
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Special Health Risks for Women
Fertility problems, menstrual disorders, early
menopause, problems in pregnancy, lung cancer, heart
disease, and respiratory diseases are among the risks.
Smoking during pregnancy increases risk for
miscarriage, stillbirths, pre-term delivery, low birth
weight, and perinatal death.
• Infants are at increased risk for sudden infant death syndrome
(SIDS).
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Special Health Risks for Men
Greater use of other forms of tobacco (cigars, pipes,
smokeless tobacco) places men at higher risk for
cancers of the mouth, throat, esophagus, and stomach.
Men may also experience problems with sexual
function (impotence) and fertility (motility and number
of sperm).
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Special Health Risks for Ethnic
Minority Groups
Mortality rates from several diseases associated with
tobacco use—including cardiovascular disease, cancer,
and SIDS—are higher for ethnic minority groups than
for whites.
African American men and women are more likely to
die from lung cancer, heart disease, and stroke than are
members of other ethnic groups, despite lower rates of
tobacco use.
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Benefits of Quitting
The risks for many health problems are reduced when smokers quit.
Health benefits begin immediately and are more significant over time.
Respiratory symptoms decrease quickly.
Recovery from illness is more rapid.
Taste and smell return.
Circulation improves.
© McGraw Hill LLC
Table 9.3 When You Quit Smoking 1
Immediately You stop polluting the air with secondhand smoke; the air around
you is no longer dangerous to children and adults.
20 minutes Blood pressure decreases; pulse rate decreases; temperature of
hands and feet increases.
12 hours Carbon monoxide level in blood drops; oxygen level in blood
increases to normal.
24 hours Chance of heart attack decreases.
48 hours Nerve endings start to regrow; exercise gets easier; senses of smell
and taste improve.
72 hours Bronchial tubes relax, making breathing easier; lung capacity
increases.
Source: Health Canada. (2008). Health Canada: On the road to quitting. Retrieved from www.hc-sc.gc.ca. 58
© McGraw Hill LLC
Table 9.3 When You Quit Smoking 2
2 to 12 weeks Circulation improves; lung functioning increases up to 30%.
1 to 9 months Fewer coughs, colds, and flu episodes; fatigue and shortness of
breath decrease; lung function continues to improve.
1 year Risk of smoking-related heart attack is cut by half.
5 years Risk of dying of heart diseases and stroke approaches that of a
nonsmoker; risk of oral and esophageal cancers is cut by half.
10 years Risk of dying from lung cancer is cut by half.
10 to 15 years Life expectancy reaches that of a person who never smoked.
Source: Health Canada. (2008). Health Canada: On the road to quitting. Retrieved from www.hc-sc.gc.ca. 59
© McGraw Hill LLC
Effects of Environmental
Tobacco Smoke
Environmental tobacco smoke (ETS): smoke from other
people’s tobacco products, also known as secondhand
smoke or passive smoke.
Significant evidence indicates that inhaling ETS has
serious health consequences.
Infants and children are especially vulnerable to the
effects of ETS.
Pets are even at risk from ETS.
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Quitting and Treatment Options 1
Treatment programs to quit smoking:
• Many smokers who enter good programs are able to quit
smoking for at least a year.
• Some are intensive, residential programs.
• Many also encourage smokers to limit or eliminate alcohol.
Medications:
• Nicotine replacement therapy (NRT)—a controlled amount of
nicotine administered to gradually reduce daily use.
• Prescription drugs—Buproprion, Zyban, Wellbutrin, Chantix.
• Experimental vaccine—NicVAX.
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Quitting and Treatment Options 2
Quitting on your own can be aided by developing a
behavior change plan.
• Record and analyze your smoking patterns.
• Establish goals.
• Prepare to quit.
• Implement your plan.
• Prevent relapse.
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Table 9.4 What to Expect When You Quit 1
Symptom Reason Duration Relief
Irritability Body craves nicotine 2 to 4 weeks Take walks, hot baths; use
relaxation techniques
Fatigue Nicotine is a stimulant 2 to 4 weeks Take naps; don’t push
yourself
Insomnia Nicotine affects brain
waves
2 to 4 weeks Avoid caffeine after 6 p.m.;
use relaxation techniques.
Coughing, dry
throat, nasal
drip
Body is getting rid of
excess mucus
A few days Drink fluids; try cough
drops
Poor
concentration
Nicotine is a stimulant,
boosts concentration
1 to 2 weeks Get enough sleep; exercise;
eat well
Tightness in
chest
Muscles are tense from
nicotine craving or sore
from coughing
A few days Use relaxation techniques,
especially deep breathing;
take hot baths
Source: Quitnet. (n.d.). Quitnet by MeYouHealth. Retrieved from www.quitnet.com. 63
© McGraw Hill LLC
Table 9.4 What to Expect When You Quit 2
Symptom Reason Duration Relief
Constipation,
gas, stomach
pain
Intestinal movement
decreases for brief time
1 to 2 weeks Drink fluids; add fiber to
diet (fruits, vegetables,
whole grains)
Hunger Nicotine craving can
feel like hunger
Up to
several
weeks
Drink water or low-calorie
drinks; have low-calorie
snacks on hand
Headaches Brain is getting more
oxygen
1 to 2 weeks Drink water; use relaxation
techniques
Craving for a
cigarette
Withdrawal from
nicotine
Most acute
first few
days; can
recur for
months
Wait it out; distract
yourself; exercise; use
relaxation techniques
Source: Quitnet. (n.d.). Quitnet by MeYouHealth. Retrieved from www.quitnet.com. 64
© McGraw Hill LLC
Limiting Access to Tobacco
Access to tobacco can be limited by increasing cost,
reducing physical availability, and regulating tobacco-
marketing campaigns.
• Raising cigarette taxes and restrictions on tobacco marketing
reduces demand.
• Laws restricting sales to minors.
• States are required to conduct random, unannounced
inspections of places where tobacco is sold.
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FDA Regulation of Tobacco
Family Smoking Prevention and Tobacco Control Act of
2009 granted authority to the FDA to regulate tobacco.
• Larger and more explicit health warning labels have so far
been successfully challenged by cigarette makers.
• “Light,” “low,” or “mild” on packaging is prohibited.
• Sale of cigarettes and smokeless tobacco to anyone under
18 years is prohibited.
• Cigarette machines are only allowed in 18+ venues.
• Single cigarette sales, free samples, and product tie-ins, along
with sports and cultural event sponsorship, are prohibited.
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<p>Chapter 9 Study Outline</p>

<p>Alcohol and Tobacco</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>1)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Know all of the vocabulary words for this chapter (bold text words listed in blue at the side of pages)</p>

<p>2)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; According to the National Institute on Alcohol Abuse and Alcoholism, what are the limits (for both men and women) for low-risk drinking? (pg. 216)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>What do they define as one drink? Be sure to include the common one-drink equivalents pointed out in the text and Figure 9.1.</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>3)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Why are the drink limits for men and women different? (pg. 216)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>4)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Which ethnic group in America has a death rate from alcoholism more than five times greater than other groups and what may be some of the factors which lead to this? (pg. 217)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>5)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; How is binge drinking (or heavy episodic drinking) defined for both men and women? (pg. 218)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>How is extreme drinking defined for both men and women?</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>6)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; What negative consequences can the drinker experience? (pg. 218)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>What negative consequences can the drinker cause others (&quot;secondhand effects&quot;)?</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>7)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; What are the risks of drinks mixing alcohol with CBD and THC? (pg. 220)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>8)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Alcohol is a central nervous system ____________________. (pg. 220)</p>

<p>&nbsp;</p>

<p>9)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Many factors affect the rate of alcohol absorption. Characterize faster/slower absorption and the reason(s) why for the following factors: (pp. 220-222)</p>

<p>Food in the stomach:</p>

<p>&nbsp;</p>

<p>Gender:</p>

<p>&nbsp;</p>

<p>Age:</p>

<p>&nbsp;</p>

<p>Body fat:</p>

<p>&nbsp;</p>

<p>Drug interactions:</p>

<p>&nbsp;</p>

<p>Cigarettes:</p>

<p>&nbsp;</p>

<p>Mood and physical condition:</p>

<p>&nbsp;</p>

<p>Alcohol concentration:</p>

<p>&nbsp;</p>

<p>Carbonation:</p>

<p>&nbsp;</p>

<p>Diet soda:</p>

<p>&nbsp;</p>

<p>Tolerance:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>10)&nbsp; What part of the body metabolizes most (90%) of the alcohol consumed? (pg. 222)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>11)&nbsp; Define blood alcohol concentration (BAC). (pg. 222)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>[TRUE/FALSE] Breath samples are accurate indicators of BAC because alcohol concentration in the breath corresponds well to alcohol concentration in the blood.</p>

<p>&nbsp;</p>

<p>12)&nbsp; Why do women tend to present higher BAC levels than men after consuming the same number of drinks? (pg. 222)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>13)&nbsp; A BAC of _______% is considered legally drunk in all states. (pg. 222)</p>

<p>&nbsp;</p>

<p>However, driving can be impaired by BAC levels as low as ______________%.</p>

<p>&nbsp;</p>

<p>14)&nbsp; Acute alcohol intoxication (a.k.a. alcohol poisoning) can occur at BAC level of _________% or greater. What are the risks of a BAC level this high? (pp. 223)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>What are the symptoms of alcohol poisoning? (Action Skill Builder pg. 225)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>15)&nbsp; When a person experiences a blackout from alcohol consumption, which part of the brain has been affected? What is this brain structure essential for? (pg. 223)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>16)&nbsp; Briefly describe each of the following alcohol consumption &quot;fads&quot; and then write the dangers associated with it. (pp. 224-225)</p>

<p>Mixed with energy drinks (mixing a depressant with a stimulant):</p>

<p>&nbsp;</p>

<p>Vaporized:</p>

<p>&nbsp;</p>

<p>By enema:</p>

<p>&nbsp;</p>

<p>Hand sanitizer:</p>

<p>&nbsp;</p>

<p>By tampon:</p>

<p>&nbsp;</p>

<p>Eyeballing:</p>

<p>&nbsp;</p>

<p>Syringe injection:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>17)&nbsp; Describe the bodily processes and effects from drinking alcohol that lead to the symptoms of a hangover the next day. (pp.225-226)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Why should caution be used with Tylenol and aspirin in treating a hangover?</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Why can it take the brain up to whole day to return to normal functioning?</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>18)&nbsp; Alcohol can cause a wide range of effects on the body, both in the short- and long-term. Characterize the following conditions on major organs. (pp. 226-228)</p>

<table border="1" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td>
			<p>Condition</p>
			</td>
			<td>
			<p>Description, effects, consequences, etc.</p>
			</td>
		</tr>
		<tr>
			<td>
			<p>Fetal alcohol syndrome</p>
			</td>
			<td>
			<p>&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td>
			<p>Cardiomyopathy</p>
			</td>
			<td>
			<p>&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td>
			<p>Fatty liver</p>
			</td>
			<td>
			<p>&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td>
			<p>Alcoholic hepatitis</p>
			</td>
			<td>
			<p>&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td>
			<p>Cirrhosis</p>
			</td>
			<td>
			<p>&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td>
			<p>Cancer</p>
			</td>
			<td>
			<p>&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td>
			<p>Brain damage</p>
			</td>
			<td>
			<p>&nbsp;</p>
			</td>
		</tr>
	</tbody>
</table>

<p>&nbsp;</p>

<p>19)&nbsp; Take notes on how alcohol affects the following risky behaviors. (pg. 228)</p>

<p>Sexual risks:</p>

<p>&nbsp;</p>

<p>Violence risks:</p>

<p>&nbsp;</p>

<p>Injury risks:</p>

<p>&nbsp;</p>

<p>Suicide risks:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>20)&nbsp; Write the correct term which matches the following definitions of problematic alcoholic consumption levels. Use these to understand the key differences between them. (pg. 229)</p>

<p>- Consuming alcohol to the point where it causes personal harm:</p>

<p>&nbsp;</p>

<p>- A pattern of alcohol use that impairs the drinker&#39;s life, causing difficulties for self and others:</p>

<p>&nbsp;</p>

<p>- Continued use of alcohol despite negative consequences, causing personal, social, and legal difficulties:</p>

<p>&nbsp;</p>

<p>- A strong, compulsive craving for alcohol, causing physiological changes within the brain and body, including signs of tolerance and withdrawal:</p>

<p>&nbsp;</p>

<p>- A chronic disease involving excessive, compulsive drinking, often progressive and fatal:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>21)&nbsp; [TRUE/FALSE] The USDA recommends that everyone should drink one glass of red wine a day for its potential health benefits. (pp. 229-230)</p>

<p>&nbsp;</p>

<p>22)&nbsp; Briefly characterize how the following approaches aim to curtail problematic drinking. (pp.230-231)</p>

<p>Interventions and education:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Inpatient and outpatient treatment:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Self-help programs:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Controlled drinking:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Laws and enforcement:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Liquor sales and pricing:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>23)&nbsp; What percent of people in the US above the age of 18 are smokers? _______ (pg. 232)</p>

<p>Compared to how many in 1965? ________</p>

<p>&nbsp;</p>

<p>24)&nbsp; Tobacco is associated with thousands of substances, of which nearly 70 are carcinogens. Match the following three tobacco elements with their definition/effects. (pg. 233)</p>

<table border="1" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td>
			<p>(1) Tar</p>
			</td>
			<td>
			<p>(a) the highly addictive component in tobacco that is both a poison and a psychoactive drug</p>

			<p>&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td>
			<p>(2) Carbon monoxide</p>
			</td>
			<td>
			<p>(b) a sticky reside that coats the lungs and encourages the growth of cancerous cells</p>

			<p>&nbsp;</p>
			</td>
		</tr>
		<tr>
			<td>
			<p>(3) Nicotine</p>
			</td>
			<td>
			<p>(c) a gaseous compound that interferes with the ability of red blood cells to effectively carry oxygen</p>
			</td>
		</tr>
	</tbody>
</table>

<p>&nbsp;</p>

<p>25)&nbsp; Whereas alcohol acts as a depressant, nicotine is a __________________. (pg.233)</p>

<p>&nbsp;</p>

<p>26)&nbsp; The negative health consequences of smoking cigarettes have been widely publicized. However, other forms of tobacco delivery cause serious health risks as well. List the toxic substances and health conditions associated with the following delivery systems. (pp. 234-237)</p>

<p>E-cigarettes and vaping:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Hookahs:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Cigars and cigarillos:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Pipes:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Smokeless tobacco:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Dissolvable tobacco:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>27)&nbsp; [TRUE/FALSE] Some health experts believe that nicotine is the most addictive psychoactive drug. (pg. 237)</p>

<p>&nbsp;</p>

<p>28)&nbsp; What are the symptoms of nicotine withdrawal? (pg. 237)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>About how long does it take for a person&#39;s brain chemistry to return to normal after quitting nicotine?</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>29)&nbsp; Beyond physiological addiction, how is a smoker&#39;s lifestyle/habits affected by... (pg. 238)</p>

<p>paired behavior associations:</p>

<p>&nbsp;</p>

<p>concerns with weight control:</p>

<p>&nbsp;</p>

<p>tobacco marketing:</p>

<p>&nbsp;</p>

<p>30)&nbsp; [TRUE/FALSE] Smoking is the single greatest preventable cause of illness and premature death in North America. (pg. 238)</p>

<p>&nbsp;</p>

<p>31)&nbsp; In what ways does tobacco contribute to the following chronic conditions? (pp. 239-240)</p>

<p>Cardiovascular disease:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Cancer:</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Chronic obstructive pulmonary disease (COPD):</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>32)&nbsp; What are the special health risks women face from tobacco usage? (pg. 240)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>What are the special health risks men face from tobacco usage?</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>33)&nbsp; Although African Americans have lower rates of tobacco use, they face a greater risk of death from its associated conditions. What reasons could be contributing to this? (pp. 240-241)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>34)&nbsp; [TRUE/FALSE] Benefits from quitting smoking don&#39;t begin until at least a year after quitting and, even then, it&#39;s impossible for a smoker&#39;s life expectancy to ever return to that of a non-smoker. (pg. 241, Table 9.3)</p>

<p>&nbsp;</p>

<p>35)&nbsp; Describe how environmental tobacco smoke (&quot;secondhand smoke&quot;) can impact... (pp.241-242)</p>

<p>non-smokers:</p>

<p>&nbsp;</p>

<p>infants and children:</p>

<p>&nbsp;</p>

<p>pets:</p>

<p>&nbsp;</p>

<p>36)&nbsp; What sort of tactics and approaches do treatment programs use for quitting smoking? (pg. 242)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>37)&nbsp; How does nicotine replacement therapy (NRT) work and why do you think it&#39;s important to have a health care professional involved in the process? (pg. 242)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>38)&nbsp; Why are exercise and hydration important while quitting smoking? (pg. 244)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>39)&nbsp; [TRUE/FALSE] Cigarette tax increases have been particularly effective in discouraging people from starting smoking. (pg. 245)</p>

<p>&nbsp;</p>

<p>40)&nbsp; In what ways does the FDA&#39;s deeming rule regulate the tobacco industry? (pg. 245)</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>&nbsp;</p>

<p>Your Health Today 2023</p>

<p>C. Kerns-Campbell</p>
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