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Chapter 8. Alcohol and Tobacco Use and Abuse. Did You Know?. Alcohol is a factor in about 60% of fatal burn injuries, drownings, and homicides; 50% of severe trauma injuries and sexual assaults; and 40% of fatal motor vehicle crashes, suicides, and fatal falls.

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Chapter 8

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Chapter 8

Alcohol and Tobacco Use and Abuse

Did You Know?

  • Alcohol is a factor in about 60% of fatal burn injuries, drownings, and homicides; 50% of severe trauma injuries and sexual assaults; and 40% of fatal motor vehicle crashes, suicides, and fatal falls.

  • 26.9% of U.S. college students do not drink at all.

  • One out of every five deaths in the U.S. is caused by a smoking-related illness.

  • Secondhand smoke contains more than 250 chemicals known to be toxic or cancer-causing, including arsenic, ammonia, formaldehyde, and benzene.

Learning Objectives

  • Discuss the prevalence of alcohol and tobacco use in the United States.

  • Describe how the body absorbs and metabolizes alcohol.

  • Describe the short-term and long-term health effects of alcohol use.

  • List strategies for preventing alcohol abuse and for treating alcoholism.

  • Explain the effects of nicotine on the body.

  • Identify the short-term and long-term health effects of nicotine use.

  • List strategies for quitting smoking.


Alcohol in the U.S.

  • There is a minimum drinking age of 21 in the U.S.

  • The establishment of the minimum age reduced traffic crashes and fatalities and suicide, and decreased consumption by those under age 21.

Alcohol Use on Campus

  • An estimated 85% of college students nationwide have tried alcohol, and 40% report binge drinking.

  • Binge drinking: A pattern of drinking alcohol that results in a blood alcohol concentration of 0.08 or above.

    • Typically, this means five or more alcoholic drinks within 2 hours for men, or four or more alcoholic drinks within 2 hours for women.

  • Binge drinking is highest among young adults aged 18–24.

Binge Drinking

  • This can be considered the most significant health risk behavior 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, drownings, and homicides.

  • It is a factor in 40% of fatal motor vehicle crashes, suicides, and fatal falls.

  • It can lead to drunk driving, violence, vandalism, risky sex, forced sex, and poor academic performance.

Why Do Students Drink?

  • Motivations can be grouped into four different categories.

    • Coping: To avoid problems.

    • Conformity: To gain peer acceptance.

    • Enhancement: To induce a positive mood.

    • Social: To make parties and outings more enjoyable.



  • 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).

A standard drink contains about 14 grams pure alcohol (one 12-oz. can of beer, one 5-oz. glass of wine, or 1.5 oz. of 80-proof liquor).


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.

  • Acute intoxication (alcohol poisoning): A potentially fatal concentration of alcohol in the blood.

    • This can occur when a person consumes alcohol at a faster rate than the liver can break it down.

Alcohol absorption and metabolism

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, physical condition

    • Food intake

    • Medications

Blood alcohol concentration (BAC) tables. The orange areas indicate legal intoxication.


  • Alcohol intoxication is the state of physical and/or mental impairment brought on by excessive alcohol consumption (a BAC of 0.08% or greater).

  • In a basic sense, it’s another term for being drunk.

  • Symptoms of intoxication vary depending on the individual.


  • Symptoms of intoxication progress through:

    • Relaxation and exhilaration;

    • Decreased fine motor skills;

    • Slowed reaction time, poor muscle control, slurred speech, wobbly legs;

    • Loss of self-restraint, impaired ability to reason;

    • Blurred vision, unclear speech;

    • Difficulty staying awake;

    • Deep sleep or stupor;

    • Deep coma and danger of death.


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 caused by an earlier bout of heavy drinking can include headache, nausea, fatigue, sensitivity to light and sound, eye redness, dry mouth, muscle aches, thirst, diarrhea, dizziness, and depression.

Alcohol Poisoning

  • A result of a dangerously high level of alcohol consumption and the toxic byproducts that result when alcohol is metabolized by the body.

    • Includes depression of the central nervous system, slowed breathing and heart rate, and compromised gag reflex that can lead to asphyxiation if the person chokes on his or her own vomit while unconscious.

Alcohol Poisoning

  • 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 can’t rouse him or her.

    • Has consumed other drugs.

    • Is experiencing seizures.

    • Is injured.

    • Has a respiration rate fewer than 8 breaths per minute.

    • Is experiencing shallow or irregular breathing (10 seconds or more between breaths).

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.

    • Heart disease.

    • Liver problems, including fatty liver, alcoholic hepatitis, and alcoholic cirrhosis.

    • Neurological ailments, including problems with learning and memory.

Alcohol and Cancer

  • Discussion Questions

    • In what ways can even moderate drinking significantly raise a women’s risk of cancer?

    • What role does a person’s family history play in risks associated with drinking?

Alcohol and Pregnancy

  • Ingesting alcohol during the first trimester of pregnancy can cause miscarriage.

  • Fetal alcohol syndrome: A pattern of birth defects that appear in children of mothers who drink while pregnant, manifesting as:

    • Facial abnormalities

    • Retarded growth

    • Permanent intellectual and behavioral problems

Short- and Long-Term Health Effects of Alcohol Use


Drinking and Driving

  • Every year, more than 160 million incidents of driving while intoxicated, also known as DWI, occur in the United States.

  • Having a BAC of 0.08% or greater will qualify you for a DWI arrest in all 50 states if you are 21 years of age or older.

  • It is illegal to have ANY alcohol in your system if you are underage.

Alcohol and Sexual Activity

  • Engaging in sexual intercourse while intoxicated can lead to:

    • Unplanned sexual activities.

    • 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 violence or rape.


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.


  • An alcoholic will display 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

  • 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.

    • Poverty.

    • Being a victim of physical or sexual abuse.

    • Those under a great deal of chronic stress sometimes self-medicate with alcohol.

Common Profiles of Alcoholics

  • Alcoholism knows no demographic boundaries.

  • There are five types of alcoholics that are most prevalent:

    • Young adult subtype

    • Young antisocial subtype

    • Functional subtype

    • Intermediate family subtype

    • Chronic severe subtype

Hidden Addictions

  • Discussion Questions

    • After watching the video, how would you define a hidden addiction?

    • What are some common warning signs that are characteristic of someone who is hiding an addiction?

    • If you suspect that someone you know has a secret addiction, why is it important to speak up and tell someone else?


Treatment Options

  • Medications

  • Alcohol counseling or talk therapy

  • Self-help groups

  • Intensive treatment programs


  • If you return to drinking after a period of sobriety:

    • Get back on track. Stop drinking—the sooner the better.

    • Each day is a new day to start over.

    • Understand that setbacks are common when people undertake a major change.

    • Don’t run yourself down. It doesn’t help.

    • Get some help.

    • Think it through to better understand why the episode happened at that particular time and place.

    • Learn from what happened.

    • Avoid triggers to drink.

    • Find alternatives that are not associated with drinking.


Smoking in the U.S.

  • Each year, 443,000 people in the United States die prematurely because of smoking-related illnesses.

  • One of every five deaths in the U.S. is due to smoking.

  • 15% of college students have tried smoking and 4.6% report smoking daily.

Why Do Students Smoke?

  • Rebellion and experimentation

  • Peer pressure

  • Family exposure

  • Aggressive advertising and marketing

  • Desire to lose weight

  • Stress


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.

What’s in a Cigarette?

  • 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 that forms when tobacco is burned and its chemical particles condense, is a byproduct.


Short- and Long-Term Health Effects of Smoking

Smoking and Pregnancy

  • When a pregnant woman smokes, so does her unborn baby.

  • Babies born to women who smoke are two to three 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.

    • More likely to weight less than 5.5 pounds at birth, increasing risk for illness or death.

  • Smoking while pregnant has been linked to miscarriages and stillbirths.

Secondhand Smoke (Environmental Tobacco Smoke)

  • The smoke nonsmokers are exposed to when someone has been smoking nearby.

    • It contains more than 250 chemicals known to be toxic or capable of causing cancer.

    • Some chemicals are in higher concentrations 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.

Health Effects of Secondhand Smoke

  • Irritation of the eyes, nose, throat, and lungs

  • Chest pain, coughing, and production of excessive phlegm

  • Premature death and disease

  • Increased risk of heart disease

  • Lung cancer

  • Respiratory illness, including asthma, in children

  • Ear infections in children

  • Sudden infant death syndrome in some babies


Other Forms of Tobacco

  • Cigars: Contain the same addictive, toxic, cancer-causing substances that cigarettes do.

  • Clove cigarettes: There is no evidence they are any safer than cigarettes.

  • Bidis: Not safer than cigarettes.

  • Smokeless spit tobacco: Increased risk of cancer and leukoplakia.

    • Leukoplakia is characterized by whitish lesions in the mouth.

    • These lesions may become cancerous and are frequently found in snuff and chew users in their 20s.

Gruen Von Behrens was hooked on chewing tobacco at age 14 and diagnosed with oral cancer at age 17. He lost his jaw, lower teeth, and part of his tongue in his fight to beat the disease.


Benefits of quitting smoking

Treatment Options

  • Nicotine replacement therapies: Gum, inhalers, lozenges, patches

  • Prescription drugs: Chantix and Zyban

  • Residential, individual, or group therapy and education and support groups


  • Smokers commonly experience withdrawal symptoms when they first quit smoking.

    • Difficulty concentrating, a negative mood, and the urge to smoke.

    • Symptoms usually peak within one or two weeks.

  • Relapse can occur months or even years after quitting.

  • Any smoking increases likelihood of a full relapse.

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