Chapter 12 lecture outline

Chapter 12 – Alcohol and Tobacco
12
Alcohol and Tobacco
LectureOutline
I. Drinking in America
A. Introduction
1. Alcohol is the most widely used drug in the world.
2. No medical conditions, other than heart disease, cause more disability and
premature death than alcohol-related problems.
3. The median age of first alcohol use is 15.
B. Why People Don’t Drink
1. More Americans are choosing not to drink and alcohol consumption is at
its lowest level in decades.
2. Nonalcoholic beverages have grown in popularity.
3. Certain people should not drink at all. These include:
a. Anyone younger than 21.
b. Anyone who plans to drive, to operate motorized equipment, or to
engage in other activities that require alertness and skill.
c. Women who are pregnant or trying to become pregnant.
d. Individuals taking certain over-the-counter or prescription
medications.
e. People with medical conditions that can be made worse by drinking.
f. Recovering alcoholics.
C. Why People Drink
1. The most common reason people drink is to relax.
a. Confirmatory drinking – drinking to reinforce the image of
masculinity associated with alcohol consumption.
b. Compensatory drinking – consuming alcohol to heighten their sense of
masculinity or femininity.

2. Other reasons men and women drink include:
a. Social ease
b. Role models
c. Advertising
d. Relationship issues
e. Childhood traumas
f. Unemployment
II. Drinking on Campus
A. Overview
1. The highest proportion of heavy drinkers and individuals with
diagnosable alcohol abuse disorders are 18 to 25 years old.
2. About one in three students increases alcohol use and encounters more
related problems throughout the college years.
3. More students drink simply to get drunk and drink more per drinking
episode.
4. More college women drink, and drink more than in the past.
5. College men drink more, more often, and more intensely than women.
A. Why Students Don’t Drink
1. About 24.4 percent of students report never using alcohol.
2. Students who do not drink give various reasons for their choice, including
not having access to alcohol, parental or peer pressure, being underage,
costs, religious reasons, and not liking the taste.
3. Spiritual and religious values also influence drinking on campus.
B. Why Students Drink
1. Undergraduates have always turned to alcohol for the same reasons.
2. The most common influences on student drinking include:
a. Social norms
b. Party schools
c. Living arrangements
d. Weekends and Special Occasions
e. Participation in sports
f. Coping
g. Parental attitudes
h. First-year transitions
i. Sexual victimization
C. High-Risk Drinking on Campus
1. The most common types of student high-risk drinking are binge drinking,
predrinking, underage drinking, binge drinking combined with
disordered eating and consumption of caffeinated alcoholic beverages.

2. Binge Drinking
a. A binge is a pattern of drinking alcohol that brings blood alcohol
concentration to 0.08 gram-percent or above.
i. For a typical adult man this pattern corresponds to consuming five
or more drinks in about two hours; for a woman, four or more
drinks.
3. Who Binge-Drinks in College?
a. An estimated four in ten college students drink at binge levels or
greater.
b. Here are some of their characteristics:
i. More likely to be male than female
ii. More likely to be white
iii. More likely to be under age 24
iv. More likely to be enrolled in a four-year college
v. More likely to live in state with fewer alcohol control policies
vi. More likely to be involved in athletics and socialize frequently
vii. More likely to be in a fraternity or sorority
viii.More likely to be dissatisfied with their bodies, not exercise, eat
poorly, and go on unhealthy diets
ix. More likely to put themselves or others at risk by driving and
drinking
x. Much more likely to miss class or fall behind in schoolwork
xi. More likely to abuse other substances
xii. Much more likely to be injured or hurt, engage in unplanned or
unprotected sexual activity, or get in trouble with campus police
xiii. Why Students Binge-Drink
c. The factors that most influence students to binge-drink are:
i. Low price for alcohol
ii. Easy access to alcohol
iii. Attending a school with many binge drinkers
iv. Peer pressure
v. Campus environment
vi. Drinking games
vii. Family attitudes
viii.Early access to alcohol
4. Drinking Games
a. Two-thirds of college students engage in drinking games that involve
binge drinking.
b. Men are more likely to participate than women.

5. Predrinking/Pregaming
a. Drinking before going out has become increasingly popular.
b. Predrinkers consistently report much higher alcohol consumption
during the evening and more negative consequences.
6. Why is Predrinking Popular?
a. College students predrink for a variety of reasons including:
i. Economic
ii. Intoxication
iii. Socializing
iv. Anxiety reduction
v. Group bonding
7. The Perils of Predrinking
a. Students drink more and have higher blood-alcohol concentrations on
days when they predrink.
8. Underage Drinking on Campus
a. Each year, approximately 5,000 people under the age of 21 die as a
result of underage drinking.
9. Binge Drinking and Disordered Eating
a. In women, the combination of these behaviors increases the risk of
many negative consequences, including blackouts, unintended sexual
activity, and forced sexual intercourse.
b. Drunkorexia is restricting calories from food prior to planned drinking
– some to avoid weight gain; others, to enhance the effects of alcohol.
10. Alcohol Mixed with Energy Drinks (AmED)
a. These drinks are premixed beverages that combine alcohol, caffeine,
and other stimulants.
b. Light energy drinks – sometimes dubbed “blackout in a can” – have
surged in popularity among teens and young adults.
D. Why Students Stop Drinking
1. As many as 22 percent of alcohol-abusing college student
“spontaneously” reduce their drinking as they progress through college.
2. Reasons include it was getting old, vomiting, urinating in hallways, being
physically fondled, sexual assault, violence, accidents, injuries,
unprotected intercourse, and emergency room visits.
E. Alcohol Related Problems on Campus
1. Consequences of Drinking
a. Atypical behavior
b. Academic problems
c. Risky sexual behavior
d. Sexual assault

i. Alcohol increases the risk of violence among couple.
e. Unintentional injury
f. Consequences beyond college
g. Illness and death
2. Drinking and Driving
a. Drunk driving is the most frequently committed crime in the United
States.
b. Alcohol impairs driving-related skills regardless of the age of the
driver or the time of day it is consumed.
c. Although most drunk drivers are men, more young women are
driving drunk and getting into fatal car accidents.
d. A young person dies in an alcohol related crash every three hours.
e. Mothers Against Drunk Drivers (MADD) and Students Against Drunk
Drivers (SADD) have organized to change the way the nation treats
drunk drivers.
i. Since establishments that serve alcohol are now liable for the
consequences of allowing drunk customers to drive, many have
joined the campaign against drunk driving.
III. Understanding Alcohol
A. Overview
1. Alcohol is a colorless liquid obtained through the fermentation of a liquid
containing sugar.
2. Ethyl alcohol, or ethanol, is the type of alcohol in alcoholic beverages.
3. Any liquid containing .05 to 80 percent ethyl alcohol by volume is an
alcoholic beverage.
4. One drink can be any of the following:
a. One bottle or can (12 ounces) beer, which is 5 percent alcohol.
b. One glass (4 or 5 ounces) table wine, such as burgundy, which is 12
percent alcohol.
c. One small glass (2 ½ ounces) fortified wine, which is 20 percent
alcohol.
d. One shot (1 ounce) distilled spirits (such as whiskey, vodka, rum),
which is 50 percent alcohol.
5. Drinks at college parties vary greatly in their alcoholic content.
6. It may be impossible for students to monitor their alcohol intake simply
by counting the number of drinks they have.
7. With distilled spirits, alcohol content is expressed in terms of proof.
a. Proof is a number that is twice the percentage of alcohol: 100 proof is
50 percent alcohol.

B. Blood Alcohol Concentration
1. It is expressed in the terms of percentage of alcohol in the blood and is
often measured from breath or urine samples. BAC is used to determine
whether a driver is legally drunk.
a. The federal Department of Transportation set the limit at 0.08 percent
for driving.
i. A 150-pound man would have had to consume three mixed drinks
within an hour threshold to be cited for drunk driving.
2. Factors that influence BAC (blood-alcohol concentration):
a. How much and how quickly you drink
b. What you are drinking
i. Absorption is the rate of the passage of substances into or across
membranes or tissues.
ii. Mixers
c. Your size
d. Your gender
e. Your age
f. Your race
g. Other drugs
h. Family history of alcoholism
i. Eating
j. Expectations
k. Physical tolerance
C. Moderate Alcohol Use
1. The federal government’s Dietary Guidelines for Americans
recommended no more than one drink a day for women and no more than
two drinks a day for men.
2. The American Heart Association advises that alcohol account for no more
than 15 percent of the total calories consumed by an individual every day,
up to an absolute maximum of 1.75 ounces of alcohol a day.
D. Alcoholic Intoxication
1. Intoxication can range from mild inebriation to loss of consciousness.
a. Characterized by at least one of the following symptoms:
i. Slurred speech, poor coordination, unsteady gait, abnormal eye
movements, impaired attention or memory, stupor, or coma.
E. Alcohol Poisoning
1. Depresses the nerves that control involuntary actions, such as breathing
and gag reflex (which prevents choking).
a. Signs of alcohol poisoning:
i. Mental confusion, stupor, coma or person cannot be roused

ii. Vomiting
iii. Seizures
iv. Slow breathing
v. Irregular breathing
vi. Hypothermia
IV. The Impact of Alcohol on the Body
A. Overview
1. Most (about 95%) of the alcohol you drink can leave your body only after
metabolism by the liver.
2. Alcohol is a diuretic which is a drug that speeds up the elimination of
fluid from the body.
a. Drink water while drinking alcohol to maintain fluid balance.
B. Digestive System
1. In the stomach, alcohol triggers the secretion of acids, which irritate the
stomach lining.
2. In the liver excess alcohol is converted to fat.
3. More than 2 million Americans have alcohol-related liver diseases.
C. Weight and Waists
1. Alcohol has 7 calories per gram.
2. In addition to being a calorie-dense food, alcohol stimulates the appetite,
so you are likely to eat more.
D. Cardiorespiratory System
1. Alcohol gets mixed reviews regarding its effects on the cardiorespiratory
system.
2. Some cardiologists contend that the benefits of moderate drinking may be
overstated, especially because of alcohol’s contribution to the epidemic of
obesity.
E. Cancer
1. Overall past and current drinking may contribute to about 10 percent of
all cancer cases in men and 3 percent in women.
F. Brain and Behavior
1. Moderate amounts of alcohol can have disturbing effects on perception
and judgment, including the following:
a. Impaired perceptions
b. Dulled sense of smell and taste
c. Diminished sensation
d. Alerted sense of space
e. Impaired motor skills
f. Impaired sexual performance

G. Interactions with Other Drugs
1. Alcohol can interact with other drugs—prescription and nonprescription,
legal and illegal.
2. Of the 100 most frequently prescribed drugs, more than half contain at
least one ingredient that interacts adversely with alcohol.
H. Immune System
1. Chronic alcohol use can inhibit the production of both white blood cells
and red blood cells.
I. Increased Risk of Dying
1. Alcohol is responsible for 100,000 deaths each year and is the third leading
cause of death after tobacco and improper diet and lack of exercise.
V. Alcohol, Gender, and Race
Experts are increasingly recognizing racial and ethnic differences in risk factors for
drinking problems, patterns of drinking, and most effective types of treatment.
A. Gender
1. In general, men drink more frequently, consume larger quantities of
alcohol per drinking occasion, and report more problems related to
drinking.
2. More than half of women drink. They drink alone more often, binge less,
have more regular drinking patterns, and drink smaller quantities than
men.
3. The bodies of men and women respond to alcohol in different ways.
4. An estimated 15 percent of women drink alcohol while pregnant, most
having one drink or less per day.
a. Fetal alcohol effects (FAE) can occur from even light consumption of
alcohol. These include:
i. Low birth weight
ii. Irritability as a newborn
iii. Permanent mental impairment
b. Fetal alcohol syndrome (FAS) can occur from women who consume
three or more ounces of alcohol a day. These include:
i. Small head
ii. Abnormal facial features
iii. Sluggish motor development
iv. Failure to thrive
v. Short stature
vi. Delayed speech
vii. Mental retardation
viii.Hyperactivity

5. Alcohol interferes with male sexual function and infertility.
B. Race
1. African American Community
a. Overall, African Americans consume less alcohol per person than
whites, yet twice as many blacks die of cirrhosis of the liver each year.
2. Hispanic Community
a. The various Hispanic cultures tend to discourage any drinking by
women but encourage heavy drinking by men as part of machismo, or
feelings of manhood.
3. Native American Community
a. Native Americans have three times the general population’s rate of
alcohol-related injury and illness.
4. Asian American Community
a. Asian Americans tend to drink very little or not at all, in part because
of an inborn physiological reaction to alcohol that causes facial
flushing, rapid heart rate, lowered blood pressure, nausea, vomiting,
and other symptoms.
VI. Alcohol-related Disorders
A. Introduction
1. By the simplest definition, problem drinking is the use of alcohol in any
way that creates difficulties, potential difficulties, or health risks for an
individual.
2. Alcohol abuse involves the continued use of alcohol despite awareness of
social, occupational, psychological, or physical problems related to
drinking, or drinking in dangerous ways or situations.
3. Diagnosis based on one or more of the following occurring during any 12-
month period:
a. A failure to fulfill major role obligations.
b. The use of alcohol in situations in which it is physically hazardous.
c. Alcohol-related legal problems.
d. Continued use despite persistent or reoccurring social or interpersonal
problems.
4. Alcohol dependence is a separate disorder in which individuals develop a
strong craving for alcohol because it produces pleasurable feelings or
relieves stress or anxiety. Leads to tolerance (takes more to acquire same
effects) and withdrawal (when drinking stops abruptly).
5. Diagnosis based on three or more of the following symptoms occurring
during any 12-month period:
a. Tolerance.

b. Withdrawal.
c. Drinking to avoid withdrawal symptoms.
d. Consuming larger amounts of alcohol.
e. Persistent desire to control drinking.
f. Great deal of time spent drinking.
g. Important social, occupational, or recreational activities given up.
h. Continued alcohol use.
6. Alcoholism is a primary, chronic, disease in which genetic, psychosocial,
and environmental factors influence its development and manifestations.
a. Characteristics include:
i. An inability to control drinking
ii. A preoccupation with alcohol
iii. Continued use of alcohol despite adverse consequences
iv. Distorted thinking
v. Denial
B. Causes of Alcohol Dependence and Abuse
1. Genetics
2. Stress and traumatic experiences
3. Parental alcoholism
4. Drug abuse
C. Medical Complications of Alcohol Abuse and Dependence
1. Liver disease
2. Cardiorespiratory disease
3. Cancer
4. Brain damage
5. Vitamin deficiencies
6. Digestive problems
VII. Alcoholism Treatments
A. An estimated 8 million adults in the United States have alcohol dependence,
but only a minority ever undergo treatment for alcohol-related problems.
B. Today individuals whose drinking could be hazardous to their health may
choose from a variety of approaches, including medication, behavioral
therapy, or both.
C. Men and women who have seriously remained sober for more than a decade
credit a variety of approaches, including Alcoholics Anonymous (AA),
individual psychotherapy, and other groups, such as Women for Sobriety.
VIII. Tobacco in America

A. According to the Center for Disease Control and Prevention (CDC), 20
percent of American adults—some 43 million men and women—smoke.
B. An estimated 400,000 individuals die prematurely in the U.S. due to tobacco
use each year.
C. Groups with the lowest smoking rates include women with undergraduate or
graduate degrees, men with graduate degrees, Hispanic and Asian women,
people over the age of 65, and the residents of Utah. .
D. Individuals with undergraduate and graduate degrees are least likely to
smoke.
E. There are now more former smokers than active smokers in the U.S. and
more than half of the population lives where smoking is prohibited in
workplaces.
F. Why Do People Start Smoking?
1. Limited education
2. Underestimation of risks
3. Adolescent experimentation and rebellion
4. Stress
5. Parental role models
6. Addiction
7. Mental disorders
8. Genetics
9. Weight control
10. Mental disorders
IX. Tobacco Use on Campus
A. Introduction
1. One in every four to five students currently smokes.
2. Many college students say they smoke as a way of managing depression.
B. Social Smoking
1. “Social smokers” average less than one cigarette a day and smoke mainly
in the company of others.
2. Even smokers who don’t inhale or nonsmokers who breathe in
secondhand smoke are at increased risk for negative health effects.
3. Social smokers are less motivated to quit and make fewer attempts to do
so.
X. Smoking, Gender, and Race
A. High nicotine intake may affect male hormones, including testosterone.
B. Women are at greater risk for developing smoking-related illnesses compared
with men who smoke the same amount.

C. Smoking directly affects women’s reproductive organs and processes.
D. Among adults, Native Americans and Alaska Natives have the highest rates
of use.
XI. Tobacco’s Immediate Effects
A. Introduction
1. Tobacco is an herb that can be smoked or chewed, directly affects the
brain.
2. While its primary active ingredient is nicotine, tobacco smoke contains
almost 400 other compounds and chemicals.
B. How Nicotine Works
1. A colorless, oily compound, nicotine is poisonous in concentrated
amounts.
2. The FDA has concluded that nicotine is a dangerous, addictive drug that
should be regulated.
3. Nicotine affects the brain in much the same way as cocaine, opiates, and
amphetamines, triggering the release of dopamine, a neurotransmitter
associated with pleasure and addiction.
4. Nicotine may enhance performance on some tasks but leaves other mental
skills unchanged.
5. Nicotine stimulates the adrenal glands to produce adrenaline, a hormone
that increases blood pressure, speeds the heart rate, and constricts blood
vessels.
C. Tar and Carbon Monoxide
1. As it burns, tobacco produces tar, a thick, sticky dark fluid made up of
several hundred different chemicals—many of them poisonous, some of
them carcinogenic.
2. Smoke from cigarettes, cigars, and pipes also contains carbon monoxide,
the deadly gas that comes out of the exhaust pipes of cars.
XII. Health Effects of Cigarette Smoking
A. Overview
1. If you’re a smoker who inhales deeply and started smoking before the age
of 15, you’re trading a minute of future life for every minute you now
spend smoking.
2. A cigarette smoker is 10 times more likely to develop lung cancer, 20 times
more likely to have a heart attack, increases the risk of breast cancer, and
is more likely to have suicidal thoughts and attempt suicide than a non-
smoker.
B. Health Effects on Students

1. Young people who smoke are less physically fit and suffer diminished
lung function and growth.
2. Long-term health consequences of smoking in young adulthood include
dental problems, lung disorders, heart disease, and cancer.
C. Heart Disease and Stroke
1. Heart attack is the leading cause of death for smokers.
2. Smokers who suffer heart attacks have only a 50 percent chance of
recovering.
3. Even people who have smoked for decades can reduce their risk of heart
attack if they quit smoking.
D. Cancer
1. Smoking is linked to at least ten different cancers and accounts for 30
percent of all deaths from cancer.
2. Chemicals in cigarette smoke and other environmental pollutants switch
on a particular gene in the lung cells of some individuals. This gene
produces an enzyme that helps manufacture powerful carcinogens, which
set the stage for caner.
E. Respiratory Diseases
1. Smoking quickly impairs the respiratory system, including the cough
reflex, a vital protective response.
2. Smoking is a major cause of chronic obstructive pulmonary disease
(COPD), which includes emphysema and chronic bronchitis.
3. COPD is characterized by progressive limitation of the flow of air into and
out of the lungs.
4. In chronic bronchitis, the bronchial tubes in the lungs become inflamed,
thickening the walls of the bronchi, and the production of mucus
increases.
F. Other Smoking-Related Problems
1. Smokers are more likely to develop gum disease.
2. Cigarette smoking is associated with stomach and duodenal ulcers;
mouth, throat, and other types of cancer; and cirrhosis of the liver.
3. Smoking may worsen the symptoms or complications of allergies,
diabetes, hypertension, peptic ulcers, and disorders of the lungs and blood
vessels.
XIII. Other Forms of Tobacco
Two percent of Americans smoke cigars and two percent use smokeless tobacco.
A. Cigars
1. Cigar smoking is as dangerous as cigarette smoking even though cigar
smokers do not inhale.

B. Water Pipes (Hookahs)
1. Also known as narghile, arghile, and hubble,-bubble, water pipes involve
the passage of smoke through water prior to inhalation.
2. Although also used to smoke other substances including marijuana and
hashish, oater pipes are most often used with flavored tobacco, made by
mixing shredded tobacco with honey or molasses and dried fruit. This mix
is called shisha in the U.S.
3. One quarter of college students have smoked tobacco from a water pipe.
4. The risks are similar to those of smoking cigarettes.
C. Pipes
1. People who have smoked only pipes and who do not inhale, are less likely
to develop lung and heart disease.
2. They are likely to suffer respiratory problems and to develop – and die
from – cancer of the mouth, larynx, throat, and esophagus.
D. Bidis
1. Bidis are skinny, sweet-flavored cigarettes. They are legal for adults and
even minors in some states and are sold on the Internet as well as in
stores.
2. Although bidis contain less tobacco than regular cigarettes, their
unprocessed tobacco is more potent.
E. Clove Cigarettes
1. Clove cigarettes typically contain two-thirds tobacco and one-third cloves.
2. The CDC reports that people who smoke clove cigarettes may be at risk of
serious lung injury.
3. Clove cigarettes deliver twice as much nicotine, tar, and carbon monoxide
as moderate-tar American brands.
F. Smokeless Tobacco
1. Types of smokeless tobacco include snuff, finely ground tobacco that can
be sniffed or placed inside the cheek and sucked, and chewing tobacco,
tobacco leaves mixed with flavoring agents such as molasses.
2. Smokeless tobacco causes a user’s heart rate, blood pressure, and
epinephrine levels to jump.
3. Powerful carcinogens, (cancer causing agents), in smokeless tobacco
include nitrosamines, polycyclic aromatic hydrocarbons, and radiation-
emitting polonium.
4. In addition, smokeless tobacco can cause cancer and noncancerous oral
conditions and lead to nicotine addiction and dependence.
XIV. Quitting Tobacco Use
A. Introduction

1. The U.S. Public Health Service’s new guidelines for treating tobacco use
and dependence recognize tobacco dependence as “a chronic disease that
often requires repeated intervention and multiple attempts to quit.
Effective treatments exist, however, that can significantly increase rates of
long-term abstinence.”
2. More than 70 percent of the 45 million smokers in the United States say
they want to quit; approximately 44 percent try to quit each year. Yet only
four to seven percent succeed in any given year.
3. While counseling and medication are each beneficial, the combination is
more effective than either alone.
B. Quitting on Your Own
1. More than 90 percent of former smokers quit on their own—by throwing
away all their cigarettes, by gradually cutting down, or by first switching
to a less potent brand.
2. Successful quitters see themselves as active participants in health
maintenance and take personal responsibility for their own health.
3. Physically active smokers have greater success quitting.
C. Virtual Support
1. Electronic communications generally resulted in higher quit rates, but
only if continued over time.
D. Stop-Smoking Groups
1. Joining a support group doubles your chances of quitting for good.
2. Aversion therapy, which provides a negative experience every time a
smoker has a cigarette, is used in some smoking cessation programs.
E. Nicotine Replacement Therapy (NRT)
1. This approach uses a variety of products that supply low doses of nicotine
in a way that allows smoker to taper off gradually over a period of
months.
2. Although NRT is touted as an aid to permanent cessation of smoking,
recent studies have found equivalent rates of relapse among smokers,
regardless of whether they used NRT, with or without professional
counseling.
3. The most effective approaches combine medication with psychological
intervention.
4. Nicotine gum maintains enough nicotine in the blood to diminish
withdrawal symptoms.
a. Nicotine patches provide nicotine via a patch attached to the skin by
an adhesive. Occasional side effects include redness, itching, or
swelling at the site of the patch application, insomnia, dry mouth, and
nervousness.

b. Nicotine inhalers are available only by prescription and total treatment
should not exceed six months.
c. Electronic or E-Cigarettes are compact, battery powered devices that
allow users to inhale a vaporized liquid nicotine solution instead of
tobacco.
d. Researchers have found that puffing on e-cigarettes produces airway
constriction and inflammation, which might lead to serious lung
diseases such as emphysema.
e. Some argue that e-cigarettes may promote continued smoking.
f. On the other hand, their use appears to enhance quitting motivation
and significantly reduce cravings in smokers and toxin exposure for
nonsmokers.
F. Medications
1. Buproprion is an alternative to the patch that is marketed in a slow-release
form for nicotine addiction as Zyban.
2. The combination of Zyban and nicotine replacement prevents the initial
weight gain that often accompanies quitting.
3. Another medication Chantix, is used to treat nicotine addiction.
XV. Environmental Tobacco Smoke
A. Introduction
1. Environmental tobacco smoke, or secondhand smoke, the most hazardous
form of indoor air pollution ranks behind cigarette smoke and alcohol as
the third-leading preventable cause of death.
a. Mainstream smoke, is what a smoker inhales.
b. Side-stream smoke is the smoke that is emitted by a burning cigarette
and breathed in by everyone in the room, including the smoker.
i. Side-stream smoke contains more tar and nicotine than
mainstream smoke.
B. Health Effects of Secondhand Smoke
1. Environmental tobacco smoke is both dangerous and deadly.
2. It leads to an estimated 3,000 deaths of non-smokers each year.
C. Third-hand Smoke
1. This is the residue that is left behind on furniture, walls, and carpeting
after a cigarette has been smoked in a room.
2. Overtime, these chemicals can contribute to breathing problems like
asthma, or possibly cancer.
3. Because ozone can continue to pull nicotine off surfaces and back into the
air for months, exposure to third-hand smoke may continue long after
smoking in the area has ceased.

4. The danger may be greatest to infants, children, pregnant women, and the
elderly.
Key Terms
absorption
alcohol use disorder
alcoholism
AmED (alcohol mixed with energy
drink)
aversion therapy
bidis
binge
blood-alcohol concentration (BAC)
carbon monoxide
environmental tobacco
smoke
ethyl alcohol
fetal alcohol effects (FAE)
fetal alcohol syndrome (FAS)
harm reduction
mainstream smoke
nicotine
predrinking
proof
sidestream smoke
snus
tar
tobacco use disorder
tolerance
withdrawal

Chapter 12 lecture outline

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