© 2012 McGraw-Hill Companies, Inc. All rights reserved.McGraw-Hill/Irwin© 2012 McGraw-Hill Companies, Inc. All rights reserved. Health Psychology 8 th edition Shelley E. Taylor Chapter Five: Health-Compromising Behaviors: Alcoholism and Smoking

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-2 Characteristics of Health- Compromising Behaviors Many of these behaviors share a window of vulnerability in adolescence: - drinking to excess - smoking - using illicit drugs - having unsafe sex - using risk-taking behaviors

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-3 Health-Compromising Behavior (cont.) - behaviors are tied to the peer culture - image of these behaviors as “cool” - behaviors, though dangerous, are pleasurable - behaviors develop gradually - substance abuse of all kinds is predicted by some of the same factors - most problem behaviors more common in lower SEC individuals

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-4 Substance Dependence Physical dependence: - body adjusts to substance and incorporates its use into normal functioning of the body’s tissues Tolerance: - larger doses needed to produce same effects Craving: - conditioning process is involved so that environmental cues trigger intense desire

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-5 Substance Dependence (cont.) Addiction: - person has become physically or psychologically dependent on a substance following use over a period of time Withdrawal: - unpleasant symptoms, both physical and psychological, that people experience when they stop using a substance on which they have become dependent

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-6 Alcoholism and Problem Drinking Scope of the problem: - third leading cause of preventable death - more than 20% of Americans drink at levels that exceed government recommendations - alcohol consumption is linked to high blood pressure, stroke, cirrhosis of the liver, fetal alcohol syndrome and some cancers - 41% of traffic-related deaths related to alcohol - many drinkers keep their problem hidden

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-7 Alcoholism and Problem Drinking (cont.) Alcoholism: - p hysical addition to alcohol - withdrawal symptoms when abstaining from alcohol - high tolerance for alcohol - little ability to control drinking Problem drinking: - may not have all symptoms listed above, but do have substantial social, psychological and medical problems resulting from alcohol

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-8 Alcoholism and Problem Drinking (cont.) Origins of alcoholism and problem drinking: - genetic, gender, physiological, behavioral and sociocultural factors are involved Drinking and stress: - drinking buffers stress, reduces negative emotions, lowers anxiety Social origins of drinking: - two windows of vulnerability: - dependence starting between 12 and 21 years - late middle age - depression and alcoholism may be linked

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-9 Alcoholism and Problem Drinking (cont.) Treatment of alcohol abuse: - 10 to 20% of alcoholics stop drinking on their own - 32% of alcoholics can stop with minimal help - some use of cognitive-behavioral modification - without employment or social support, prospects for recovery are dim

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-10 Alcoholism and Problem Drinking (cont.) Treatment programs: - self-help groups such as AA (Alcoholics Anonymous) - inpatient/outpatient programs: - detoxification - short-term, inpatient therapy - continuing outpatient treatment

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-11 Alcoholism and Problem Drinking (cont.) Treatment programs (cont.): - cognitive-behavioral treatments: - self-monitoring - contingency contracting - motivational enhancement - medications - stress management techniques - family therapy and group counseling - relapse prevention

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-12 Alcoholism and Problem Drinking (cont.) Evaluation of alcohol treatment programs: - success involves environmental factors, outpatient services, family/social support - minimal interventions: - can make a dent in drinking-related problems - social engineering - banning alcohol advertising - raising the legal drinking age - strictly penalizing drunk driving

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-13 Alcoholism and Problem Drinking (cont.) Can recovered alcoholics ever drink again? - Alcoholics Anonymous philosophy: An alcoholic is an alcoholic for life - Drinking in moderation seems possible for: - young, employed problem drinkers - those who have not been drinking for long - those who live in supportive environments

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-14 Alcoholism and Problem Drinking (cont.) Preventive approaches to alcohol abuse: - appealing to adolescents to avoid drinking - social engineering programs Drinking and driving: - pressure state and local governments for tougher alcohol control measures - hosts/hostesses/friends intervening to recognize those too drunk to drive - need for stiffer penalties - designated drivers

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-15 Alcoholism and Problem Drinking (cont.) Is modest alcohol consumption a health behavior? - modest alcohol intake (1-2 drinks/day) may add to a long life - coronary artery disease may be reduced - HDL (“good” cholesterol) may increase - fewer strokes - moderate drinking among younger adults may enhance risks of death, probably due to alcohol- related injuries

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-16 Smoking - single greatest cause of preventable death - in the U.S., accounts for about 1 in 5 deaths - increases the risk of many diseases and disorders - smokers are generally less health-conscious than non-smokers - dangers not confined to the smoker; hazards of secondhand smoke - may lower cognitive performance in adolescents

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-17 Smoking (cont.) Synergistic effects of smoking: - smoking enhances the impact of other risk factors in compromising health: - smoking and stress can interact in dangerous ways - weight and smoking can interact to increase mortality - smokers engage in less physical activity - smoking is considered a potential cause of depression, especially among youth - smoking is related to an increase in anxiety among adolescents

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-18 Smoking (cont.) A brief history of the smoking problem: - considered sophisticated and a “manly” habit s - large numbers of women smoke – 53% of the adult male population was smoking first U.S. Surgeon General’s warning is issued – 20% of adults smoke

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-19 Smoking (cont.) Why do people smoke? - genetics: smoking runs in families - Factors associated with smoking in adolescents: - 22% of high school students already smoke - peer and family influences - self-identity and smoking - Nicotine addiction and smoking

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-20 Smoking (cont.) Interventions to reduce smoking: - changing attitudes toward smoking - the therapeutic approach to the smoking problem: - Nicotine replacement therapy - multimodal interventions - social support and stress management - interventions with adolescents - maintenance - relapse prevention - evaluation of interventions

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-21 Smoking (cont.) Brief interventions: - work-site - commercial programs and self-help - public health approach

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-22 Smoking (cont.) Smoking prevention: - advantages of smoking prevention programs: - potentially effective, cost-effective and easily implemented - social influence interventions: - modeling - McGuire’s behavioral inoculation

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-23 Smoking (cont.) Evaluation of social influence programs: - can reduce smoking rates for as long as 4 years The life-skills training approach: - encourage self-esteem and coping enhancement as well as social skills in adolescents - has shown success in the reduction of smoking onset over time

© 2012 McGraw-Hill Companies, Inc. All rights reserved.5-24 Smoking (cont.) Social engineering and smoking: - liability litigation - regulation of access of tobacco by the Food and Drug Administration - heavy taxation - restricting smoking to particular places - the perils of secondhand smoke