chapter 12 lecture outline

12Alcohol and Tobacco

Lecture OutlineI. Drinking in America

A. Introduction1. 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 Drink1. 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 Drink1. 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.

Chapter 12 – Alcohol and Tobacco

2. Other reasons men and women drink include:a. Social easeb. Role modelsc. Advertisingd. Relationship issuese. Childhood traumasf. Unemployment

II. Drinking on CampusA. 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 normsb. Party schoolsc. Living arrangementsd. Weekends and Special Occasionse. Participation in sportsf. Copingg. Parental attitudesh. First-year transitionsi. Sexual victimization

C. High-Risk Drinking on Campus1. 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 femaleii. More likely to be whiteiii. More likely to be under age 24iv. More likely to be enrolled in a four-year collegev. More likely to live in state with fewer alcohol control

policiesvi. More likely to be involved in athletics and socialize

frequentlyvii. More likely to be in a fraternity or sororityviii.More likely to be dissatisfied with their bodies, not

exercise, eat poorly, and go on unhealthy dietsix. More likely to put themselves or others at risk by driving

and drinkingx. Much more likely to miss class or fall behind in

schoolworkxi. More likely to abuse other substancesxii. 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-Drinkc. The factors that most influence students to binge-drink are:

i. Low price for alcoholii. Easy access to alcoholiii. Attending a school with many binge drinkersiv. Peer pressurev. Campus environmentvi. Drinking gamesvii. Family attitudesviii.Early access to alcohol

4. Drinking Gamesa. Two-thirds of college students engage in drinking games that

involve binge drinking.b. Men are more likely to participate than women.


5. Predrinking/Pregaminga. 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. Economicii. Intoxicationiii. Socializingiv. Anxiety reductionv. Group bonding

7. The Perils of Predrinkinga. 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 Eatinga. 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 Campus1. Consequences of Drinking

a. Atypical behaviorb. Academic problemsc. Risky sexual behaviord. Sexual assault

i. Alcohol increases the risk of violence among couple.e. Unintentional injury


f. Consequences beyond collegeg. Illness and death

2. Drinking and Drivinga. 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 AlcoholA. 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 drinkb. What you are drinking

i. Absorption is the rate of the passage of substances into or across membranes or tissues.

ii. Mixersc. Your sized. Your gendere. Your agef. Your raceg. Other drugsh. Family history of alcoholismi. Eatingj. Expectationsk. Physical tolerance

C. Moderate Alcohol Use1. 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 Intoxication1. 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 Poisoning1. 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. Vomitingiii. Seizuresiv. Slow breathingv. Irregular breathingvi. Hypothermia


IV. The Impact of Alcohol on the BodyA. 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 System1. 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. Cancer1. 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 perceptionsb. Dulled sense of smell and tastec. Diminished sensationd. Alerted sense of spacee. Impaired motor skillsf. Impaired sexual performance

G. Interactions with Other Drugs1. 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 System1. 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 RaceExperts are increasingly recognizing racial and ethnic differences in risk factors for drinking problems, patterns of drinking, and most effective types of treatment.

A. Gender1. 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 weightii. Irritability as a newborniii. 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 headii. Abnormal facial featuresiii. Sluggish motor developmentiv. Failure to thrivev. Short staturevi. Delayed speechvii. Mental retardationviii.Hyperactivity

5. Alcohol interferes with male sexual function and infertility.B. Race

1. African American Communitya. 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 Communitya. 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 Communitya. 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 DisordersA. 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 alcoholiii. Continued use of alcohol despite adverse consequencesiv. Distorted thinkingv. Denial

B. Causes of Alcohol Dependence and Abuse1. Genetics2. Stress and traumatic experiences3. Parental alcoholism4. Drug abuse

C. Medical Complications of Alcohol Abuse and Dependence1. Liver disease2. Cardiorespiratory disease3. Cancer4. Brain damage5. Vitamin deficiencies6. Digestive problems

VII. Alcoholism TreatmentsA. 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 AmericaA. 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 risks3. Adolescent experimentation and rebellion4. Stress5. Parental role models6. Addiction7. Mental disorders8. Genetics9. Weight control10. Mental disorders

IX. Tobacco Use on CampusA. 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 RaceA. 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 EffectsA. 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 Works1. 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 Monoxide1. 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 SmokingA. 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 Students1. 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 Stroke1. 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 Problems1. 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 TobaccoTwo percent of Americans smoke cigars and two percent use smokeless tobacco.

A. Cigars1. 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. Bidis1. 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 Cigarettes1. 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 UseA. 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 Own1. 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 Groups1. 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. Medications1. 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 SmokeA. 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 Smoke1. 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

Education