Limits

• The NIAAA defines (National Institute on Alcohol

Abuse and Alcoholism) one standard drink as equal to
about 12 ounces of beer, 5 ounces of wine, or 1.5
ounces of hard liquor. For men, 5 or more drinks a day
or 15 or more a week is considered risky, while for
women it is 4 or more a day or 8 or more a week.
 Alcoholism

• Alcoholism is a condition resulting from excessive

drinking of and dependence on beverages that contain
alcohol.
• Those affected experience:
• Physical dependence
• Tolerance
• Craving
• Loss of control
 Alcohol abuse

• Alcohol abuse is defined as a pattern of drinking that

results in particular situations, such as failure to fulfill
major work, school or home duties, or having recurring
alcohol-related legal problems, such as arrests for
driving under the influence of alcohol.
 Is Alcohol Good for Anybody?

• For men over 40 and for women past the menopause,

drinking 1-2 units per day helps to protect against heart
disease and stroke.

• At that level of consumption, there is increased levels

of HDL and decreased platelet aggregation

• The legal drink-drive limit is 80 mg/dL blood; In India,

the limit in blood is 30 mg/dL
 Progressive Effects of Alcohol
BAC Behavior Impairment
10 – 60 Relaxation, Sense of Well-being, Loss of Thought, Judgment;
mg/dL Inhibition, Lowered Alertness, Joyous Coordination; Concentration

Impaired reflexes, reasoning,

60 – 100 Blunted Feelings ; Disinhibition; depth perception, distance
mg/dL Extroversion; Impaired Sexual Pleasure acuity, peripheral vision, glare
Recovery
Reaction Time; Gross Motor
110-200 Over-Expression; Emotional Swings;
Control; Staggering; Slurred
mg/dL Angry or Sad; Boisterous
Speech
Severe Motor Impairment; Loss
210-290 Stupor; Lose Understanding; Impaired
of Consciousness; Memory
mg/dL Sensations
Blackout

300-390 Severe Depression; Unconsciousness; Bladder Function ; Breathing ;

mg/dL Death Possible Heart Rate

>400 mg Unconsciousness ; Death Breathing ; Heart Rate

 Effects On Growth & Development

• Some Asians have reduced levels of Aldehyde

dehydrogenase & also metabolise alcohol rapidly
causing flushing;

• Women have lower ADH than men

 Effects On Growth & Development

Fatty change:
Alcoholic hepatitis: produces
fever, liver tenderness &
jaundice; may show
alcoholic hyaline, focal
necrosis, inflammation
Cirrhosis: 10-15% alcoholics
develop this
 Alcohol & CNS

• Depression and addiction are due to altered membrane

fluidity, signal transduction;
• Associated thiamine deficiency leads to neuronal
degeneration, gliosis and atrophy of cerebellum &
nerves causing Wernicke Syndrome (ataxia, disturbed
cognition, nystagmus and ophthalmoplegia)
• Korsakoff syndrome: severe loss of memory
 Other Organ Systems

• CVS: Cardiomyopathy and hypertension

• GIT: Acute gastritis, acute and chronic pancreatitis;
• Skeletal muscle: Rhabdomyolysis;
• Gonads: chronic usage in males result in testicular
atrophy and infertility; in females, decreased fertility
and increased risk of abortion;
 Foetal Alcohol Syndrome

• Caused by maternal alcohol consumption of only one

drink per day;
• Characterised by retardation of growth and
development, microcephaly, atrial septal defect,
maxillary hypoplasia, short palpebral fissures,
genitourinary abnormalities;
• Most likely cause is acetaldehyde, which crosses the
placenta
 Ethanol & Cancer

• Increased incidence of carcinoma of oral cavity,

pharynx, oesophagus, liver and probably breast;
• Acetaldehyde may act as promoter;
• Alcohol also prevents the detoxification of nitrosamine,
a known GIT carcinogen;
 Toxic Contents of Cigarettes

• Tobacco contains over 4,000 chemicals, many are

harmful. These include:
• Benzene - solvent used in fuel and chemical
manufacture
• Formaldehyde - highly poisonous, colourless liquid
used to preserve dead bodies
• Ammonia - found in cleaning fluids. Used in cigarettes
to increase the delivery of nicotine
 Toxic Contents of Cigarettes

• Hydrogen cyanide - poisonous gas used in the

manufacture of plastics, dyes, and pesticides. Often
used as a fumigant to kill rats
• Cadmium - extremely poisonous metal found in
batteries
• Acetone - found in nail polish remover
• Arsenic - ingredient in rat poison
 3 Main Components

• The three main components of inhaled smoke are

nicotine, carbon monoxide and tar, all of which can
cause disease.
• Nicotine
Nicotine is the addictive drug in tobacco. It is absorbed
into the bloodstream and affects the brain within 10
seconds. It increases the heart rate and blood pressure
by stimulating release of hormones such as adrenaline
and constricting blood vessels.
 Carbon Monoxide (CO)

• A poisonous gas also found in car fumes, it reduces the

amount of oxygen carried in the blood and reduces
oxygen delivery to tissues. Also binds to myoglobin &
cytochrome oxidase. It is linked to heart disease &
stroke.
 Tar

• Tar contains many substances proven to cause cancer.

Irritants found in tar damage the lungs causing
narrowing of the tubes (bronchioles) and damaging the
cilia that protect the lungs from dirt and infection.
 Heart & circulatory Diseases

• Smoking increases the risk of heart disease, stroke and

several other causes of death. Smokers in their 30’s and
40’s are five times more likely to have a heart attack
than non-smokers.
• Accelerates atherosclerosis and therefore increases the
risk of heart attack and stroke.
• Buerger's disease, which can lead to gangrene
 Smoking & Cancer

Lung cancer (Smoking is the single

largest cause)
Mouth, throat and nose cancer
Cancer of the larynx
Oesophageal cancer
Pancreatic cancer
Bladder cancer
Stomach cancer
Kidney cancer
Leukaemia
 Smoking & Respiratory Diseases

• Smoking also increases the risk of chronic obstructive

lung disease and consequent infection
This disease is due to three processes:
• Persistent cough and phlegm production (‘smoker’s
cough’)
• Thickening & narrowing of the airways in the lung
• Emphysema (expansion and damage of the smallest air
chambers in the lung)
 Smoking & Pregnancy

• It is well known that smoking during pregnancy can

damage the baby and even cause a miscarriage.
Compared with non-smokers, smoking during
pregnancy can cause:
• Reduced birth weight
• Increased risk of the baby dying just before or just after
birth
 Smoking & Other Diseases

• Impotence
• Adverse effects on fertility (Female infertility)
• Peptic ulcer
• Tobacco amblyopia (defective vision) and other eye
diseases such as cataract
• Tooth/gum disease
• Women smokers are also at greater risk of hip fracture
from osteoporosis than non-smokers.
 Passive Smoking

• Breathing in smoke from other

people's cigarettes is called
passive smoking. It consists of
smoke from the burning end of
the cigarette - called side stream
smoke
 Effects of Passive Smoking - Adults

• Irritation to the eyes, nose and throat

• Headaches, dizziness and sickness
• Aggravation of asthma and allergies
• Increased risk of coronary heart disease and stroke
• A 10% to 30% increased risk of lung cancer for non-
smokers exposed to passive smoking over long periods
 Babies & Young Children

• Increased acute respiratory illness in early childhood

(including infections)
• Chronic cough, phlegm and wheezing
• Chronic middle ear effusions (glue ear)
• Increased risk of sudden infant death syndrome (cot
death)
• Reduced levels and growth of lung function
• Increased prevalence of asthma
• Increased likelihood of low birth weight
• Decreased adult height.
Summing Up