SMOKING

• smoking is the largest preventable cause of disease and premature death

• Smoking associated with higher levels of chronic inflammation of lungs and other damaging process that may result in oxidative stress

Ingredients in cigarettes• Toxic travel throughout the body causing damage in

different ways.1. Nicotine reaches the brain within 10 seconds after smoke is

inhaled. It has been found in every part of the body and in breast milk

2. Carbon monoxide binds to hemoglobin in red blood cells, preventing affected cells from carrying a full load of oxygen

3. Cancer causing agent (carcinogens) in tobacco smoke damage important genes that control the growth of cells, causing them

1. to grow abnormally or 2. to reproduce too rapidly.

What smoking do to your health?1. Lung disease; eg ; lung cancer bronchitis emphysema. There

are RARE DISEASES in the absence of smoking2. Heart disease 30% death due to heart attacks and coronary

diseases. The risk of heart attack is increased 6 times in women and 3 times in men (this is at one pack per day)

3. CVA or strokes4. Cancer of bladder, stomach, pancreas, esophagus, larynx,

mouth5. Peptic ulcers disease6. Teeth : discoloration and strains, plaque and gum disease7. Mouth and throat : sore throat, reduced sense of taste,

breath smells

Why should quit smoking?

1. Save money2. Save time3. Feel better in the long run4. Food does smell and taste better

Prevention; Government

1. Raise taxes on cigarettes 2. Anti smoking campaign, such as “TAK NAK

MEROKOK”3. New anti-tobacco rules is taking to ban

promotion of cigarettes and other products4. Shops won’t be allowed to sell

1. Smaller packs2. Single stick of cigarettes

Prevention; Self help tips

1. Analyze your smoking habits by determining when and why you smoke– Use notebook to record about your thoughts and feelings each

time you light up

1. Make up your mind to quit2. Choose the day and quit on that day3. Discuss your aims with others.

-- It’s best to be a few hours into quitting when you come for your first session

ALCOHOL AND DRUGS

DEFINITIONS

1. INTOXICATION2. WITHDRAWAL3. TOLERANCE4. DEPENDENCE

INTOXICATION

• The psychological and physical effects of the substance which disappear when the substance is eliminated

• Example :

WITHDRAWAL

• Symptoms and signs occuring when the substance is reduced or stopped. – The nature, time to onset and course of the

symptoms vary for different substances

• Example:

TOLERANCE

• The state in which repeated administration leads to decreasing effect

• Example:

DEPENDENCE

• A syndrome that includes withdrawal states, sometimes tolerance and other features such as persistent use despite harmful effects.

• May be both physiological and psychological

Dependence syndrome characteristic:

1. Strong desire or sense of compulsion to take the substance

2. Difficulties in refraining from using the substance/ stop using it/ limiting the amount taken

3. A physiological withdrawal state when substance use has stopped or been reduced.– Withdrawal symptoms may be avoided by

further use of the substance

Dependence syndrome characteristic:

4. Evidence of tolerance, a state in which increasing doses of the substance are required to produce the effect originally produced by lower doses.

5. Progressive neglect of alternative pleasures or interests due to use of the psychoactive substance and in the time needed to obtain supplies or to recover from its effects

6. Persistence use of the substance despite clear evidence of harm

What is alcohol?

• Pure alcohol is a colorless liquid obtained through fermentation of liquid containing sugar

• TYPES:– Ethyl alcohol (ETHANOL)– Methyl alcohol (METHANOL)

• Any liquid containing 0.5 to 80% ETHANOL by volume is an alcohol beverage

What is Drink?ONE UNIT 8 gm alcohol

ONE OUNCE (10Z) 30 gm

ONE BOTTLE/CAN of BEER 12 ounces

5% alcohol

ONE GLASS of table WINE 4 ounces

20% alcohol

ONE SMALL GLASS of FORTIFIED WINE2.5 ounces

20% alcohol

ONE SHOT of DISTILLED SPIRIT (WHISKY, VODKA, RUM)1 ounce

50% alcohol

• With distilled spirit( BOURBON, SCOTCH, VODKA, GIN, RUM)• Alcohol content is expressed in terms of :

PROOF: a number that is TWICE the percentage of alcohol• Example :1. 100 PROOF BOURBON is 50% of alcohol2. 80 PROOF GIN is 40% of alcohol

What is moderate drinking?

• No more than one drink per day for a woman • No more than two drinks per day for a man

Binge drinking

• Having 5 or more drinks in a single sitting for a man

• Having 4 or more drinks in a single sitting for a woman

Safe level

• Man up to 21 units per week• Woman up to 14 units per week

Dangerous level

• Man over 50 units per week• Woman over 35 units per week– Levels of drinking between safe level and

dangerous amount are called hazardous.

What is blood alcohol concentration (BAC)?

• Percentage of alcohol in the blood• Often measured from breath or urine samples

Factors that affect BAC1. How much?2. How quickly you drink?3. What you’re drinking?4. Your size (BMI)5. Gender6. Age7. Race8. Drugs9. Family history10. Food11. Physical tolerance

1. How much?2. How quickly you drink?3. What you’re drinking?

I. Beer and wine contain lower concentration of alcohol and non alcoholic substances that slow the rate of absorption

II. CO2 whether in champagne, ginger ale or a coke whisks alcohol into bloodstream

III. Alcohol in warm drinks moves into your bloodstream more quickly than the alcohol in chilled wine or scotch

4. Your size (BMI)5. Gender – Women tolerance level is lower than men due to

enzymes and hormone levels

6. Age7. Race– Asians and native American unable to

breakdown alcohol as quickly as caucasians

8. Drugs– Aspirin, analgesics, antabuse (an aid to quit

smoking and alcohol), anti anxiety, anti histamines, antibiotics, anti depression

9. Family history of alcoholism

10. Food– Slow down the absorption of alcohol by diluting

it, covering some of the membranes through which alcohol would be absorbed, prolong gastric emptying time

11. Physical tolerance– In regular drinking pattern / individuals