CHAPTER 6: Health-Compromising Behaviours

Smoking is the number one __________ ______ of death and disease in Canada

preventable cause

Smoking rates are high in....

The age group 20-35Low SESAboriginal populationsNon-immigrant canadians

People typically begin smoking in their ___________

teenage years

Younger adults (35 and younger) smoke _____ per dayThose 35 and older smoke ______per day

12 cigarettes15-16 cigarettes

The percentage of people who smoke tends to decline with __________ in income, education, job prestige, and level of education

Increases

Reasons people begin to smoke

1. parental modelling2. peer influence3. cigarette advertising4. personal characteristics (low self-esteem, social isolation (increase tendency to imitate other), risk taking behaviours)

\______________ is important in the brains reward system and is thought to be the stronger genetic contributor to smoking initiation

Dopamine

Four explanations as to why people continue to smoke (Tomkins, 1966-1968)

1. Positive affect smoker2. Negative-affect smoker3. Habitual smoker4. Addictive smoker

Positive affect smoker

A smoker who smokes to attain positive affect (e.g., increased stimulation, relaxation, or gratification of sensorimotor needs)

Negative affect smoker

A smoker who smokes to reduce negative affect, such as anxiety, distress, fear, or guilt

Habitual smoker

Smokers who smoke without the awareness that they are doing so; do not derive any benefits from smoking

Addictive smoker

A smoker who develops a psychological dependence on smoking and are keenly aware when they are not smoking; can tell you exactly when they smoked their last cigarette and when they will smoke their next one and they deem their first one the most important of the day (always have cigarettes with them and usually keep at least one extra pack)

Heredity and smoking

-Genetics factors may underlie certain personality traits associated with smoking-May determine the extent to which people find tobacco pleasant or unpleasant-Genetically based differences in reaction to nicotine influence the degree to which people exposed to nicotine become dependent on it

Once people begin smoking regularly, they become __________ _________ on nicotine cigarettes

physiologically dependent

Nicotine Process

-Nicotine passes through cell membranes in the mouth and nose on route to the lungs where alveoli absorb nicotine and carry it to the blood-In a very short time, the blood has carried the nicotine to the braino In the brain nicotine triggers the release of various chemicals that activate both the central and sympathetic nervous systems resulting in an increase in heart rate and blood pressure-This entire process takes approximately 10 seconds

Smoking increases risk for illnesses like.....

Cancer, cardiovascular disease, high blood pressure, high cholesterol, emphysema, pneumonia, gum disease, osteoporosis, cataracts and sleeping problems

The more you smoke

the worst your odds become

How does smoking increase risk for cardiovascular and cerebral vascular disease?

-Cigarette smoking increases the level of serum cholesterol and the size of plaque within the arteries-Nicotine has a stimulant effect on the nervous system resulting in increases in heart rate blood pressure and cardiac output combined with the construction of blood vessels

Smoking and chronic lower respiratory diseases

-Chronic lower respiratory disease includes a number of respiratory and lung diseases such as chronic bronchitis and emphysema-Virtually all chronic lower respiratory diseases are experienced by smokers(These conditions are relatively rare in non-smokers)-Smoking irritates and damages respiratory organs this damage leads to reduced airflow when breathing is particularly noticeable when trying to excel with force

Environmental tobacco smoke (ETS)

Smoke that is in the air we breathe because of other smoking; also known as second-hand smoke (passive smoking)

Passive smoking

the breathing of environmental tobacco smoke

Who is especially susceptible to ETS?

-Pregnant women fetuses and young children are especially susceptible- Health consequences include complications of pregnancy and low birth weight, increase risk of sudden infant death syndrome and ear infections, reduced lung development, and increased severity of asthma and other respiratory illnesses

Addiction

the state of being physically or psychologically dependent on a substance

Withdrawal

The unpleasant symptoms people experience when they stop using a substance to which they are addicted

Best way to quit smoking

reduce the number of cigarettes consumed daily

Quiting smoking on your own

-Most relapses occur within the first three months-Almost half of those who attempt to quit smoking will do so on their own without any professional health self-help materials or stop smoking medications-If you really want to quit you can do so on your own

Nicotine replacement therapy

A stop smoking technique that provides some form of nicotine to replace that previously obtained through smoking-They contain replacement therapy is more effective when used in conjunction with various psychological approaches to treatment

Nicotine gum

provides small amounts of nicotine when chewed

Nicotine patch

Resembles a large bandage and releases a small continuous dose of nicotine into the body system; patches with smaller and smaller doses of nicotine are worn until the person is no longer addicted to the nicotine

aversion therapy

Therapy that includes pairing the behavior is that one is attempting to eliminate with some unpleasant stimulus so that the undesired behavior will elicit negative sensations

Electric shock

can be paired with smoking situations so that when a person smokes, he or she is shocked and made uncomfortable

Adverse scenes

Used, people are directed to think of an adverse scene that includes beginning to smoke followed by something disgusting

Rapid smoking

Seldom used; it involves placing the smoker in a small, enclosed room where he or she inhales from a cigarette rapidly every few seconds while concentrating on the smoke the stinging burning throat and other unpleasant elements

Self-management strategies

Strategies used to help people overcome the environmental conditions that perpetuate smoking

self-monitoring (smoking)

requires that people record each cigarette they smoke the time of day their location who they are with and their mood

Stimulus control (smoking)

focus on removing the cues that lead a person to smoke

Behavioural contracting (smoking)

involves establishing a contract according to which a person will be rewarded for fulfilling the contract or punished for failing to do so

Gender difference in alcohol consumption

-women are more likely than men to be non-drinkers-Men are more likely than women to report drinking alcohol at least once a week, to exceed the low-risk guidelines than are women, to binge drink (that is to consume five or more drinks at a sitting) and to binge drink at least once a week

Current alcohol consumption guidlines

men= 15 standard drinks; three per daywomen= 10 standard drinks; two per dayteens= 1-2 drinks; 1-2 times per week

Standard drinks

5 ounces of wine12 ounces of beer or cider1.5 ounces of spirits

Effects of Alcohol

-ethanol is a depressant drug-Alcohol slows down the nervous system which may cause drowsiness and do sleep or relieve pain-The initial apparent stimulant effect usually results from depression of centres in the brain that inhibit our actions in control our behavior-After one drink most people report feeling more relaxed-With more than one drink a person may feel more outgoing and self-confident, but some people will become aggressive depressed or withdrawn-At higher doses thinking judgment and ability to estimate distance can be impaired and reaction times increase

What effects can chronic alcohol abuse have?

Have adverse effects on almost every system in the body resulting in higher morbidity and shorter life expectancy-Chronic alcohol abuse causes liver disease and damage to the stomach pancreas and intestines-Chronic drinking causes high blood pressure and suppression of the immune system and is associated with coronary artery disease and cancers of the throat, larynx, mouth, esophagus and liver

Blackouts (consequence of drinking alcohol)

periods of memory last occur while a person is drinking heavily

Hangovers (consequence of drinking alcohol)

occur after the drinking has stopped and are caused by mild alcohol withdrawal and maybe experienced 8 to 12 hours after a bout of heavy drinking; symptoms include fatigue headache nausea and sometimes vomiting and shakiness

Death (consequence of drinking alcohol)

occur following moderate doses of alcohol taken together with other depressant drugs such as sleeping pills and tranquilizers or from an overdose of alcohol as a result of excessive consumption

fetal alcohol syndrome (FAS)

the range of disabilities caused by prenatal exposure to alcohol; these effects are permanent

Benefits of drinking alcohol

-These protective effects are primarily for coronary heart disease and cerebral vascular effects-Researchers believe that consuming alcohol increases levels of high density lipoprotein which is responsible for decrease risk of heart attacks-Other benefits include a lower risk of for gallstones, type 2 diabetes, and a possible protective factor against cognitive deficits

Alcohol consumption is a _______ curve

J shaped; with lowest mortality occurring when one to two drinks are consumed daily

Disease model of problem drinking

The theory suggesting that alcoholism is a disease resulting from the physical properties of alcohol

Types of alcoholism

Gamma alcoholism (loss of control once drinking begins)Delta alcoholism (the inability to abstain from alcohol)

Gamma alcoholism

the loss of control once drinking begins

delta alcoholism

the inability to abstain from alcohol

Alcohol dependency syndrome model

A theory suggesting that for a variety of reasons people do not exercise control over their drinking and this leads to problem drinkingElements essential for development: a salience of drinking-seeking behavior, and an increased tolerance for alcoholCritisim: emphasis on the physical properties of alcohol and neglect on cignitive and social learning aspects of drinking

Tension reduction hypothesis

The hypothesis that people drink alcohol because of its tension reducing properties-There is little empirical support for this theory some research suggests that alcohol reduces participants tension where others do not-One factor that blurs our understanding of tension reduction hypothesis is expectancy- when one expects reduction intention one is more likely to experience exactly that

Stress response dampening effect

The hypothesis suggesting that people do not respond as strongly psychologically or physiologically to stressors if they've been drinking

Self-awareness model

The theory that drinking makes people less self-aware because it inhibits the use of normal complex information processing strategies such as memory an information acquisition-Decrease self-awareness leads to decrease monitoring of behavior resulting in disinhibition and increase in self-criticism that often occurs when people are drinking

Social learning model

This theory when applied to drinking behavior proposes that people drink because they experienced positive reinforcement for doing so or because they observe others drinking and model the behavior-The mere exposure of alcohol related contextual cues reduce the threshold for engaging in behaviors that would otherwise be inhibited-Social learning theory can explain why people begin to drink, why they continue to drink in moderation, and why sometimes people drink to excess- drinking may occur because of modeling or because once you stop drinking you experienced negative reinforcement in the form of a hangover or withdraw symptoms-According to this model drinking behavior is learned and can be unlearned

Preventing Alcohol abuse

-public policy and legal approaches (including implementing age restrictions for individuals buying or consuming alcohol)-Health promotion and education strategies incorporating social influence approaches have also been useful in helping adolescents avoid drinking heavily

Treating alcohol abuse

-12 step programs such as alcohols and ominous are extremely popular- but this program doesn't seem to be more effective than other formal treatments-Psychotherapy, drug therapy, contingency management, and aversion therapy have all been used with limited success-Relapse is a persistent problem with all out-alcohol treatment approaches-There are three distinct forms of relapse: negative effect social pressure que/craving-The stages of change model are often adopted for guiding both treatment processes and prevention goals-Primary prevention is key but if an individual is currently using or continue to use alcohol harm reduction strategy is appropriate

Three distinct forms of relapse

1. negative effect2. social pressure3. que/craving

What are the most likely outcomes of excessive alcohol consumption?

1. relationship failure2. shorter life expectancy3. job loss4. Fetal alcohol syndrome disorder5. higher morbidity

Drinking and Driving

-Alcohol causes people to think less negatively about drinking and driving-It's illegal to drive with a blood alcohol content (level) more than 50 milliliters of alcohol per 100 milliliters of blood-Rates of drinking and driving in Canada have decreased since the 1980s-Moderate drinkers are finding alternative forms of transportation-Heavy drinkers seem to be immune to the anti-drinking and driving programs that have been implemented; this group of drivers will get behind the wheel after consuming three or more times the legal limit-Young drivers are even more likely to drive after cannabis use than after consuming alcohol

When is Illicit drug use highest?

-Males are two times more likely to take illicit drugs compared to females-Illicit drug use is three times higher among youth-Less education low-income households being single younger age groups are all more likely to be drug dependent-Non-immigrants were three times more likely to be alcohol or drug dependent

Cannabis

-Cannabis is composed of the leaf's flowers and small branches of cannabis sativa, a plant that grows in almost every climate-THC is the intoxicating ingredient of cannabis-People use cannabis because they experience euphoria a sense of well-being relaxation a heightened sexual responsiveness- the psychological effects of cannabis seemed to depend in part on the setting in the personal expectation

What are the effects of cannabis use?

-Cannabis use leads to disturbances in short term memory, judgment, and time perception; when large doses are consumed heart rate is increased-Rapid heart rate may lead to health hazards for people who have coronary problems-Long term use is the risk factor for a diagnosis of schizophrenia and the development of psychotic symptoms-This is understandable since the cannaboid system interacts with the dopamine neurotransmitter systems and psychotic disorders involved services in the system

Side effects of Cannabis use?

-Smoking cannabis leads to the same respiratory problems of smoking tobacco but those who smoke cannabis are exposed to unfiltered smoke, larger puffs, deeper inhalation, and breath holding suggesting that negative respiratory effects may occur sooner than when smoking cigarettes-Cannabis has been used in medical situations because of its physiological effects- It has been used in an appetite stimulant for aids patients and has been used medically to treat glaucoma, to relieve pain, and to prevent the vomiting and nausea associated with chemotherapy

Hallucinogens

Drugs that dramatically affect perception emotions and mental processes; can cause hallucinations-Physiological reactions to hallucinogens include increased blood pressure heart rate and temperature; dilated pupils; impaired motor skills and coordination; dizziness; and nausea-Larger dusters can cause convulsions coma and death, persistent speech problems memory loss severe depression and anxiety and social withdrawal

MDMA (ectsasy)

The derivative of methamphetamine that people use for its hallucinogenic qualities-MDMA causes feelings of tranquility an empathy for others resulting from the relax rapid release of the neurotransmitter serotonin- the effects usually last up to 8 hours'

LSD, PCP, psilocybin

Have more complex effects on neurotransmitters; these drugs dramatically affect perception emotions and mental processes and can cause hallucinations-Hallucinations can elicit feelings of euphoria but can also cause one to feel threatened- this fear anxiety or panic can cause the user to behave quite violently-Users report a sense of well-being in heightened tactile sensations and emotions more often-The effects of LSD can last up to 12 hours' while the effects of PCP may last as long as several days when taken in a single dose (high doses a PCB can last from 10 days to two weeks)

Cocanie

A stimulant drug extracted from the cacao plant indigenous to the Andes mountains in South America-Cocaine is most often snorted through the nasal passages but is also smoke and freebased (injected intravenously)-It provides a sense of well-being, heightened attention, and a powerful euphoria; its effects last 15 to 30 minutes-When the effect wear off the user is often left with the feeling of fatigue, sluggish, and a strong desire to use again-Increase doses does not make the euphoria last longer and can endanger the cardiovascular system

stimulant

A drug that increases alertness decreases appetite and need the need for sleep and may produce intense feelings of euphoria and a strong sense of well-being

Effects of cocaine

-Using cocaine causes blood vessels to constrict, blood pressure to increase, and heart rate to speed up suddenly; it can also trigger cardiac arrhythmia- factors may cause a stroke or myocardial infraction-Physiological withdrawal symptoms do not accompany cessation of cocaine use, but psychological dependence does seem to occur

Prescription Drug Misuse

Commonly abused prescription medication includes opioid pain relievers (fentanyl, Percodan, Demerol, oxycodone and oxy neo) stimulants (Ritalin, Concerta, Adderall, Dexedrine) an tranquilizers and sedatives (benzodiazepine Valium, Ativan, Xanax)

Preventing Illicit Drug Use

-Prevent programs aimed at youth include:-educational programs based on social influence and life scanning trail training methods to teach children and adolescents how to resist starting to use drugs-parental monitoring-A second preventative technique that is common in all Western countries is the use of laws to limit the legal access to drugs- this approach may produce other social problems

Treating Illicit Drug Use

-Treatment programs for drug abuse are similar to those for alcohol abuse-The most promising treatment approaches include both behavioral and cognitive methods such as self-management techniques-There is a high rate of relapse in the first six months after treatment are critical

Who is most likley to be dependent on drugs and/or alcohol?

Nadia is a divorced woman with three children. She never graduated high school and lives on social assistance

C. Zillah is 17-years-old and has no money in the bankD. Miigwan is an Indigenous, single male living on a reserve in Québec

Negtiave unsafe sexual behaviiour

These effects include unplanned pregnancy and serious health consequences such as sexually transmitted diseases, infertility, and HIV infection

Factors that contribute to unsafe sex

-Anxiety both in terms of social anxiety and stressful life events is a contributing factor to unsafe sex-Individuals who are intoxicated are more likely to engage in unsafe sexual practices because alcohol has on decision making-Sexual arousal acts as an amplifier of sorts- far greater range of activities were deemed sexually appealing when the participants were sexually aroused

Theories developed ________________ and applied from within it; including the health belief model, the theory of reasoned action, the theory of planned behavior, and the stages of change model

outside the domain of sexual and reproductive health

Theories have been developed and applied specifically ___________ including the sexual behavior sequence model, the aids risk reduction model, and the information motivation behavioral skills model

Within the area of sexuality and reproductive health

Information motivation behavioural skills model

A theory maintaining that there are a number of steps word plus go to to successfully achieve safe sex practices

Steps in Information motivation behavioural skills model

1. they must recognize and accept that they are sexually active2. they must create a sexual and reproductive health agenda- individuals must be motivated to engage in safe sex practice to prevent pregnancy and infection3. individuals must be capable of engaging and behaviors that fulfill this agenda- they must be able to negotiate cooperation in contraceptive economies with a with a partner; if cooperation is not forthcoming the individual must be able to exit the situation4. To maintain safe sexual practices overtime individuals must have this behavior reinforced5. individuals must be able to adjust sexual and reproductive health behavior scripts appropriately as their needs change overtime

Which of the following options were shown to be contributing factors for unsafe sex among gay and bisexual malesliving in Ontario?

1. social anxiety2. stressful life events

Obesity

Is excess of body fat that may impair health

How is obesity measured?

Is measured using the body mass index; measure of obesity is calculated by dividing swan weight in kilograms and height in meters squared

Obesity is defined as a BMI of ______ or greater

30.0

What are the issues with BMI measurements?

may not be accurate for selected populations

The relationship between body weight an increased risk of death is a _____ or _________ shaped curve

J, U;-Those who are underweight have a slightly increased risk of mortality compared that to those who are classified as normal weight-The relative risk of death is highest among the thinnest and heaviest individuals in our society

Obesity creates _______, ________, and _________ burden

economic, emotional, physical

Health consequences of Obesity

Include premature death, hypertension, type 2 diabetes, cardiovascular disease, lung disease, cancer and more

Personal costs of Obesity

Overweight adolescents are less likely to marry had lower household incomes and academic achievements; they also face prejudice and discrimination when seeking college admissions employment health care or a place to live

Set point theory

the idea that the body contains a set point that works like a thermostat; one person gains weight biological control mechanisms diminish caloric intake; when a person loses weight similar mechanisms increase hunger levels until the weight returns to its ideal or target level

Leptin

Leptin reports to the neurons of the hypothalamus weather there are sufficient fat stores in the body or whether additional energy is needed- it is produced by fat cells therefore when fat stores increase the body's level of leptin increases this in turn suppresses the neurons that stimulate hunger and activates those that reduce food intake-There are individual differences in sensitivity to leptin- it may be that obese individuals are simply less sensitive to leptin or that there are they are leptin resistance

Ghrelin

Involved in hunger- ghrelin is produced by cells in the stomach wall and its primary function is to tell the brain to stimulate appetite and less it seems to be involved in the short-term regulation of food

Psychosocial Factors

-Our biology is now almost maladaptive in our environment of food abundance and sedentariness-Social norms and values serve to reinforce behaviors that promote obesity-We associate food with celebrations rewards and social occasions therefore it is not surprising that we turn to food when anxious or depressed-Stress and eating-People of average weight who are not preoccupied with food often and or or misinterpret physiological cues to hunger and therefore eat less; in contrast stress can cause dieters to lose control cause disinhibition or counter regulation and consequently overeating stress may also influence the food choices people make-There is a tendency for people experiencing stress to increase their fat consumption and reduce their consumption of fruits and vegetables as well as increase snacking

internality-externality hypothesis

Assertion that in people of normal weight feelings of hunger and satiety come from within in the form of internal stimuli whereas obese people are more likely determine their level of hunger in response to external stimuli

Social Facilitation approach

This approach states that people tend to eat more when in the presence of others

Modeling or matching effect

People tend to eat the same amount as those in their presence

Imprression management approach

when people believe they're being observed they will eat less than when they believe no one is watching