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ALCOHOL : A SOCIAL PROBLEM

Dr.Rajan B i kr am Rayam ajh i

Sc hoo l o f Pub l i c He a l t h & Com m uni t y M e d i c i ne

B . P. Ko i r a l a I n s t i t u t e o f He a l t h Sc i e nc e s

Dha ra n , Ne pa l

BackgroundA state of complete physical, mental & social wellbeing

& not merely an absence of disease or infirmity that enables an individual to lead socially & economically productive life.

Family is the primary unit of all the societies. It is a group of biologically related individuals living together and eating from the same kitchen.

The family share the common physical and social environment.

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o Family, being a part of cultural unit. It reflects the culture of the wider society of which it forms a part and determines the behavior and attitudes of the members.

o Alcohol abuse is a pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work.

o Current guidelines set by America Health Society states that alcohol consumption per week, for adults noted to be nine drinks for a male and seven for a female.

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Alcohol abuse is a psychiatric diagnosis describing the recurring use of alcoholic beverages despite negative consequences.

Alcohol abuse is sometimes referred to by the less specific term alcoholism.

Alcoholics – 2 Types: Those who have social and pleasure-seeking tendencies & Those who are anxiety-ridden people who are able to go without drinking for long periods of time but are unable to control themselves once they start

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o Easy accessibility of alcohol is one of the main reason behind alcohol abuse.

o Another influencing factor among adolescents and college students are the perceptions of social norms for drinking.

o People often drink more to keep up with their peers because they believe that their peers drink more than they actually do or that they expect to drink more given the context. (sporting event, fraternity party).

o Alcohol abuse is also associated with acculturation because social and cultural factors such as an ethnic group’s norms and attitudes can influence alcohol abuse.

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Binge drinking: Four or more drinks for

a female and f ive or more drinks for a

male at one si t t ing.

Chronic drinking: Daily or almost

daily alcohol consumption

(60 drinks per month)

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Drinking is a personal choice but affects the person and environment

surrounding you.

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o 58.5% of them were male whereas rest of them were

female.

o 56.6% of them belonged to groups which traditionally use

alcohol.

o 64.8% of them were from rural areas whereas others were

from urban areas.

o About 0.8% of them had drink for 20+ days in a month.

o The median age of drinking was 13 years.

o Traditional and cultural occasions were the most important

occasion for initiating drinking. (60%)

o Individual who responds to alcohol in a certain way. [ Pos i t i ve r ewa rd ]

o Personal i ty character i s t ics that encourage use. [ Im pu l s i ve ne s s ]

o Member of social group: o Pressure to dr ink . [ Co l l e ge F ra t e rn i t y ]

o Confus ion over dr inking ground ru les .oDrink wi th meals or dr ink to get drunk.

Social Factors

Alcoholism is high:

Americans, Swiss, Irish, Poles.

Low in others:

Chinese, Greeks, Orthodox, Jews

Culture with Lower Alcoholism

o Chi ld ren l e a rn a l coho l i s a

beve rage .

o Served in d i l u t e fo rms .

o Abs t inence i s a ccep tab l e .

o Paren t s mode l mode ra t e

d r ink ing

o Get t ing d runk no t s een a s

comica l .

o Everyone knows g round ru l e s .

Culture with Higher Alcoholism

o N o g r o u n d r u l e s .

o M i x e d m e s s a g e s f r o m d i f f e r e n t

i n d i v i d u a l s a n d g r o u p s .

o G e t t i n g d r u n k i s a c c e p t a b l e .

o H e a v y d r i n k i n g i s e n c o u r a g e d .

o D r i n k i n g a s i g n o f m a s c u l i n i t y o r

a d u l t h o o d .

Media Images of Alcohol

o I r e l a n d h a s h i g h e s t

h e a v y d r i n k i n g r a t e s

i n E u r o p e .

o Yo u t h b o m b a r d e d

w i t h a l c o h o l a d s .

o H a v e b e g u n t o

r e s t r i c t a d v e r t i s i n g .

o C h a n g e t h e c u l t u r e .

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Driving Limits

In United States,

Most states set the legal level of intoxication at 0.08 to 0.10 BAL ( Blood Alcohol Level)

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Drinking is a Personal Choice But Still

Others are affected !!!!

Friends and family Strangers

Unborn babies: Fetal alcohol syndrome

When mother drinks, baby drinks.

Alcohol disrupts brain development

Fetal Alcohol Spectrum Disorders

The most serious risk during pregnancy is fetal alcohol spectrum disorders (FASD).

It describes permanent birth defects caused by maternal consumption of alcohol during pregnancy.

Establishing the prevalence of FASD is very difficult, but it is estimated that at least 1 percent of children in the U.S suffers from FAS or other alcohol-related birth defects.

Approximately 1 percent of children are affected by fetal alcohol spectrum disorder

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Smoking

o Women aged 15 and over who smoked any form of tobacco, including cig., cigars and pipes excluding smokeless tobacco: 28.57% [2009].

o Similarly, in males it was found to be 35.95% [2009].

o Study done in Dharan by S. R Niraula found that majority of the smokers were in the age group 15-24 years.

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TRADITIO NAL

o Smoked in a pipe for ceremonial purposes

o Used as an offering to a healer, elder or other person as a sign of respect or thanks

o Medicinal tobacco was often used as a painkiller

CO M M ERCI AL

oDeliberate targeting of specific consumer groups

oPremeditated and conscious addition of chemicals that lead to addiction

oScarcely contains actual tobacco

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o 85% of teenagers who smoke two or more cigarettes completely, and overcome the initial discomforts of smoking, will become regular smokers.

o In a study of high school seniors, only 5% of those who smoked believed they would still be smoking two years after graduation. In fact, 75% were still smoking eight years later.

o One-third to one-half of young people who try cigarettes go on to be daily smokers.

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o Nicotine is a vessel constr ictor, reducing the body’s blood f low. Smoking increases cholesterol levels and hardens ar ter ies .

o Diabetes increases cholesterol levels and the levels of some other fats in your blood.

o The combined cardiovascular r isks of smoking and diabetes is as high as 14 t imes those of ei ther smoking or diabetes alone.

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Familial & Social Connection with Smoking

o People who encounter smoking on a regular basis will be desensitized to cigarettes and won’t see the health risks readily.

o Parents are the greatest influence on their children’s behavior.

o Children whose parents smoke are twice as likely to become smokers themselves.

o Perceived parental opinion is also a major contributing factor in youth smoking. If children believe their parents disapprove of smoking they will be less likely to become smokers.

o Siblings also serve as contributors to youth smoking.

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Societal or Economic Costo Alcohol abuse is associated with many accidents, fights,

driving offenses and unprotected sex.o Alcohol is responsible in the world for 1.8 million deaths and

results in disability in approximately 58.3 million people. o Approximately 40 percent of the 58.3 million people disabled

through alcohol abuse are disabled due to alcohol related neuropsychiatric disorders.

o In South Africa, where HIV infection is epidemic, alcohol abusers exposed themselves to double the risk of this infection.

o Additionally, alcohol abuse increases the risk of individuals either being the victim of sexual violence or perpetrating sexual violence.

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o Alcoho l misuse cos t s t he Na t iona l Hea l th Se rv ice (UK) th ree b i l l i on pounds s t e r l ing pe r yea r and the cos t t o employer s i s 6 .4 b i l l i on pounds s t e r l ing pe r yea r.

o I t doesn’ t i nc lude the c r ime and soc ia l p rob lems as soc ia t ed wi th a l coho l misuse .

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Preventiono Increased taxation of alcohol and smoking.

o Stricter regulation of alcohol and smoking advertising.

o Brief Interventions for alcohol abuse reduce the incidence of accidents, sexual violence, unplanned pregnancy.

o Information and education on social norms and the harms associated with alcohol abuse delivered either via the internet or face to face has been found to result in a decrease in harmful drinking behaviors in young people.

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T H A N K Y O U