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Health Psychology of smoking and alcohol use

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Addiction is behavior -- shaped by learning as well as by social and ... Factors in teens who start smoking (pairs exercise) II. Maintenance. Use BPS model ... – PowerPoint PPT presentation

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Title: Health Psychology of smoking and alcohol use


1
Health Psychology of smoking and alcohol use
(Worldwide, alcohol and tobacco are the most
widely used drugs.)
2
Models of Addiction
  • Biomedical Models
  • Dependence chronic brain disease
  • Concordance studies of MZ and DZ twins suggest
    that genes play a role in physical dependence

3
Reward Models
  • Addiction is motivated by pleasure seeking (via
    dopamine pathways)
  • Support
  • lab studies -gt
  • Multi-substance dependence (e.g., smokers are 10
    to 14 times more likely to abuse alcohol than
    nonsmokers)

4
Social Learning Models
  • Addiction is behavior -- shaped by learning as
    well as by social and cognitive factors
  • Through conditioning, smokers learn to smoke in
    a variety of situations (which are triggers or
    DS)
  • A persons identification (Im a drinker) plays
    a key role in the initiation and maintenance of
    an addiction (social cognition)

5
Tobacco Use
  • Peaked in the US in the early 1960s (half of
    adult men and one-third of women smoked)
  • Today, 22.5 of adults smoke
  • State with highest percentage? Lowest?
  • Kentucky Utah
  • Most of the decrease occurred among upper-SES
    groups and men (Nearly 33 percent of adults
    living below the poverty level smoke, compared to
    22 percent of those above the poverty level. )
  • Decrease rate wont meet objectives of lt12 by
    2010

6
Smoking by Education and Sex
7
Smoking Among U.S. High School Students
http//www.tobaccofreekids.org
36.4 in 97 -- 21.9 in 03
8
Physical Effects of Smoking
  • Cigarette smoking is the single most preventable
    cause of illness, disability, and premature death
    in much of the world
  • Cigarette smoking is the single most preventable
    cause of illness, disability, and premature death
    in much of the world
  • In the US, men and women who smoke have their
    lives cut short by 13.2 and 14.5 years,
    respectively (CDC, 2004).

9
Physical Effects of Smoking
  • Half of all deaths due to cardiovascular disease,
    lung cancer, and chronic obstructive pulmonary
    disease are smoking-related

10
Pathophysiology of Smoking
  • Components of the smoke
  • Known carcinogens (e.g., benzenes)
  • As many as 2500 compounds created in smoke
    (arsenic, radioactive compounds, lead)
  • CO ? ? CVD
  • Nicotine
  • cholesterol increase
  • disturbances in heart rhythm

11
Environmental Tobacco Smoke (ETS)
  • contains an even higher concentration of many
    carcinogens
  • Nonsmokers who are regularly exposed to ETS are
    2070 more likely to die from cardiovascular
    disease

12
Stages of Smoking (see fig 5.4)
  • I. Initiation
  • initial use for most is unpleasant, so how does
    it start?
  • Factors in teens who start smoking (pairs
    exercise)

13
II. Maintenance
  • Use BPS model
  • Biological -- Reinforcing properties of smoking
  • Seven seconds
  • Nicotine stimulates the sympathetic nervous
    system, causes the release of catecholamines and
    serotonin, stimulates dopamine release in the
    brains reward system, and induces relaxation.
  • Negative reinforcement (smoking takes away
    withdrawal)
  • Nicotine-titration (maintaining a steady level)

14
Maintenance
  • Psychological
  • Affect Management Model -- smokers strive to
    regulate their emotional states (stress, positive
    moods) and performance (e.g., concentration)
  • Behavioral conditioning
  • 73,000 trials for a 1 ppd smoker
  • Associated with coffee, ETOH
  • Social
  • Social cues (e.g., friends, settings) and peer
    pressure
  • Parental beliefs and behavior
  • Societal norms and laws

15
III. Cessation
  • Motivation to quit (including persistence
    despite withdrawal symptoms)
  • Level of physical dependence on nicotine
  • Barriers to or supports in remaining smoke-free

16
Other factors in cessation
  • Previous quit attempts
  • Stages of change model (precontemplation)
    (next slide)

17
Percentage of Abstinent Former Smokers by Stage
of Quitting
18
IV. Maintenance or relapse
  • The relapse process (see Fig 5.6)
  • Lapse vs. Relapse and The abstinence violation
    effect (dissonance and attributions)

19
Health Psychologys approach to smoking
  • Individual Treatment
  • Public Health initiatives (including prevention)

20
Individual treatment
  • Addiction Model Treatments
  • Nicotine gum, transdermal patches, and inhalers
    moderately successful as a stand-alone treatment
  • Cognitive-Behavioral Treatments
  • Which of the methods that we have discussed might
    be particularly effective?
  • Use of multi-modal treatments (e.g.,
    multi-perspective cessation clinics -- p.119)

21
Public Health Initiatives
  • Docs advice (small, but significant effect)
  • Worksite interventions (see Focus on Research
    5.2)
  • Community-based programs
  • e.g., Inoculation Programs (e.g., with
    adolescents)
  • are tailored to developmental needs (rather than
    being based on adult programs)
  • provide social supports
  • teach adolescents practical skills in resisting
    social pressures to smoke

22
Public Health Initiatives
  • Government interventions
  • Advertising restrictions
  • Increase the aversive consequences of smoking
    (increasing cigarette tax increasing the
    punishment associated with underage smoking)
  • Banning of smoking in public areas (e.g., NYC)
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