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public health final

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leading cause of death
tobacco--but not regulated by the FDA
how many tobacco deaths per year?
400,000-425,000
how many deaths from second hand smoke?
4,000-8,000
how many deaths per day?
1200
lowest tar cigareets have
the highest nicotine
what percent are smokers
29% of those 12 or older
three main ingredients in cigarette
tar, carbon monoxide, nicotine
six factors affecting tobaccor absorption
exact composition of tobacco used, density of packing, length of cigarette, filter or not, volume inhaled, number of cigs smoked in day
what factors influence tobacco use?
availability, age, SES, gender, advertising
three roles of tobacco advertising
increase number of existing smokers, replace smokers who quit or die, and reasure smokers about health worries
methods of smoking cessation
cold turkey, clinic or group settings, work site quitting programs, self help programs,
chemically assisted (nicoderm, etc.) alternative assisted (hypnosis, herbs, accupuncture)
mystification
redefinition of everyday medical problems as medical conditions that require treatement (if you take this....)
keep consumers in dark, don't tell whole truth or complete picture
who is involved in mystification
patients/consumers, advertisers, pharmaceutical, medical, herbal, government
which catergories are involved in mystif
OTC, including herbal, black market, prescription, licit and illicit, gray market
gray market
using a legal drug illegally---using someone else's prescription
why be wareful of dietary supplements
safety or efficacy of the product doesn't have to be proven before it's put on market
what are the five supplements that the FDA warns about?
belladonna: used to treat intestinal problems and asthmas--overdoes can cause death
broom: used to treat low blood pressure and various heart ailments
comfrey: used to treat blunt injuries (broken bones, cuts, and bruises)
lobella: treat asthma and induce vomiting
pennyroyal: used to treat indigestion, liver and gallbladder problems
four main influences of drug mystif
over manufacture, over advertise, over prescribe and over consume
suggested solutions to mystification
regulate advertising, limit production, detail persons should have drug training, continuing education, consumer responsibility
consumer friendly ad
describe prescription, risks and benefits, success rates, lifestyle changes, costs
Fetal alcohol syndrome vs. exposure
less exposure in exposure---less severe
distinguishing characteristics of FAS/FAE
weigh less, shorter than normal, small heads, deformed facial features, abnormal joints and limbs, poor coordination, problems with learning, short memories
FAS is the leading cause of what
mental retardation in newborns
safe amount of alcohol?
NO SAFE AMOUNT
FAS more likely with what
heavy drinkers, other drug use, correlated with other lifestyle factors, poor medical care,
which is easier to diagnose
FAS--more physical characteristics FAE--more subtle effects---invisible
victims of FAS often experience
mental health problems, disrupted school performance, inappropriate sexual behavior, trouble with the law, alcohol and drug problems, difficulty caring for themselves, homelessness
undeserved population
an identified group whose chemical dependency needs are not being met
what populations have special treatment needs
elderly, adoles, women, native amer., hispanic, A.A. lesbian/gay
common problems with special groups
different access points, needs not being met, need to prepare to function in own community, may require separate programs, lack of insurance
access point
places where people can recieve help
elderly
alcohol and prescrips
adolescents
captive populations, habilitation, insurance problems, fam participation, labeling
women
60% of prescrips for women, programs designed for men may not fit women's needs, isolation in home setting, incest rape, child care
african americans
different access points, role of church 3-4% of minnesotans, not just crack and heroin
native americans
roughly 40% have chemical dependency problems, usually must leave community for treatment, cultural diffs important
hispanic
organization a problem, vast diffs among groups, role of church
gay/lesbian
few treatments regarding orientation, little known about lesbian dependency, gay male's socialization
habilitation for adolescents
teaching new skills
aftercare
after primary treatment
characteristics of aftercare
must reinforce new lifestyle learned in treatment, six months to year, AA most common, family, new friends, new activities, avoid new enviroments
characteristics of self help groups
low status affliction, voluntary, no professionals, anonymous
self help success
higher success rates than individual help
chemical dependency
craving that must continue to be satisfied by repeating the experience for its usually pleasureable effects even when non pleasureable accompany or result
adaptive impoverishment
life is so screwed up it feels normal to you
surreptitious use
sneaky use...hiding
social user
one who uses alcohol simply to enhance the pleasure of normally pleasureable situations
experiences no negative consequences, nor surprises, no loss of control, no complaints, no need for limit setting
substance abuser
uses to enhance pleasure or compensate for something negative, such as physcial or emotional pain experiences neg consequences, limit settings, promises that are made and kept, complaints that are heard and dealt with
addict
one who uses to celebrate, compensate, or for any other reason, legitimate or not. experiences neg consequences recycled, limit setting and promises broken, complaints denied, reliable symptoms of addictive disease
addictive cycle
negative consequences->one's intention to control use->failure to control use->denial and other defenses->continued use despite consequences->same cycle
how many chemically dependent
5-10% 14-28 million
society is screwed up theory
high unemployment, racism, poverty, lead to increased drug use
genetic theory
risk of becoming chemcially dependent increases 4-8 times with a bio mother or father who was/is dependent
personality theory
no good measurement--psycoanalytic theory
deviant behavior theory
rewards for being different, people pay attention to you
cultural theory
history and tradition of your people
learning theory
small behavior, small reward (smoking), small behavior large reward(cocaine)
warning signs of chemical dependency
increased tolerance, preoccupation, sneaking doses, rapid intake, memory blackouts, drinking alone, hiding doses, using to relieve symptoms of prior use, using more than intended
overall goal of assessment
solve problems, not stop use
what does cage stand for
cut down, annoyed, guilty, eye opener
problems facing physcians when it comes to screening for alcoholism
not trained, don't want to lose patients
how to screen and conduct brief interventions
ask quantity frequency questions, ask CAGE, determine appropriate action, advise and assist, arrange followup, support
keith influenced by what factors
modeling peers, environemnt of bartending, genetics
intervention
expressing concerns and motivatin to change
coercive and non coercive intervention
no difference in success rates

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