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Substance Use & Misuse (Smoking (Synergistic effects
enhance impact…
Substance Use & Misuse
- window of vulnerability = adolescence
~ tied to peer culture and self-representation
~ problem behaviour syndrome - excessive drinking, smoking, drugs, unsafe sex, risky behaviours
- habitual, difficult to change
- harmful to health
- enhance ability to cope with stress
- gradual buildup
Alcoholism
characterized by
- little control over drinking
- withdrawal symptoms
- high tolerance
- physical addiction
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linked to
- cognitive impairments, memory loss
- poor job performance, absenteeism
- health disorders
- car accidents
Associated factors:
- gender (M > F)
- genetics
- little social support, low SES
- chronic stressors, negative life events
- work difficulties
- negative affect, depression, powerlessness
- role modeling
- age: 12 - 21/ late middle age
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Smoking
- chief cause of death in developed countries
- accounts for 30% of all cancers
- greatest cause of all preventable deaths
- ^risk of chronic bronchitis, retarded fetal development, low infant birth weight, respiratory disorders
Synergistic effects
- enhance impact of other risk factors in compromising health
- serum cholesterol = higher rates of morbidity and mortality due to heart disease
- stress for men = increase HR, BP = increase risk for cardiac crisis
- women = higher risk of breast cancer after menopause
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Associated factors:
- peer influence (70% of cigarettes smoked by adolescence are in presence of peers)
- reduces negative affect
- parental modeling
- positive image of smokers as rebellious, tough, mature
- teenage problem behaviour
- social pressures
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Ways to reduce smoking
Media campaign
- ^ awareness of vulnerability to health issues and risks
- ^ receptivity to change
- ^ sense of self-efficacy
- move from pre-contemplation to contemplation
Smoking cessation
Nicotine replacement therapy
Aversion therapy
- pair smoking with unpleasant stimuli
- through Classical Conditioning = learn to associate smoking with unpleasantness
Operant conditioning
- external rewards for non-smoking activities
- only effective for initial quitting
Multimodal intervention
precontemplation > contemplation
- emphasize negative consequences of smoking + negative social attitudes towards smoking
Contemplation > action
- develop timetable for quitting
action phase
- CBT:
self-monitoring, contingency contracting, social support, modify env to reinforce non-smoking activities, social skills training, other behaviours etc
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