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Thursday, September 25, 2014

Chronic Drinkers and Smokers Are Costly Junkies

If we really, really want to face the problem of drug abuse as it relates to the financial woes of America, we have to consider substances many consider less harmful than illicit drugs. We must take a long look at the damage inflicted by tobacco and alcohol. These substances drain money from our economy just as much, or more than illegal substances.

Abuse of tobacco, alcohol, and illicit drugs is costly to our Nation, exacting over $600 billion annually in costs related to crime, lost work productivity and health care.

Health Care Overall
Tobacco $96 billion $193 billion
Alcohol $30 billion $235 billion
Illicit Drugs $11 billion $193 billion

("National Threat Assessment." Centers for Disease Control and Prevention
and the National Drug Intelligence Center. 2010)

Much less stigma is associated with people who abuse tobacco and alcohol than with those who abuse illicit drugs.

In many ways, this is understandable considering the great risks with consuming illicit substances such as overdose and criminal behavior; however, research by the National Institute on Alcohol Abuse and Alcoholism found that approximately 46 million adults used both alcohol and tobacco in the past year, and approximately 6.2 million adults reported both an AUD (co-occurring tobacco and alcohol use disorder) and dependence on nicotine.

(D.E. Falk,  Hsiao-ye Yi, and S. Hiller-Sturmhöfel, S. "An Epidemiologic Analysis of Co-ocurring Alcohol and Tobacco Use Disorders." Findings from the National Epidemiologic Survey on Alcohol and Related Conditions. Alcohol Research & Health  29. 2007)

Alcohol and tobacco are among the top causes of preventable deaths in the United States. Multiple cancers, lung disease, and heart disease (cardiovascular disease) are major killers resulting from alcohol and tobacco abuse.

(A.H. Mokdad, J.S. Marks, D.F. Stroup, and J.L. Gerberding. "Actual Causes of Death in the United States." JAMA: Journal of the American Medical Association 291:1238–1245, 2004.) 

Moreover, a substantial body of research over many years has shown these substances often are used together. Studies have found that people who smoke are much more likely to drink, and people who drink are much more likely to smoke.

(J.K. Bobo and C. Husten, C. "Sociocultural Influences on Smoking and Drinking."  
Alcohol Research & Health 24. 2000)

Dependence on alcohol and tobacco also is correlated: People who are dependent on alcohol are three times more likely than those in the general population to be smokers, and people who are dependent on tobacco are four times more likely than the general population to be dependent on alcohol.

(B.F. Grant, D.S. Hasin, S.P. Chou,et al. "Nicotine Dependence and Psychiatric Disorders in the United States." Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry 6. 2004)

Teach Your Children Well

The 14th annual survey conducted by the National Center on Addiction and Substance Abuse (CASA) at Columbia University examined the impact of parental attitudes on certain teen behaviors. The resulting statistics and figures quantify the behaviors of teens based upon the example and attitudes of their parents.

* Just over half of the 17-year-olds surveyed have witnessed one or both of their parents drunk, and about a third of 12- to 17-year-olds have witnessed one or both of their parents drunk.

* Compared to young people who have not seen their parents drunk, teenagers who have are more than twice as likely to get drunk themselves in a typical month.

* Those teens who get drunk regularly are three times more likely to use cannabis (marijuana) and smoke cigarettes.

* The use of marijuana and alcohol often leads to even more risky behavior involving alcohol, drugs and sex, and associating with others who are involved in harmful behavior.

* The drinking teens were 18 times more likely to have tried marijuana, three times more likely to have friends who use marijuana and four times more likely to be able to get marijuana in an hour.

* Over a quarter of teens say marijuana is easier to find than beer, cigarettes or prescription drugs.

* These teens are nearly four times more likely to know peers who abuse prescription drugs and more than twice as likely to know peers who use illegal drugs such as cocaine, methamphetamines, heroin, ecstasy or LSD.

("Parents Influence Teens' Attitudes Toward Drinking and Smoking." October 26, 2009)

This study makes an association between parents and their children very clear: teens' behavior is strongly associated with their parents' behavior and expectations, so parents who expect their children to drink and use drugs will have children who drink and use drugs.

Bottom Line

Oh, I can hear the arguments against this proposition already.

Let's see. Social drinkers and discrete smokers will deny that anything in moderation can possibly cause such ill effects.

Then, those who preach "Do as I say, not as I do" will chime in about the difference between adults making risky personal decisions and raising their children not to make the same "mistakes."

Then, of course, the Constitutional evangelists will wave Old Glory and scream about their rights of expression while citing the colorful American history of tobacco, alcohol, and liberty. (In the background, strains of Steve Earl's "Copperhead Road" will be heard.)

Yet, after all the hubbub about the acceptance of smoking and drinking finally recedes, there remains stark reality and a bitter pill for all of us to ingest. Nothing is good about the vices of smoking and drinking. Nothing.

The only difference between legal and illegal consumption of unhealthy drugs that cost us immeasurable money, misery, and death is a questionable governmental judgment that we are better off without illicit substances yet strangely tolerable of similar, popular sources of equal corruption.

Hell, I don't like the facts either. But, if we truly want to improve our standards of health and stop wasting money dealing with those who abuse drugs, we have to face highly prevalent alcohol and tobacco abuse.

Does it bother you to say that the war of drugs must include controlling these two substances? It bothers me: my father was a cigarette salesman long ago, and I enjoy drinking beer. But I know the truth sometimes is very painful, hard on our held beliefs and hard on our clouded perception.

It must be said: If you are a chronic smoker or drinker, you may be negatively influencing the lives of your children. God forbid you are recklessly wielding the hammer that drives their last coffin nails. If you both smoke and drink with abandon, your dependency likely doubles that chance.

Read this and weep:

Cigarette smoking causes about one of every five deaths in the United States each year. Cigarette smoking is estimated to cause the following:
  • More than 480,000 deaths annually (including deaths from secondhand smoke)
  • 278,544 deaths annually among men (including deaths from secondhand smoke)
  • 201,773 deaths annually among women (including deaths from secondhand smoke)
(Centers For Disease Control and Prevention. 2014)

Excessive alcohol use led to approximately 88,000 deaths and 2.5 million years of potential life lost (YPLL) each year in the United States from 2006 – 2010, shortening the lives of those who died by an average of 30 years.

(Centers for Disease Control and Prevention. 2014)

Alcohol-Attributable Deaths Due to Excessive Alcohol Use
Average for Ohio 2006-2010
  • All Ages

Harmful Effects Summary

Chronic Causes1,455997458
Acute Causes1,8331,284549
Total for All Causes3,2882,2811,007

Harmful Effects
Chronic CausesOverallMalesFemales
Acute pancreatitis321814
Alcohol abuse604713
Alcohol cardiomyopathy23194
Alcohol dependence syndrome816417
Alcohol polyneuropathy000
Alcohol-induced chronic pancreatitis220
Alcoholic gastritis000
Alcoholic liver disease503370133
Alcoholic psychosis19145
Breast cancer (females only)19019
Chronic hepatitis< 1< 1< 1
Chronic pancreatitis835
Degeneration of nervous system due to alcohol660
Esophageal cancer29263
Esophageal varices22< 1
Gastroesophageal hemorrhage< 10< 1
Ischemic heart disease402911
Laryngeal cancer14122
Liver cancer423210
Liver cirrhosis, unspecified312172141
Low birth weight, prematurity, IUGR, death*963
Oropharyngeal cancer19163
Portal hypertension< 1< 10
Prostate cancer (males only)10100
Spontaneous abortion (females only)000
Stroke, hemorrhagic816714
Stroke, ischemic22165
Superventricular cardiac dysrthymia1578
Acute CausesOverallMalesFemales
Air-space transport220
Alcohol poisoning413110
Child maltreatment743
Excessive blood alcohol level000
Fall injuries324163161
Fire injuries432518
Firearm injuries330
Motor-vehicle nontraffic crashes862
Motor-vehicle traffic crashes38529986
Occupational and machine injuries550
Other road vehicle crashes651
Poisoning (not alcohol)401260141
Suicide by and exposure to alcohol110
Water transport110

(Centers for Disease Control and Prevention. 2014)

The Toll of Tobacco in Ohio

High school students who smoke 15.1% (95,000)
Male high school students who use smokeless or spit tobacco 15.1% (females use much lower)
Kids (under 18) who become new daily smokers each year 11,900
Packs of cigarettes bought or smoked by kids each year 28.0 million
Adults in Ohio who smoke 23.3% (2,069,100)

Deaths in Ohio from Smoking

Adults who die each year from their own smoking 17,700
Kids now under 18 and alive in Ohio who will ultimately die prematurely from smoking 259,000

Smoking kills more people than alcohol, AIDS, car crashes, illegal drugs, murders, and suicides combined — and thousands more die from other tobacco-related causes — such as fires caused by smoking (more than 1,000 deaths/year nationwide) and smokeless tobacco use.

(Campaign For Tobacco-Free Kids. 2014)

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