FALLSEM2024-25 BHUM101L TH VL2024250107932 Reference Material I PDF

Module 4 Addiction and health 1 Peer pressure You know, educational institutions and family are important social units which anchor the health and well-being of all individuals. Educational institutions have the prime responsibility to promote and optimize the physical, social and...

Module 4 Addiction and health 1 Peer pressure You know, educational institutions and family are important social units which anchor the health and well-being of all individuals. Educational institutions have the prime responsibility to promote and optimize the physical, social and also the mental health of students. The emerging challenges have necessitated that they too shift the focus to the psychosocial needs of students and take care of the overall wellbeing. Mental health and psychosocial wellbeing are one of the most neglected areas in our country. Our module 3 is titled as Addiction and health. So what is this health? Is it only the physical health? What do you think? The World Health Organisation definition of health includes physical, social, spiritual and mental health, and not merely the absence of disease or infirmity. The health of people in India is changing due to socio-demographic and epidemiological transition. Mental disorders affect everyone, irrespective of age, gender, residence and living standards, even though some groups are at a higher risk for certain illnesses; only the impact varies. For example, mental disorders among children, depression among pregnant mothers, and dementia among the elderly are well known. You might also be aware of the severe stress and trauma undergone by people during the pandemic period. How there was a complete panic situation in some of the states in the country? Whenever we open news channel or our mobile phones, we were receiving information about the pandemic. Some may be true whereas some were hoax. But sometimes so much exposure to information can also drag us into stress and affect our health. Growing evidence from research has demonstrated a close association of mental disorders as precursors or risk factors or consequences of a wide range of acute and chronic conditions. For example, depression and cancer are known to coexist, while anxiety disorders are linked to the occurrence of cardiovascular disorders. Non-recognition of associated mental health problems often leads to delayed recognition and recovery. Mental disorders can also be caused by a complex interaction of biological, social, environmental, cultural and economic factors. In countries like India, the social determinants of health like employment, education, living standards, environment, access, equity and others contribute significantly to both cause and recovery. Persons with mental disorders are also known to be associated with a wide range of social and societal problems if their illness is unrecognised or inappropriately managed. Some mental health conditions are implicated not only in lower productivity and earning potential, but also in a number of antisocial behaviours, crime, homelessness, domestic violence, alcohol and drug use.Now, why is it required to discuss about mental health at this juncture of your life? What is the speciality of this age that you people are in? And what is this stage of your life known as? Yes, you got it right. Adolescence!! Adolescence is a transitional stage of physical and mental human development that occurs between childhood and adulthood. As adolescents you may experience increased independence allowed by the parents or legal guardians with relatively lesser supervision. This transition period is a stage where people face frequent mood changes. They reflect feelings of anger, happiness, sadness, fear, guilt, shame, and love. During this age, social skills are required for having positive and healthy relationships with others, including people of the opposite sex. Adolescence is also a stage when you make certain decisions which may impact the rest of your lives. For example, adolescents have to decide about the typical courses or stream that they have to opt for in the high school, they have to decide about after school activities that they must participate in and which peer group to join and so on. They begin to make future educational and occupational plans with the help of their teachers and parents as well as with their peers and try to implement these plans through secondary school course work and out of school vocational and volunteer activities. Now, who are these peers? Peers are individuals with whom we identify ourselves. Our peers are our friends and those people close to us with whom we spend most of our time and share common interests and feelings. Peers are our like- minded friends and companions. As we grow older and become more independent, our peers play a greater role in our lives, even more than our parents and siblings. They are like our extended family. Among peers there can be friendship and acceptance. We can share anything with them which in turn, help us in building bonds. So, in very simple terms we can say that a peer group is a group of people of approximately the same age, social status and interest. Peer relationships play an important and formative role in the development of social skills in children. Peer interactions as well as peer conflicts are necessary conditions in which a child learns to accept the point of view of another. Through this process, children begin to engage in social behaviour which involves team work, co-operation, discussion and planning with others. The greater the participation in a social group, the more developed are their social skills and through this social interaction, a child begins to understand his own behaviour from the point of view of others. Well, now how does peer relationship become peer pressure? Do you remember the time when you were young? When you wanted to do exactly as your friends from the same age group did? You wanted the same toy, or bicycle, wanted the same dress or may be join the same club and go to the same restaurant. To put it simply, this is peer influence. Such influence can bring about changes in that individual's attitude or behaviour to fit into that group. And as you know it is very natural for all individuals to identify with, and compare themselves to the people with whom they interact. In the process they influence and get influenced by each other. Friends influence us in many ways - the way we dress, think, ' take decisions, buy things etc. With more social interactions outside the home and more awareness of others, the influence of peer increases and sometimes the problem arises when this influence gets transformed into peer pressure. Peer Pressure occurs when an individual experience implied or expressed persuasion to adopt similar values, beliefs and goals or to participate in the same activities as those in the peer group. Peer Pressure exists for all ages - A six year old boy insists that his mother takes him to the - toy shop immediately, to buy him the latest toy or gadget or the sports bike because 'his friends' have it. When the mother says 'No' he might show a temper tantrum. A ten year old girl wears a dress once to a party and then refuses to wear it again because she thinks that 'her friends' might notice it and make fun of her. Teenage boys do work out in gyms to have a 'perfect body' like the school heroes and girls starve themselves to look like the most attractive girl at school. They do it to confirm. Peer pressure peaks during adolescence, but it never entirely disappears. Even adults feel the pressure to conform in order to belong to a desired group and this can be in the place of work, neighbourhood or even in the family. As adults we can find a rational balance between accepting group beliefs and holding on to our own individuality. But pre-teens and teenagers face many challenges related to conformity and peer pressure. They are pulled in two different directions - the desire to be seen as an individual and the desire to belong to a group where they feel secure and accepted. The result is that often children, especially teens, ignore the views of family and society in general, and feel pressure to conform to the values of their peer group. Well this was about peer pressure. But our discussion on peer pressure is still not over as in the coming lectures we will understand the types of peer pressure. Until then, bye and take care. 1.1 Types of peer pressure There are basically four types of peer pressure. The first category of peer pressure occurs in a one-on- one environment and it is known as direct peer pressure. It is normally behaviour centric. Examples of these kinds of behaviour would be when a teenager hands another teen an alcoholic drink, or makes a sexual advance, or looks at another student’s paper during a test. So, here the other person is put in a position of having to make an on-the-spot decision. This form of peer pressure can happen when a teenager asks, suggests, persuades or otherwise directs another to engage in a specific behaviour. Yes, in such a situation, there are chances that the recipient of the influence may adhere to his or her core values and beliefs or may even go along with the pressure of the group if the recipient lacks strong decision making skills. Next, we have indirect peer pressure. This is a form of unspoken peer pressure where a person is exposed to the actions of one or more peers and is left to choose whether they want to follow along. This could take the form of fashion choices, personal interactions or ‘joining’ types of behaviour (clubs, cliques, teams, etc.). I won’t say only teenagers but also sometimes adults find it difficult to control the impulse. You know, indirect peer pressure is subtle but can still exert a strong influence on an impressionable young person. We can have another example for this like if a teenager learns that the popular kids’ birthday parties include alcohol or drugs, that indirect pressure may prompt him/her to experiment this as a way to gain acceptance. Next, the next form of peer pressure is negative peer pressure. As the name clearly explains, this form of peer pressure has a negative impact on the recipient. Asking someone or may be a teenager to engage in behaviour that is against their moral code or family values is a type of negative peer pressure. Here, again people are put in a position where either they can follow the influencer or they can simply walk away. Sometimes people take part in such dreadful situation where they force themselves against their own morals only to gain acceptance in their peer group. Well, even adults of my age and much older can also fall into negative peer pressure, but mostly adults find some excuses and escape from such situation whereas young people often lack the skills to come up with an excuse or reason to say no to negative peer pressure. It is not necessary that peer pressure only has a negative impact whereas it also has a positive side to it. The dynamics within a group can become positive if the behaviours of its members are healthy, age- appropriate and socially acceptable. For instance, if a peer group wants to make good grades, a young teen can be positively influenced to study. If members of the football team of a college take a pledge to abstain from drinking alcohol to focus on staying healthy and having a winning season, other students may adopt the same behaviour. You might have heard about peer leader programme where some students are chosen as peer leaders and are trained to participate in counselling, support groups, drug or violence prevention programmes and other such community programmes where students act as positive role models for other students. You know, schools promote student participation in student groups like NSS, NCC, Scouts and Guides etc. You know, due to positive peer pressures students can be motivated to join sports club and youth organizations. 1.3 Impact of peer pressure Peer groups exert a powerful influence on growing children especially adolescents. No matter how foolish it may seem to grownups, belonging to a group is something very important and significant to a child. Peer groups are a place where youngsters feel accepted, where they can act themselves, feel good about themselves and their self-esteem is enhanced. It is commonly seen that children feel happy when they conform to the values of their peer groups. Naturally, young people gravitate towards other young people feeling that they will be understood and accepted. There is a very strong need to satisfy' that thirst - the need for acceptance. The feeling of 'belongingness' is a very powerful force that can outweigh ties to family, school, society or community. positive and negative impacts of peer pressure include; o It can influence, direct and dominate a child’s social behavior o It also influences emotional development o Sometimes, it can even lead to self-doubt. o It can stimulate mental disorders like anxiety and depression o peers can be positive and supportive as well, they can help each other in developing new skills, or developing interest in books, music or extracurricular activities o Along with positive traits, peers can also push some negative habits in each other like skipping classes, steal, cheat, consume drugs, alcohol, etc. o Not just that, even most of the substance abuse cases have been found to be an outcome of peer pressure During the teenage years it is not easy to say no, because it is the age where youngsters are in extreme need of acceptance and belongingness. Now, all of this can create a lot of pressure on youngsters and the impact of this may not lead to best of choices. 1.4 Handling peer pressure First of all, we all must realize that it’s not possible to completely avoid peer pressure. We can’t live and survive in isolation. We need our peer groups and sometimes they are the ones who make us feel acceptable and important. Hence, it is essential to understand some of the measures to handle peer pressure. First of all, you need to pay attention to how you feel. If something doesn’t feel right about a situation, it probably isn’t. Even if your friends seem ok with what is going on, the situation may not be right for you. So in such a situation, what should you do? You need to plan ahead. Think about how you will respond in different situations. Plan what you can say or what you can do. You can even talk to the person who is pushing you to do something. You can be polite yet firm and assertive while making them realize about how you feel regarding the situation. You can even give an excuse. Right? You know some people find it very difficult to say “no” and then apologize or give an explanation. But giving an excuse makes it easier than saying a no. Perhaps you can come up with reasons like allergies that make it dangerous for you to take anything. Or you can say that your parents are coming home or they want you to reach home early or if you feel it would be best to leave the situation all together. So to avoid such conflicting situations, it’s always better to have friends with similar values and beliefs. It is easier to say “no” if someone else is also saying it. You should also develop self-esteem and confidence to say no even to your friends who might push you into doing something which can cause a formidable situation for you. Moreover, you should get support from a trusted adult such as a parent, teacher, mentor or school counsellor. A reliable adult can listen to you and help you with strategies that might work in your situation. As a growing individual who has to survive on their own, make their own family, you should train yourself in critical and analytical thinking and also develop good communicative skills that can be used in daily lives. Hence, before taking any decision, please weigh your decisions by considering the consequences. 2. Addiction What is addiction? You know, recent scientific advances have described addiction as a brain disease that develops over time as a result of initially, due to voluntary behaviour. Addiction is, thus, a disease in and of itself, characterized by compulsion, loss of control, and continued use in spite of adverse consequences. The primary elements of addictive disease are three Cs: The first one is compulsive use. It is that irresistible impulse, thoughts that are repetitive and intrusive. For example, a person may not be able to start the day without a cigarette or may be coffee or tea. However, only compulsive use doesn’t signify addiction. The second characteristic is loss of control. As you all know, it is the inability to limit or resist inner urges. Ones it starts, then it becomes quite impossible to stop it without external help. Well, this is the most important stage of addiction. The individual might swear to not repeat the addictive habit of may be drinking or smoking, instead the person drinks and might repeat the same response in the next day also. The individual may be able to stop it for some time, or may even control it but there are always chances that they might continue the same compulsion. The last characteristic of addiction is continued use despite adversities which means that the use of the substance continues despite consequences which may include declining health, such as liver impairment in the alcohol addict; embarrassment, humiliation, shame; or increasing family, financial, and legal problems. The term addiction was formally replaced by the term substance dependence in 1964 when the World Health Organizations Expert Committee on Drug Abuse proposed that the terms addiction and habituation be replaced with the term dependence and they distinguished the two types- psychological dependence and physical dependence. According to UNIDCP (United Nations International Drug Control Porgramme), psychological dependence refers to “the experience of impaired control over drug use” while physical dependence involves “the development of tolerance and withdrawal symptoms upon cessation of use of the drug, as a consequence of the body’s adaptation to the continued presence of a drug event”. Earlier, the problem of addiction was not as widespread as it is now. Studies show that experimenting with drugs including alcohol is beginning at an earlier age than before. In India, the problem is steadily increasing, both among urban and rural populations, due to several reasons which includes growing prosperity, stresses of modern life, expanding economic and social disparity and also exposure to such addictive substances at an early age. Public awareness programmes are being taken up by governmental and nongovernmental agencies for prevention of addiction. We all know that addiction is a phenomenon which can alienate a person from society and deprive them of a healthy and respectful life. Now, why is that so? It is because of the number of issues caused as an impact of addiction. An addict won’t be able to function physically and psychologically without the addictive substances, they consume these addictive substances beyond socially acceptable level and also sometimes at inappropriate places and times. In the advanced stages of addiction, they might face issues in their personal, professional and social life as well. As we have already discussed, addiction is a complex phenomenon which can be caused by a number of factors rather than a single factor. And there is no fixed type of personality which is addiction prone. But certainly there are certain factors that contribute and create a favourable environment for the development of addiction and there are also some factors which make it difficult for people to give up addiction. Now, first let us look into the physiological factors. There are studies which say that if both parents of a child are addict then there is a probability that the child would develop addiction. But I must say that there are exceptions also. We can’t say that children of all addicts will become addicts. Yes! It suggests a greater possibility. For example, alcoholism, in particular, tends to run in the family, which suggests that the addiction might be inherited. However, there are several other factors also which should not be undermined like; the quantity of consumption of any addictive substance, the process of intake like whether it’s injected or swallowed or inhaled, the availability of the substance, and definitely its access and price, also there can be other influencing factors that might have an impact on the individual than familial reasons. Even though we lack conclusive findings but there are certain studies which state that physiological factors like nutritional deficiency, dysfunction of body system etc. maybe also associated as reasons. Now, let us look into the individual or psychological factors. There have been cases where many addicts have reported symptoms of mild to severe mental disturbances. However, it is still not clear whether metal disturbances cause addiction or addiction causes mental issues. Well, whatever be the relationship, there are many studies and cases which indicate that addicts suffer from deep personality problems like feeling of inadequacy, dependency, powerlessness, isolation and low self- esteem. It can also be argued that the pleasurable feeling or the feeling of euphoria acts as a reward which motivates an individual to continue the usage of addictive substances. Apart from these two factors, we also have other factors like sociocultural or environmental factors. Several theories claim that addiction has sociocultural origins. People living in societies where consumption of drugs and alcohol are acceptable, and where drugs are easily and cheaply available are likely to have high consumption of drugs/alcohol. In some tribal societies, the consumption of alcohol is a part of religious rituals and ceremonies. Such regular consumption may cause some people to become addicts. The legal status of the addicting substance is also an important factor in determining the incidence of addiction. Among young people, growing up is like proving oneself to their peer group. And as you may already know, some individuals have a misunderstanding that alcohol toleration represents manhood which can again trigger consumption of alcohol or drugs among young people. As in the case of age and cultural background, occupation too has been found to be related to addiction. Persons in jobs that create stress—physical or mental are known to become addicted. For example; people working as morgue workers, rag pickers whose job is associated with unpleasant activities, those performing excessively exhausting, monotonous, laborious work, example like load- carriers and porters, drivers, etc. are prone to some form of addictions. Even family influence is also believed as another important environmental factor that can initiate addiction in an individual like the presence of an addict in a family, absence of parental control and supervision, or dysfunctional family. As mentioned earlier, peer group influence can also initiate and encourage the use of addictive substances. 2.1 Alcoholism WHO Experts Committee on Mental Health has recognized alcohol as a special type of drug. In simple terms, alcoholism is a chronic disease or behavioural disorder, characterized by repetitive and uncontrolled consumption of alcoholic drinks. This addiction causes functional and structural damages to our body. Now, let me ask you a question. Read the following options and identify which case shows the signs of alcoholism? 1. A 33-year-old male drinks six to eight beers per night, every night per week. He comes home and fights with his family, only to repeat the same the next day. 2. A 40 year old female consumes a small quantity of wine before sleeping occasionally. So, which one amongst these options show the signs of alcoholism. You should understand that it is not repeated drinking which can be called as alcoholism but when the drinking exceeds customary use and social standards of a community and along with that starts to interfere with the drinker’s health as well as social and economic functioning leading to continuous problems then we can name it as alcoholism. Drinking alcohol in controlled and limited quantity that doesn’t harm and affect the mental and physical stability of an individual can be considered socially acceptable. But if you ask me, I would not suggest anyone to drink alcohol even occasionally. Because as an individual, I see the possibility of addiction hidden in those occasional drinking. Well that’s my personal view and you can even argue against it or for it. We didn’t say the correct option. So, option 1 shows a typical example of an alcoholic. As you all now it is a treatable disease, as it can be checked and its progress stopped with proper treatment. It is a progressive disease and absence of treatment can lead to severs medical issues like cirrhosis. Alcoholism basically develops through three phases which are early phase, middle phase and chronic phase. During early phase an individual might be preoccupied with the thought of how, when and where they could get another drink. Also, during this stage they need more alcohol to get the same effect as earlier. They might even avoid talking about alcoholic drinks sometimes, due to guilt and shame. In the middle phase, there will be a complete loss of control over the quantity, time and place of consumption. They might start finding excuses and reasons for drinking which sometimes might result in aggressive behavior. At times, the alcoholic might seek help for alcoholism at this stage and might even stop consuming alcoholic drinks for a while. Next, in the chronic phase even a little quantity of alcohol is enough to get them drunk which shows decreased tolerance. During this stage, if the consumption of alcohol is discontinued, they would face severe physical discomfort and pain. In some cases, alcoholics might resort to criminal behavior and ethical breakdown only to obtain alcohol. Some might even show lack of motor coordination like shivering, shakes which prevent them from performing simple tasks. Paranoia, suspicion, hallucinations all these issues might develop during this phase of alcoholism. Even death or mental illness may also result in this final stage. 2.2 Causes of alcoholism The causes of addiction which we have already discussed are also applicable here and along with those reasons we will also look into some of the other factors that can make someone vulnerable to alcoholism. So, before look into the causes, lets have a reflection spot. Among the following, identify the causes of alcoholism? 1. Family history of alcoholism 2. Stressful life situations 3. Elderly undergoing mandatory retirement Which one do you think is the right answer? Well, all of them can contribute to developing the habit of drinking in an individual or may even aid in initiating the habit of drinking. As I already said before, there are studies which say that people with a family history of alcoholism may develop the habit of drinking. Those experiencing grave personal problems or stressful life situations such as desertion, divorce, separation, parental rejection, aging, role change, or role conflict can become causes that may result in the onset of drinking. Even the elderly are at risk because of mandatory retirement and the necessity for living on a fixed income, which may restrict choices, leading to stress and anxiety. Older people are often lonely and unhealthy and lack feelings of worth and purpose – and while they drink, it relaxes them and helps them to forget their problems, that too momentarily; they believe that drinking can fill the voids in their lives. Such people won’t be able to accept and face the reality and as a result they resort to alcohol or other substances. Some people see drinking as an easy answer for the complexities of life. Even people with history of other addictions are more likely to develop an alcohol -related problem. Again I repeat there can be exceptions in all these cases. 2.3 Impact of alcoholism There can be primary effects like withdrawal, toxicity and deficiency syndrome along with secondary effects like aggressive behaviour, domestic violence and in some cases injury caused by drunk- driving offences. Health problems associated with alcohol abuse include higher rates of cancer of oral cavity, liver, and esophagus. It becomes much more dangerous when people combine heavy alcohol intake with heavy smoking. Even the risk of esophageal cancer is 44 times more for those who consume more than six drinks and one or more packs of cigarettes daily. Therefore, we can say that excessive consumption of alcohol causes variety of problems like family issues, social, physical, occupational and even legal issues. As I already discussed, there can be problems in the family like quarrels over drinking, physical abuse, decreased socialization with friends, financial worries etc. issues in a family can also cause behavioral issues in children who are exposed to drinking. It might even affect their studies. As you already know, alcohol withdrawal symptoms may occur during a variety of circumstances including lack of money to purchase alcohol, acute illness or injury, nausea and vomiting or a decision to stop drinking. The most severe reaction to alcohol withdrawal, are delirium tremors, which are characterized by disorientation, paranoia, and outbursts of irrational behavior, leading to threat of self-harm. Sensitivity towards alcohol’s effect is decreased when an individual consumes large doses of alcohol over an extended time and this phenomenon is called tolerance. It forces an individual to continually increase the dosage to achieve the desired result. It is common to all potentially addictive drugs. Alcoholism also leads to maladaptive behavior in individuals and has negative impact on interpersonal relationships. It hampers an individual from fulfilling their personal, family and social responsibilities. It lowers self-esteem and confidence. Irritability, lack of motivation, depression, anxiety, and aggression are some of the other impacts caused by alcoholism on an individual’s behavior. Legal issues and disorientation are the impacts of alcoholism. There are some other symptoms of alcoholism which include: 1. Inability to control alcohol intake. 2. Inability to reduce intake despite severe physical and social consequences and several attempts. 3. Considerable time is spent for drinking causing reduced socializing with friends and family. 4. Inability to fulfill household and occupational responsibilities. 5. Reduced social activities. 6. Consuming alcohol in unsafe and unwanted circumstances such as when driving. 7. Requiring more quantity of alcohol to produce similar effect. 8. Experiencing withdrawal symptoms like nausea, sweating and shaking while making an attempt to stop or delay drinking. And some of the health problems which can be caused due to alcoholism include: Liver disease, heart problems, diabetic problems, increased risk of cancer, weakened immunity and neurological complications. We don’t have to go in-depth into these issues and if you are interested, you can do further reading on this. And my only request to you people would be to think many times before initiating the habit of drinking even for fun. Your friends might suggest, or challenge or gift an opportunity for you to try it and there are chances that you may. But as I said, it only requires a moment of courage to make a huge difference in your life. 2.4 Laws and Prevention of alcoholism The preventive measures which can be implied to cure alcohol abuse or addiction. Treatment of alcoholism occurs in multitude of forms. Yes it’s true that psychological counseling and family support can help to better understand the problem and aid faster recovery. Even withdrawal symptoms can be prevented through detoxification and medications. There are certain oral medications prescribed by doctors which cause nausea, vomiting and other physical reactions if a person takes alcohol again. Actually, the intention here is to reduce the good feeling triggered by drinking alcohol which can help to reduce its cravings. Another very important thing is to engage oneself in activities that involve physical activity, eating well, good sleep and having a positive attitude. Ministry of Social Justice and Empowerment, Government of India has a scheme of assistance for the prevention of alcoholism and substance abuse implemented for identification, counseling, treatment and rehabilitation of addicts through voluntary and other eligible organizations. Under this scheme, financial assistance is provided to voluntary organizations and other eligible agencies. In a developing country like India, alcohol consumption tends to be a major problem because of the various socio-cultural practices across the nation, different alcohol policies and practices across states, lack of awareness on alcohol-related problems among the community, false mass media propaganda about alcohol use, various alcohol drinking patterns among the alcohol consumers and the emergence of social drinking as a habit because of the widespread urbanisation across the country. Stringent alcohol policies are needed to reduce alcohol consumption, and alcohol consumers have to be educated about the various harmful effects of alcohol consumption and the effects it can have on their mind, body and soul. Alcohol consumption becomes a serious problem when individuals start engaging in problematic drinking pattern that puts them at the risk of developing adverse health events. Though prohibition of alcohol use is encouraged in the constitution of India, but alcohol policy is a state policy. Hence, states have full control over alcohol related legislations, excise rates and the production, distribution and sale of alcohol. In India, alcohol prohibition was retained until mid-1960s. When alcohol enters the blood-steam, it circulates all over the body. Its effects depend on the quantity taken. They vary depending on the speed at which a person drinks. His/her weight and the presence of food in the stomach also make a difference. Therefore, when a person consumes an alcoholic beverage, there will be a rise in their BAC (Blood alcoholic concentration) because of which there can be a gradual and progressive loss of driving ability due to increase in the reaction time overconfidence, degraded muscle coordination, impaired concentration and decreased auditory and visual acuity. You would feel that you have stepped on the break, but in reality you wouldn’t have. Alcohol affects the brain directly by slowing down its activities as well as those of the spinal cord. It acts as a depressant, i.e. it slows down responses. It gives the false impression of being a stimulant because it lowers inhibition and makes people lively. Now, as per the Motor Vehicle Act, any person whose BAC values are found to be more than a particular limit are booked under the first offence and they may be fined about INR 2,000 to 10,000 or they may even face a maximum of 6 months to 4 years imprisonment. Advertising alcoholic beverages has been banned in India as per the Cable Television Network (Regulation) Act 1995, and the code of conduct under Advertising Standards Council of India (ASCI). Still, private channels are often permitting alcohol companies to advertise using surrogate means like using brand names for soda or water or music. However, as the target audience is moving from watching television to mobile phones, liquor companies have now begun to invest in online video marketing. According to the National Crime Records Bureau of India, the crimes related to alcohol consumption fall under four major acts namely, the Prohibition Act, Gambling Act, Psychotropic Substance Act and Excise Act. If you are interested, you can do further research on these acts. Well, the major reason because of which the public nuisance created by alcohol abuse goes unnoticed is that such crimes are classified under petty crime and they largely go unrecognized or they may get overlooked. 2.5 Ill effects of smoking As you all know, tobacco is one of the most common substances used in India and is also highly addictive. In India, it is both legally and socially sanctioned and is used in a variety of ways including smoking, chewing, applying to gums, sucking and gargling. It is considered as a significant risk factor in many health problems such a lung diseases, cancer and cardiovascular diseases. In case of smoking, the risk is also high for passive smokers and it can also cause serious health consequences. There are nearly 3000 chemicals in tobacco smoke and 4000 in smokeless tobacco. Cigarette smoking is perhaps the most common form of nicotine use in the world and is the most lethal in the long run. And yes, nicotine is the main active chemical in tobacco that leads to addiction as it stimulates the pleasure centre of the brain and therefore the user feels a highly satisfying and rewarding experience which triggers repeated use. In India, the most commonly used smokeless tobacco product is khaini or tobacco-lime mixture followed by gutkha and betel quid with tobacco, which is a variant of paan. Well, bidi is the most commonly used smoking product followed by cigarette and hukkah. Now, what causes tobacco dependence? As we discussed in the previous lecture on addiction, there are various factors that causes addiction. There are some biological and environmental factors which mutually interact together to give rise to addiction. An individual initiates smoking due to the factors which include environmental, behavioral, and even personal factors. Environmental reasons include factors like exposure to the habit of smoking at an early age, for example, parental smoking which increases the likelihood of the child to start smoking and smoking by siblings and friends. Even tobacco advertising and promotions also play an important role in targeting young people with images of celebrities in the advertisements. Young people from deprived backgrounds where smoking is a norm might also become smokers. Moreover, the availability of the product, social sanction and peer pressure are also some of the major factors which promote initiation and continuation of smoking. Smoking in adolescents is frequently associated with poor academic performance, bunking class hours, and addiction towards other substances like alcohol and drug use, behavioral issues along with low self-esteem, anxiety, and depression. Sometimes, stressful living conditions may also lead to high rates of smoking amongst unemployed, single parents, people who have faced divorce or desertion, homelessness, drug users and prisoners. Use of tobacco leads to premature deaths. You might have seen a lot of awareness videos provided by the government of India where they seek to provide awareness regarding cancer, chronic respiratory diseases and other circulatory diseases. Smoking is recognized to cause 80 per cent or more of all lung cancers. In addition, it also causes cancer of the lip, tongue, mouth, pharynx and larynx, bladder, pancreas, oesophagus and kidney. Tobacco use, let it be smoked or smokeless, it causes harm to the soft tissues of the oral cavity. It also causes discoloration of teeth and lips. Continued tobacco use has an adverse effect on the sexual and reproductive health of both men and women. Here, you can look at the chemicals which are present in a cigarette. Nicotine narrows your veins and arteries which can damage the heart by making it work faster and harder. Tar is a sticky substance that coats your lungs like soot in a chimney. Carbon monoxide deprives your heart of oxygen. Ammonia irritates your eyes, nose and throat. Similarly, there are many cancer causing chemicals in these tobacco products which makes the abnormal growth of cells in your body. As you all know, it also affects the way you look. It causes yellow-brown stains on teeth, fingers and tongue. It increases the risk of tooth loss and bad breath. It also causes premature ageing as your skin becomes saggy and wrinkles start to appear. Apart from these factors you should also understand that smoking is expensive and why should you spend money to harm yourself? You know smoking reduces your life expectancy and the quality of your life and it is upon you to decide what you choose, would you choose a cigarette upon life? I hope from my heart that you would not choose any tobacco product upon your life. Ministry of Health & Family Welfare, Govt. of India enacted a comprehensive legislation, namely the Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003 (COTPA 2003) to discourage the consumption of tobacco products in order to protect the masses from the health hazards attributable to tobacco use. You must also be aware of e-cigarettes which come in many shapes and sizes. They have a battery, a heating element and a place to hold a liquid. You must understand that these products are banned in India through the Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export, Transport, Sale, Distribution, Storage and Advertisement) Act of 2019. They are not safe for youth, young adults, pregnant women and people who have not yet used any tobacco products. E- cigarettes produce an aerosol by heating a liquid that usually contains nicotine, flavours, and other chemicals that help to make the aerosol. Users inhale this aerosol into their lungs. Bystanders can also breathe this aerosol when the user exhales into the air. These aerosols also contain very harmful chemicals that can cause cancer, ultrafine particles causing serious lung issues and heavy metals like nickel, tin and lead. E-cigarettes are known by many different names. They are sometimes called “e- cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” “tank systems,” and “electronic nicotine delivery systems (ENDS).” Yes, they also can end our lives and so as a teacher and as your well-wisher, who is concerned about your, I would suggest that it’s always better to stay away from them.