Many people start smoking and/or drinking alcohol as teenagers. Choose either drinking or smoking as an example and explain why this age is a particularly vulnerable time to initiate these behaviors. Develop a behavioral intervention for a teenager who has a problem with excess smoking or drinking
What will be an ideal response?
ANSWER:
Related to smoking:
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Most tobacco users begin smoking in childhood or early adolescence, long before decision-making abilities are mature. Due to the addictive nature of nicotine, about half of those who experiment with tobacco will continue to use it. In addition to its action on synapses where the neurotransmitter acetylcholine is released, nicotine has the ability to stimulate the dopamine reward circuits of the brain and to produce a particularly unpleasant set of withdrawal symptoms. Developmentally, adolescence is also a time in which people try out new roles and learn important skills for getting along with peers, making them frequently susceptible to peer pressure. Teens often overestimate how many other people are using tobacco, so they might begin using it to avoid looking different. Finally, most smokers have friends and parents who also smoke, suggesting a role for social learning.
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The text notes that a very troubling aspect of the initiation of smoking is the prevalence of tobacco use among people with diagnosed psychological disorders. Tobacco use among people with schizophrenia and other severe mental illnesses is about 70% in the United States, more than 3 times as high as the 20% of users in the general population, as reported by the CDC. Evidence has begun to emerge supporting a causal role for nicotine in the development of some psychological disorders, especially depression.
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The social nature of people also plays a role in quitting smoking. A person’s chances of successfully quitting are reduced by 67% if a spouse smokes, 25% if a sibling smokes, 36% if a friend smokes, and 34% if a coworker smokes. In order to quit, it may be necessary to physically separate oneself from family and friends when they smoke, which may be difficult for a teenager to do.
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Related to drinking alcohol:
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Many of the same factors that encourage teens to begin smoking also operate to encourage drinking. Most people who go on to abuse alcohol are drinking heavily by late adolescence, and most cases of alcohol dependence are well established by the age of 30 years. This timeline provides insight into when prevention programs are likely to be most effective. Peer pressure, the need to fit in or look cool, overestimates of “everybody’s doing it,” modeling the behavior of parents and other family members, and the teen’s characteristic sense of being immune to harm from risky behaviors can contribute to decisions to begin drinking. Because alcohol reduces anxiety, socially anxious teens are especially at risk for problem drinking. If teens feel more socially competent while drinking, they are likely to continue this practice due to operant conditioning. Reduced feelings of anxiety are rewarding, so a person is likely to repeat the behavior (alcohol consumption in this case) that is associated with this reward.
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Among the environmental influences on problem drinking is the age at which a person takes his or her first drink. Individuals exposed to alcohol at earlier ages show a much higher rate of alcohol dependence later in life. The age of first drink interacts with a person’s genetic predisposition to alcohol dependence. In an example of epigenetic mechanisms, early exposure to alcohol might impact the expression of genes related to problem drinking. Another similar interaction is found between child maltreatment and neglect and genetic vulnerability to alcohol dependence. Not all children who are maltreated go on to become dependent on alcohol, although many do. The maltreated children who do not develop drinking problems are likely to be protected by combinations of genetic predisposition and the presence of peer and parental support.
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Students’ proposed behavioral interventions will vary.
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