Smoking, drinking,

where am I at?

 

Smoking and drinking;
What about my freedom and health?

Revision: 06.08.2012

 
 

Without anybody looking over my shoulder,

would I appreciate a self-assessment?

 

Two main points:

• Getting free from tobacco? How much motivated? Who may help?
• Getting free from alcohol? The questonaire starts with the worse and ends with the questions anyone will raise.

 

Freedom first: am I hooked?

If I suspect that I may be addicted and if only I continue to read what follows, it may be half way to freedom.

Regarding safety and health: what about my risks?

The time has come to opt for health !

The following check-list is typed on a narrow column. To read it comfortably or to distribute it, it may be printed. Prepare an empty document on two columns, with 13 mm margins, single spaced. Select the check-list and copy-paste on the document, aligned on left.
Put a space between the paragraphs, centre the titles.
Use Times New Roman or Arial condensed light fonts,12 pt or 11 pt types.
Print in black (if photocopies will follow)

The times needed are 4 minutes for copying-pasting, then the time for eventual printing and photocopyng.

There is no need to write the answers: they are only for me.

Internet users are free to print it for themselves and for other smokers and to show a specimen to their physician.

Concerning alcohol, the list starts with the heaviest damages. Unfortunately, these are not seldom.
At the end are found the questions raised even by those who don't have any alcohol problem

 

SMOKING: WHERE AM I AT?

• My habits?
- How old was I when I started?
- Do I relieve anxiety through smoking?
- Do I inhale?

• Harm?
- Am I often out of breath?
- A flower's fragrance, a tomato's flavour: still   appreciated?
- Does smoking no longer give me pleasure?
- Am I always worried about running out of cigarettes?
- My skin, my voice?
- Tobacco + pill = risk of embolism.
- Impaired fecundity?
- If pregnant, increased risks of premature birth; then, sudden death, asthma, bronchitis for the baby.
- Early menopause. Osteoporosis.

- Chronic bronchitis:  breathlessness, cough,   expectoration, pneumonia, suffocation.
- Cancers: lung, oesophagus (swallowing), throat,   tongue, bladder are to be watched.
- Hypertension, palpitations, myocardial infarction
- Arteries of legs and fingers.
- Relapses of duodenal ulcer?

• HARD TO GIVE UP?

• Degree of dependence?
- How early do I smoke my first cigarette?
- How many cigarettes a day?

• Previous experience of giving up or cutting   down: what worked best?

• My motivation for giving up?

- My freedom, passive smoking by my children and   spouse, my sport, a pregnancy, pollution?
In reality, pollution is the cause of most diseases and   deaths, but which? People cry out about pollution   from others. In fact, nearly all hazardous pollution is self-inflicted:
  too much in my ashtray, perhaps my glass, my   plate, my carburettor and my medicine cabinet.

- Belief that I will succeed?
- Belief that I will keep up more than six months?
- Is my motivation enormous? Then I will not even   finish an opened pack: to the bin!

DRINKING?

These questions concern nobody else.
They start with the worse.
They end in what everybody asks for.

I, DO I SUFFER DAY AFTER DAY?

- Quality of sleep? Nightmares?
- Depression? If not, anxiety?
- Early morning anguish?
- Do a few drinks relieve it?

• Seek one or several other morning symptoms of    withdrawal:
- tremor, sweat, nausea, vomiting?
   Are these disorders relieved by alcohol?
- A history of delirium, hallucinations, seizure?

• If no withdrawal symptoms:

- Need to increase my intake to get the effect?
- Do I find it difficult to stop
   after two or three drinks?
   If yes, this is the first stage of dependence.


- Have I ever tried to cut down?
   What was the result?
- Do I feel trapped by alcohol? Hooked?
  What about my freedom?

II, IF ALCOHOL DEPENDENT

• The need for alcohol, besides withdrawal:

- Failed attempts to cut down?
- Obsessed by alcohol supply?
- Craving?
- Persisting drinking in spite of harm and expense?
- Giving up other priorities?
- Who is winning, the person or the bottle?

• Disorders not explained by the need:

- Loss of pleasure:
   only drinking in order to feel less  bad?
- Denial: to myself and others, hiding bottles?
- Hostility towards myself and others?
- Loss of positive emotions?
- Loss of communication with my close relatives?
- Loss of tolerance: at a late stage: are three drinks   enough to fall over?

• Emotional condition
- Broken relationships?
- Feeling enslaved?
- Quality of life? Any suicide attempts?

• Retrospect:

- How old was I when I started drinking to excess?
- How many years were there between social   drinking and the appearance of withdrawal?
- Did I abuse tranquilizers, dissolving my energies?
- Once hooked, which succeeded:
   stopping or cutting down?

- How long did I succeed?

- Did I attend self-help groups, in order to give up?
- Alcohol-related hospital stays?
- If I relapsed into dependence, how many days elapsed between the first drink and the recurrence of withdrawal symptoms?

• A noxious environment?

- Domestic violence? Loneliness?
- Disappointments, separations, mourning?
- Conflicts, worries, unemployment, retirement?
- Distressing home environment, lost home?
- Family drinking habits or being led astray?
- Disinformation. Early initiation to alcohol?

• A personal propensity?

- Often drunk as a teenager? Other addictions?
- If depression, did it occur before, during or after   dependence? If anxiety, the same.

• Circumstances of craving?

- Festivities: being unable to say no
   to the first excess drink?
- Vexations? Being criticized or threatened by my   employer or spouse?
- Bodily pains?

- Did I notice these circumstances?
- Did I devise coping  strategies?

• Harm, other than broken relationships and   suicide attempts?

- Inability to hold down a job, invalidity?
- Traumas, sex at risk?
- Pathological drunkenness ?

- Heart (infarction n° 1 of death causes): palpitations, hypertension, breathlessness?
- General and digestive condition: loss of appetite   (prelude to cirrhosis), weight loss, jaundice,
   pancreatic pain?
- Neuro-psychic impairment: muscular pain or   weakness, impaired sight of colours, memory   disturbances?
- Congenital defects affecting my child (fetal   alcoholism)?

- Accidents… Fires… Police… Incarceration?

• After all, am I sick owing to alcohol?
   Am I 90% convinced that I need to change my
   drinking habits?

• Projects shared with my physician?

If dependent, then choosing to quit:

My motives:
- Stop suffering and being hooked?
- My own experiences
   of failed attempts to cut down.
- Having met a recovered alcohol dependent?

• Agreeing to be helped: I am the only one to decide, but I won't succeed alone!
- Armistice with my relatives!
- Agreeing to meet a recovered alcohol dependent?
- Weaning at home is often possible.
- After weaning, close support, e.g.telephone calls.

- Recovering only succeeds in groups:
   either institutional or self-help groups.
- Supervision at appointed times, regular attendance to group meetings and consulting-room are   essential.

• After weaning, alcohol will remain on my mind
   for at least two months.
- If dependent, I can never hope to drink in
   moderation again
   or to recover the lost pleasure.

• Succeeding through abstinence?

12 to 15 months after weaning,
   focus on freedom and quality of life.

• Freedom?
- Do I feel completely free from alcohol?
- If yes, what words can describe this freedom?

• Well within myself?
- Depression, suicidal ideas, sleep, self-esteem ?
- Able to cope with vexations?
- Having realistic purposes?
- General health perception?

• Well with my relatives?
- Communication, social life, loneliness?

•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

III, IF NOT DEPENDENT,
CHOOSING BETWEEN
MODERATION OR ABSTINENCE

- Relying on my own experience and medical advice.

• Mandatory conditions for controlled drinking   after heavy drinking without dependence:
- two weeks without alcohol;
- then abstention three days a week;
- then no more than sixteen drinks a week
   (twelve for females).
- Within this framework, no more than fours   units/day and three units/hour.

• Learn to smile and politely say no
   to the first excess drink.
- Never drink alone, nor to drown my sorrows,
   nor as a medicine
- Then I reduce my risks of accidents, hospital days   and dependence.

•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••

IV, IF I AM A MODERATE DRINKER,
OR AN ABSTAINER

"Moderate" means being usually free to stop after the second or third drink.

• How much may I drink before driving?

- All alcoholic drinks, i.e. beer, wine, port, whisky…
   contain the same amount of alcohol,
   that is around 11 grams = one unit.
- Counting the drinks (units) provides a safe guide.
- Three units (two for a woman) can be enough to test positive when breathalised at .5 gram of   alcohol per litre of blood. This is enough for the   driver to become dangerous, without noticing it.
- I may get into trouble for breaking the law.
- It would take at least six hours just to reduce blood   alcohol concentration by one gram per litre:
   one drink over the limit means waiting for one   additional hour.

- A successful party, how many drinks?
- And then, driving? Pregnancy? Contamination?

• How much without risking my health?

- There is not one answer for everybody.
  
In many cases one cannot drink any alcohol:
   some sports; in combination with medication; when depressed; a history of dependence on  alcohol, medicines or drugs; hepatitis; pregnancy.
- Therefore, the proper answer cannot be expected   from television, but from my personal physician.

• Is little wine good for my health?

- Not if I am a woman or a young man or if I smoke.
- It is now deemed that if other categories of abstainers have a shorter life expectancy, it is due to factors other than their abstinence.
- Anyway, physicians no longer recommend alcohol to abstainers, for want of being able to predict how far it will go.

• It is up to me to make my own mind!

from: https://parlersante.medicalistes.fr

 

REFERENCES

other than those in the book:
Besançon F: Communiquer avec une victime de l'alcool, 2° edition. Paris, Dunod 1999,
Alcoholic? Alcoholism? How to communicate

- Agence française de sécurité sanitaire des produits de santé (Afssaps), Groupe d’auteurs. Les stratégies thérapeutiques médicamenteuses et non médicamenteuses de l’aide à l’arrêt du tabac. Alcoologie et Addictologie 2003; 25 (Suppl 2): 1S-42S, avec 105 références  bibliographiques
- Andreasson S, Allebeck P, Romelsjö A: Alcohol and mortality among young men: longitudinal  study of Swedish conscripts. Brit Med J 1988: 296: 1021-1025
- Besançon F: La place des facteurs de risques et des maladies évitables dans la morbidité hospitalière, et la place de l’hôpital général dans l’action préventive. Médecine Interne 1973; 8: 699-709
- Blanchard N, Kopp P: Le coût social de l'alcoolisme en France. Alcoologie & Addictologie 2001; 23 (2): 125-129
- Fillmore KM, Golding JM, Graves KL, Kniep S, Leino EV, Romelsjö A, Shoemaker C, Ager CR, Allebeck P, Ferrer H: Accohol consumption and   mortality. Studies of female   populations. Addiction 1998; 93 (2): 219-229
- Finfgeld D: Use of self-help manuals to treat problem drinkers. J Psychosocial Nursing 2000; 38: 20-22
- Fouquet P, Clavreul J: Entretiens pour une thérapeutique de l'alcoolisme. Paris, Presses Universitaires 1956. Réédition : -Fouquet P: Lettres aux alcooliques. Riom,  RiomLaboratoires 1993
- Hispard E, Herrbach-Joubaud F, Thépot V, Girre C, Dally S: Le budget "alcool" du malade   alcoolique : 3 000 F par mois. Entretiens de Bichat Médecine. Paris, Expansion Scientifique 1991, pp. 90-92
- Lagrue G : Tabagisme : toxicologie, dépendance.Encycl Med-Chir, vol. Toxicologie-Pathologie professionnelle, 16-001-G-40 (7p). Paris, Elsevier 1999
- Lagrue G, Légeron P, Azoulai G, Pelissola S, Aubin HJ, Humbert R: Élaboration d'un test permettant d'évaluer la motivation à l'arrêt du tabac. Alcoologie & Addictologie 2002; 24(1): 33-37

- Miller WR, Munoz RF: How to control your drinking. Englewood Cliffs (USA), PrenticeHall 1976

- Sanchez-Craig M: C'est assez ! Comment arrêter de boire ou réduire votre consommation d'alcool. Toronto, Addiction Research Foundation 1994

 

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