366 Chapter 10The ratio of fat to water in a woman’s body
is greater than that in a man’s body; in other
words, men have more water available in their
systems to dilute consumed alcohol. In addi-
tion, more of the alcohol is metabolized by
enzymes in the stomachs of men compared to
women. Thus, men and women who drink the
same amount of alcohol in proportion to their
body weight will not have the same blood-
alcohol levels. This may be one reason why
alcohol is more strongly associated with cir-
rhosis of the liver in women than in men. The
progression from the first drink to an alcohol-
related problem is faster among women than
men, a process referred to as “telescoping.”
Thus, women are more vulnerable than men
to both acute and chronic (long-lasting) ef-
fects of alcohol. Alcohol also seems to be more
strongly related to depression in women than
men (Harrell & Karim, 2008; Tuchman, 2010).Prevalence. Alcohol usage and alcohol-
related problems are higher among men than
women. The prevalence of alcohol usage was
examined in the 2008 National Survey of Drug
Abuse, which is a national survey of over 8,000
persons of age 12 and above (Substance Abuse
and Mental Health Services Administration,
2009). This representative survey revealed that
58% of males and 46% of females have used al-
cohol in the past month. Binge drinking in the
past month, which is defined as five or more
drinks on a single occasion for males and four
or more drinks on a single occasion for females,
is three times as prevalent among men than
women over the age of 18 (24% vs. 8%; Centers
for Disease Control and Prevention, 2009c).
The rate is highest among Whites and lowest
among Blacks. There is cross-cultural sup-
port for these sex differences. In a study of 10
countries (Australia, Canada, Czech Republic,
Estonia, Finland, Israel, Russia, Sweden, Neth-
erlands, and United States), men drank alcoholphysiologically addicted because nicotine
patches are more effective in relieving men’s
withdrawal symptoms than those of women.
A third theory is that women are more con-
cerned than men with the weight gain that
follows smoking cessation. This concern may
interfere with initial cessation efforts but does
not predict relapse. People do gain weight
when they quit smoking but probably not as
much as they expect.Alcohol
The relation of moderate alcohol intake to
health is mixed. On the one hand, alcohol
in moderation is protective against heart
disease and appears to provide immunity
from the common cold (Rich-Edwards et al.,
1995). However, alcohol in moderation
may also be associated with breast cancer
(American Cancer Society, 2009).
Large quantities of alcohol are clearly
harmful to health. Heavy use of alcohol is
associated with a variety of health risks, in-
cluding injury, violence, poisoning, and birth
defects/miscarriage in the short-term and
cardiovascular disease, cancer, and liver dis-
ease in the long term (Centers for Disease
Control and Prevention, 2008). Alcohol is
linked to accidents in general and to mo-
tor vehicle accidents in particular. Of fatal
crashes, 25% of men and 13% of women
were driving under the influence of alcohol
(U.S. Department of Transportation, 2008a).
Alcohol has different consequences for
women and men (Nolen-Hoeksema & Hilt,
2006). Although women have a lower genetic
risk for alcohol-use disorders, the physiologi-
cal consequences of alcohol are more dam-
aging to women. It takes proportionally less
alcohol to have the same effect on a woman as
a man; even if a woman and a man of similar
weight drink the same amount of alcohol, the
woman will have a higher blood-alcohol level.M10_HELG0185_04_SE_C10.indd 366 6/21/11 8:54 AM