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SMAD. Revista eletrônica saúde mental álcool e drogas

versão On-line ISSN 1806-6976

SMAD, Rev. Eletrônica Saúde Mental Álcool Drog. (Ed. port.) v.6 n.1 Ribeirão Preto  2010


Alcohol, tobacco and human habits



Moacyr Lobo da Costa Júnior

Associate Professor, Department of Psychiatric Nursing and Human Sciences, University of São Paulo at Ribeirão Preto College of Nursing. WHO Collaborating Centre for Nursing Research Development, Brazil



In the 1900s, especially at the peak of the Hollywood cinema industry, cigarettes had a special "glamour". Smoking was chic. There were no heroes, specially war ones, or good guys from the Wild West, without a lighted cigarette between their fingers.

There were no known contraindications, and the commercial appeal was huge. The tobacco industry grew in a very quick way, becoming politically and economically powerful in many countries, as the "Marlboro country".

With the development of medical knowledge, people discovered the health risks of smoking. Gradually, voices were gathering against tobacco. Numbers start to show economic losses, beyond health, due to tobacco, such as expenses from more and more costly treatments.

Despite the economic power, exemplified by the sponsorship of the most expensive of sports, Formula 1 racing, the tobacco industry could not resist and, slowly, the cigarette is being banned from acceptable social habits all around the globe. If it is considered difficult to completely banish it, smoking will still diminish to the habit of a few people.

Among the causes for this change in global behavior, consider the fact that, historically speaking, the coexistence of society with tobacco is relatively recent (500 years?, discovery of the Americas?), and the intensive use of tobacco began only 200 years ago, in the last two centuries (the 19th and 20th centuries).

Maybe this fact, added to the evidence that there are only negative consequences to tobacco use, has helped to change people's habits, considering all the economic power of tobacco industries, which have always sponsored sports and leisure activities, like car races and cinema.

On the other hand, familiarity with alcohol is thousands of years old. Culturally, the alcohol in its varied forms has always been part of innumerable nations.

There is, for each nation, what might be called a "spirits trade mark". For example, Latin European countries, such as Italy, Spain, France and Portugal are noted for wine; the English, Scottish and Irish for whisky; Germans for beer; vodka is associated with Russia and Poland; sake with Japan; rum with Cuba; sugar-cane rum (cachaça) with Brazil; champagne with France; gin with the Netherlands, although its use was spread by the English; cognac (brandy) with France and Spain; tequila with Mexico; and so on. The list of nations with a cultural symbol as an alcoholic beverage is enormous.

Not to mention that for countless religious rituals, alcoholic drink has always been part of the ceremonies. And this occurs throughout the four corners of the world.

Therefore, while the tobacco is historically recent in the human history, alcohol is part of it since the beginning of humanity. And this is not only for one or another nation, but for the entire planet.

Besides these aspects, while the health damages from tobacco are numerous, more direct and easily identified, the health damages caused by alcohol, in many ways, are indirect and more complex to be perceived by the population.

Additionally, there is the fact that, in small amounts, there is no damage, because alcohol is part of the eating habits, for example, of the Latin Europeans (wine).

While the fume of smoking will always do harm, with alcohol this will not happen all the time, and it actually does not happen, turning it into not a dichotomous question, consume or do not consume, but into a more complex matter of the amount consumed.

A great Brazilian public heath physician, Walter Leser, used to say that the difference between poison and medicine is the dose used.

Hence, the struggle against alcohol is much more difficult and delicate than all other drugs, licit or illicit.

Besides the undeniable economic power of the beverage industries, the social, cultural and religious aspects, all historical, render difficult the actions of health professionals in this area.

The path should be another, not the proposal of elimination, pure and simple prohibition, as it is made with cigarettes nowadays.

Two fronts ought to be attacked simultaneously.

Teaching moderate use, reducing damage to the entire society; the educational aspect in this case is extremely important; teaching to drink moderately, which is beginning to be practiced among us.

In parallel, measuring the many indirect harms caused by alcohol, publishing the results of these studies is also important, so that society as a whole gradually begins to achieve a greater awareness of this matter.

In the same way, habit studies, student use, suicide and pregnancy-related problems, problems related to care and professional training, in addition to all comorbidities associated with alcohol use are useful, and not to mention all the violence caused by alcohol, such as car accidents, homicides, which are research fields more and more referenced in this subject.

Only by disseminating information about the countless problems caused by the use of alcohol and their consequences, will people be able to reduce the negative effects of the abusive use of alcohol, avoiding greater consequences for individual and collective health.

And this is exactly what SMAD proposes, itself, to do.

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