Alcohol is a widely used and powerful drug which is present in alcoholic drinks. It is also known as ethanol, and is a product of fermentation of different food substances, such as grapes, barley, wheat, and rice. This drug is a central nervous system depressant that slows down the activity of the brain. Contrary to popular belief, alcohol is not a stimulant that excites brain activity.
Here are some examples of alcoholic drinks and their ABV:
|
Alcoholic Drink |
ABV (%) |
|
Beer |
3.5 – 5 |
|
Wine |
11 – 15 |
|
Rice Wine |
30 |
|
Whisky / Brandy |
40 (35 – 57) |
|
Gaoliang (sorghum wine) |
60 |
Note:
The effect of alcohol on a person depends on both the type of alcoholic drink, and the amount consumed. Other factors include age, sex, overall health, and frequency of drinking.
Alcohol moves rapidly through the walls of the stomach and small intestine before entering into the bloodstream. It passes through the liver in small quantities where it is broken down into carbon dioxide and water. Assuming no more alcohol is consumed, the alcohol is gradually removed from the bloodstream. However, complete removal can take a considerable time. For example, it will take the liver of a healthy adult male weighing about 80 – 90kg approximately one hour to process and remove one pint of full strength beer.
BAL is the measure of alcohol concentration in the blood. It can be stated as a decimal number or in milligrams of alcohol per 100ml of blood. BAL is an important measure, because the extent to which the nervous system and subsequent actions are slowed down or impeded is dependent on the concentration of alcohol in the bloodstream. The higher the BAL, the greater effects alcohol has on the body. If the BAL reading is over 0.45 (or 450 mg alcohol per 100 ml of blood), death is a possibility. This is because breathing can slow down so much, it may actually stop.
The BAL of an individual is dependent on a number of different factors. For example, a group of people who have consumed the same quantity of alcohol at the same time may not have the same BAL reading. Factors that affect the BAL in an individual include:
Their sex, weight and build.
Their volume of blood and bodily fluids.
The health of their liver.
The span of time over which alcohol is consumed.
Whether food is consumed at the same time.
Whether the individual is on medication.
Individuals who have lower volumes of blood and body fluids will have a higher BAL reading than those who have a greater volume of blood and water in their body. This is because alcohol dissolves more readily in water. For this reason, children or adolescents who consume alcohol are more likely to have a higher BAL, and exhibit signs of the nervous system slowing down more quickly.
Muscle tissues contain more water than fatty tissues of the same weight. Consequently women, who generally have a higher proportion of fatty tissue than men, will have a higher BAL than men, even when they consume the same quantity of alcohol within the same time frame.
Besides affecting health, the over-consumption of alcohol can lead to accidents and other social problems. Some of these problems are due to excessive intake in the short term, while others are due to persistent and frequent heavy consumption.
Once absorbed by the body, alcohol has an almost immediate effect on the nervous system. Noticeable effects include:
General impairment of senses
Delayed reactions
General loss of coordination
Depression of inhibitions (e.g. a person becomes more talkative or aggressive, which may lead to the myth that alcohol is a stimulant)
While the long-term effects of alcohol consumption vary between individuals, any individual who regularly consumes an excess of alcohol over a period of time may suffer from some or all of the following problems:
Liver damage
Brain damage (especially loss of memory)
Cardiovascular disease
Mental problems
Death
Heavy drinkers may also struggle with alcoholism and suffer from negative consequences in social relationships and finances.
Problems can be avoided by not drinking or drinking in moderation. However, if an excessive amount of alcohol is consumed, some of the following problems can occur in the following scenarios or people:
Under the influence of alcohol, a person’s judgement is impaired, e.g. their vision blurs, they have a slower reaction time, they lose focus, co-ordination and balance. For all these reasons, they are more likely to have an accident when operating machinery or driving a vehicle. A common example is when someone drink drives: the drunk driver, his/her passenger(s), and other road users are all put at risk.
If alcohol is taken together with other depressant drugs, such as tranquillisers, sleeping pills and antihistamines, the person risks further depression of the central nervous system and may show signs of alcohol poisoning.
Alcohol also interferes with the absorption and metabolism of other drugs, increasing the burden on the liver. In some cases, alcohol enhances the absorption of matter into the bloodstream so much that it can dangerously magnify the dosage of the medication absorbed by the body.
If a pregnant woman has a habit of drinking, both the health of the mother and the foetus could be affected. Alcohol in the mother’s bloodstream reaches the baby via the umbilical cord, and drinking large amounts of alcohol at any point during pregnancy, especially in the first trimester, may lead to a miscarriage. If the baby survives the pregnancy, there is a chance the baby may develop Foetal Alcohol Syndrome (FAS).
Signs and symptoms of FAS include: mental retardation, short attention span, extreme anxiety and other behavioural impairments, low birth weight, small head circumference, and poor fine motor skills.
In newborn babies, the brain and other parts of the body are in the early stages of development. A nursing mother who drinks alcohol will produce breast milk containing alcohol which affects the baby’s development. In addition, alcohol consumption can inhibit the mother’s production of milk, thereby depriving the baby of natural breast milk.
Drinking alcohol carries physical and behavioural risks for adolescents. As their brains are still developing, heavy alcohol consumption can lead to the impairment of brain function. Scientists are still researching if such damage can be reversed.
In addition, as mentioned earlier, BAL increases faster in adolescents than in adults, impairing the nervous system at a faster rate. This, in turn, can affect their judgement and behaviour more quickly and to a greater intensity.
Behaviourally, young people yield more easily to peer pressure and end up drinking too much. They may then:
Display embarrassing conduct.
Become aggressive, start disputes or fights.
Break the law, e.g. vandalise public property, steal.
Become victims of violent crimes or sexual assault.
Become involved in unintentional injuries.
Suffer blackouts and not remember what happened while drunk.
Engage in unprotected sex, which in turn, may hurt the personal reputations of both parties, jeopardise social relationships, and result in unplanned pregnancy or contracting sexually transmitted diseases.
It is important for young people to be able to identify the circumstances in which drinking becomes too risky. To avoid these potential problems, it is best to abstain altogether. If, however, they must drink alcohol, drinking with responsible adults can help lessen the risks.
Police have the power to demand a breath test from any driver who:
Is involved in a traffic accident.
Has committed a moving traffic offence.
Is suspected of drink driving.
Additional breath, blood or urine tests are mandatory if the screening results indicate an alcohol level above the legal limit as listed below:
|
Proportion of alcohol in a person’s breath, blood or urine |
Minimum Driving Disqualification Period |
|
|
First |
Second/ (Note 1) |
|
|
Tier 1 |
6 months |
2 years |
|
Tier 2 |
1 year |
3 years |
|
Tier 3 |
2 years |
5 years |
|
Note 1: Note 2: |
||
Penalties
Maximum fine of HK$25,000 and 3 years’ imprisonment.
Mandated to attend a driving improvement course.
Incur 10 driving offence points.
Assigned a driving disqualification period.
For detailed information, please refer to the following websites:
Transport Department
Department of Health
While cigarettes are the most commonly used tobacco product, leaves of the tobacco plant can be prepared and made into other products that are smoked, chewed, or inhaled.
Manufactured cigarettes consist of shredded tobacco, processed with hundreds of chemicals and different flavours such as menthol. Researches show that a lit cigarette releases over 7,000 chemical substances, of which 69 are carcinogens. The three main harmful chemicals found in smoked tobacco products are: tar, nicotine, and carbon monoxide.
A mixture of chemical compounds, many of which cause cancer
Inhibits or damages the cilia along the airways, so smokers become more susceptible to coughs and colds
Damages the bronchi and alveoli, leading to coughs, increased phlegm and difficulty in breathing
Long-term smoking may lead to emphysema or lung cancer
A stimulant drug found in tobacco products
Increases the heart rate, causes blood vessels to constrict, raising blood pressure, decreasing blood flow, and reducing oxygen in the blood
Is addictive
Colourless and odourless
It reduces the oxygen-carrying capacity of red blood cells, leading to less oxygen going to different parts of the body. This results in premature wrinkles and coronary heart disease.
First-time smokers may experience dizziness and nausea. After one or two cigarettes, the blood pressure may rise, the heart may beat faster, the person may lose his/her appetite, and his/her skin temperature may drop. Other symptoms include:
Irritation to the eyes, causing them to water more, and the person may blink more frequently
Difficulty in breathing, especially during exercise
Athletic performance may decline
Poor circulation leading to cold hands and feet
Tremors
Less oxygen supply to the brain
Increase of stomach acid
Addiction to nicotine develops quickly, as does the body’s tolerance to it. Over time, this means the body will need more nicotine, and need it more frequently to achieve the same effect. This may lead to long-term effects such as:
Chronic bronchitis and other diseases of the airways
Heart attacks and strokes caused by narrowing of the blood vessels that carry blood to the heart and brain
Emphysema, where alveoli loses elasticity and rupture, making breathing exhausting
Cancer of the lungs, oral cavity, throat, vocal cords, bronchi, stomach, bladder, kidneys, cervix, etc.
Gangrene (death of tissue in parts of the body, such as the toes) caused by poor blood circulation
Gastric ulcers
Osteoporosis (when bones become weak and brittle due to loss of tissue)
Decreased dexterity
Blindness
Studies have shown that young people are more concerned about the short-term effects of smoking, especially ones related to appearance and image. Some cosmetic effects include:
Body odour (from oral cavity, hair, clothes)
Stained teeth and fingers
Accelerates greying and thinning of hair
Wrinkles and premature ageing
There are two types of second-hand smoke: mainstream smoke and sidestream smoke. Mainstream smoke refers to the exhaled smoke from a smoker’s lungs; it makes up roughly 15% of second-hand smoke. The remaining 85% is sidestream smoke which is released directly into the air from the burning end of a cigarette. Sidestream smoke burns at a lower temperature and is not filtered, therefore it is even more toxic than mainstream smoke.
The number of cigarettes lit, the distance a non-smoker is from a cigarette, the ventilation, and the size and kind of place where the second-hand smoke is inhaled, all contribute to the amount a person actually takes in. The more smoke a non-smoker inhales, the more his/her body is affected.
Whether the second-hand smoke is mainstream or sidestream, it contains over 7,000 chemical substances, of which many are known to cause cancer.
Numerous studies have found that exposure to second-hand smoke can cause many of the same diseases as active smoking. It increases the risk of contracting lung cancer by 30% and coronary heart disease by 25%.
Summary of Effects of Second-Hand Smoke
Small but significant reduction in lung function, leading to a higher risk of lung cancer
Increased risk of lower respiratory tract infections, such as bronchitis and pneumonia
Increased chance of miscarriage or stillbirth in pregnant women
If pregnant women are exposed to second-hand smoke, babies are born smaller/lighter. There is also an increased risk of developmental problems in the baby at birth.
Children who live with smokers have an increased chance of developing fluid in the middle ear, a sign of chronic middle ear disease; catching upper respiratory tract infections (common colds and flu); and an increased frequency and severity of asthmatic episodes. They will also be more likely to smoke due to parental behaviour towards smoking.
Third-hand smoke refers to the chemical residue of tobacco smoke left behind on clothing, walls, furniture, carpets, hair, skin and other materials after the cigarette is extinguished.
As well as nicotine, toxic substances in third-hand smoke include the following:
Carbon monoxide
Hydrocyanic acid (used in chemical weapons)
Butane (used in lighter fluid)
Toluene (found in paint thinners)
Arsenic
Lead
Polonium-210 (which is a highly radioactive carcinogen)
Even if smokers smoke outside, a residue of nicotine will permeate into their skin and clothing. Tobacco toxins can persist on the surface of objects for weeks and even months after nicotine vapour has been absorbed. Even opening the windows will not remove the third-hand smoke straight away.
Many studies have shown that infants and children are at a higher risk than adults. As they crawl around and play, they tend to touch and sometimes swallow dangerous particles from tobacco residue, allowing harmful chemicals to enter their bodies.
Some of the effects of third-hand smoke are as follows:
Leads to respiratory problems and increased risk of asthma
Increased risk of middle ear infection
Cognitive deficits in children, e.g. the higher the exposure to tobacco smoke, the higher the risk of reading deficit
Tobacco and Alcohol Control Office
Hong Kong Council on Smoking and Health
Department of Health
Hospital Authority
Chinese Association on Tobacco Control
Taiwan
John Tung Foundation
World Health Organization
The Tobacco Atlas
Tobacco plants are monocrops that are vulnerable to different pests and diseases, prompting farmers to use large amounts of chemical fertilizers, growth regulators and insecticides, which deplete the soil of nutrients, resulting in a polluted environment.
With polluted soil and decreasing areas of good land, many low and middle-income countries look for new places for tobacco farming and the wood needed for curing tobacco leaves, leading to large-scale deforestation. This contributes to climate change by removing trees that eliminate carbon dioxide from the atmosphere.
Tobacco farmers work without protective gear, resulting in the daily absorption of about 54 mg of nicotine through the skin, equivalent to smoking 50 cigarettes. According to the World Health Organization, people who have long-term direct contact with nicotine-containing plants will experience dizziness, nausea and vomiting. In severe cases, it may lead to anaemia or nicotine poisoning. In addition, many tobacco farmers take their children with them to work, believing their health will not be endangered if they do not smoke. However, contact with these plants can be harmful to children, causing headaches, abdominal pain, muscle weakness, difficulty in breathing and other symptoms. In severe cases, exposure leads to problems with the nervous system.
Tobacco use is the most common preventable cause of death. Studies have shown that for every two long-term smokers, one will die prematurely, with an average loss of 10 years of life. The World Health Organization estimates that more than 5.7 million people around the world die each year from tobacco use, and the death toll will increase to more than 8 million deaths by 2030. In Hong Kong, the number of deaths due to smoking and second-hand smoke is about 7,000 each year. Smoking-related diseases such as cancer, heart and vascular diseases, and chronic lung diseases also incur considerable medical expenses and loss of productivity in Hong Kong, leading to the loss of more than HK$5 billion every year.
Hong Kong’s daily smoking prevalence is recorded in the following surveys:
Thematic Household Survey Report
Survey of Drug Use among Students
The survey is an independent, territory-wide survey conducted by the Census and Statistics Department. The sample of households is drawn up scientifically to collect statistics on various social issues, including smoking in Hong Kong.
According to the 2019 survey, the daily cigarette smoking prevalence of the Hong Kong population (aged 15 or above) was 10.2%. In the 15-19 age group, the daily cigarette smoking prevalence has been decreasing in the past 10 years. The report has also revealed that the percentage of daily electronic cigarettes smokers aged 15 and above has increased 26.3% in 2019, compared to the 2017 survey. Therefore, we must educate young people on the effects of tobacco use at an early stage, helping them to break the myths of different tobacco products and lead them to live a healthy and drug free lifestyle.
The Narcotics Division of the Security Bureau commissions an investigatory body every four years to conduct a large-scale survey on drug use, including smoking, among students in Hong Kong. In the last survey, the students were from local schools (Primary 4 to Secondary 6), International schools (Year 5 to 13) and tertiary programmes (including public-funded and self-financing degree programmes and sub-degree programmes). The proportion of students who had smoked increased from 7% in 2017/18 to 7.4% in 2020/21.
Note: Data above are updated regularly.
Census and Statistics Department: Thematic Household Survey Report No. 75
Narcotics Division, Security Bureau: 2020/21 Survey of Drug Use among Students
A number of different tobacco control laws have been enacted around the world, including those restricting tobacco advertising. In Hong Kong, under Part IV of the Smoking (Public Health) Ordinance (Cap 31), no person shall display or cause to be displayed, or publish or distribute any form of tobacco advertisement for display purposes. The display of tobacco advertisements in printed publications, public places, films and the Internet is also prohibited. However, this leads to tobacco companies using grey areas of legislation to promote tobacco products.
Brand extension is extending the original brand name into other new product items; an indirect way of advertising tobacco products. This not only increases the sales of new and old products, but also brings publicity to the tobacco brand.
In Hong Kong, the tobacco industry benefits from grey areas in the existing legislation since it does not regulate any advertising of non-tobacco products that are an extension from cigarette brands. As long as these advertisements do not show any cigarette products, they can promote any products with lifestyle messages that may resonate with young adults and at the same time make associations with the tobacco brand. As a result, brand extension will continue to attract people to start smoking.
Youth Smoking Prevention (YSP) Programmes
Tobacco companies around the world have provided financial sponsorship, professional advice and support to relevant government and civil society organizations to help them organise programmes to prevent young people from smoking. Their ultimate goal is actually not to prevent young people from smoking, but rather to build a responsible corporate citizen image for themselves, tricking young people into smoking with their publicity.
In summary, YSP programmes sponsored by tobacco companies have the following problems:
They portray smoking as an adult choice which leads students to thinking that smoking is related to freedom and maturity, and may stir a rebellious attitude in some young people to try smoking
They fail to discuss how tobacco advertising promotes smoking or the health risks of smoking
There is no evidence that these programmes decrease smoking among young people
Electronic cigarettes, known as e-cigarettes or electronic nicotine delivery systems, are battery-powered devices designed to look and feel like traditional cigarettes. They use cartridges filled with a liquid that contains nicotine. A heating device in the e-cigarette converts the liquid into a vapour that is inhaled into the lungs.
Chemical substances in electronic cigarettes may include:
nicotine
propylene glycol
formaldehyde
acetaldehyde
glycerol
additives
Studies have pointed out that the electronic cigarettes contain many toxic substances, including propylene glycol which irritates the eyes and respiratory tract, increasing the risk of respiratory problems; and formaldehyde which is a known carcinogen.
Under the Pharmacy and Poisons Ordinance (Cap. 138), electronic cigarettes containing nicotine are classified as pharmaceutical products and must be registered with the Pharmacy and Poisons Board of Hong Kong before they can be sold or distributed locally. Under the Smoking (Public Health) Ordinance (Cap. 371), it is an offence to use e-cigarettes in a no-smoking area. The offender is liable to a fixed penalty of HK$ 1,500. From April 30, 2022, no person may import, promote, manufacture, sell, or possess for commercial purposes alternative smoking products, including electronic smoking products, heated tobacco products and herbal cigarettes.
Electronic cigarettes vary in taste, shape and packaging. Most do not list their ingredients, and some packaging even has misleading phrases such as “not addictive” or “help quit smoking”. According to a report by the World Health Organization, there is still only limited evidence to show that electronic cigarettes can help people quit smoking. It is therefore important to remind students not to try electronic cigarettes.
Tobacco and Alchohol Control Office
Hong Kong Council on Smoking and Health (COSH)
Street name: Weed, Pot, Grass, Dope
Appearance: Marijuana is the most commonly used form. It is made from the dried leaves, stems and flowers of the plant “cannabis sativa”. Cannabis resin is made from the plant’s resin, which is extracted from the flowering tops and leaves of the female plants, then dried and compressed.
Medical use: The active ingredients in cannabis are Delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD). Some countries have legalized the medical use of cannabis, acknowledging its use in treating the nausea and vomiting of cancer patients due to chemotherapy, reducing seizures in people with epilepsy and reducing chronic pain. However, there are a lot of risks associated with cannabis use. Therefore, it is highly regulated in terms of the legal amounts allowed, user’s age limit and venues for use.
Category: Cannabis is a depressant but also possesses hallucinating effects at higher doses.
Method of use: Marijuana is usually smoked in hand-rolled cigarettes often called “joints” or in smoking implements such as pipes and bongs. Cannabis herbs or cannabis resin can also be taken orally, usually in tea, cakes or cookies while cannabis extract is usually spread on a cigarette and smoked. In recent years, some users have added cannabis oil in electronic cigarettes (the most potent form of cannabis is oil which is produced by further refining cannabis resin).
Effects of cannabis vary from person to person depending on factors such as dosage, how potent the marijuana is, the way it is used, characteristics of the user, mood, previous experience with the drug and the setting.
Effects of Small Doses
If cannabis is used in conjunction with other depressants, the depressant action generally increases. When cannabis is combined with alcohol, it can frequently lead to accidents. Using cannabis with other drugs increases the risks and makes the consequences unpredictable.
Institute of Mental Health Castle Peak Hospital
https://www3.ha.org.hk
Narcotics Division, Security Bureau: Anti-drug Information and Resources
https://www.nd.gov.hk
Narcotics Division, Security Bureau: Anti-drug Resources for Teachers and Social Workers
https://www.nd.gov.hk
Hong Kong Police Force: Types of Drugs
Methamphetamines are a group of drugs commonly referred to as speed. They speed up or stimulate the activity of certain chemicals in the brain and are classed as stimulants.
Methamphetamine, also known as ice, is a potent form of amphetamine, and has been gaining popularity in Hong Kong since the early 1990s.
Amphetamines bought on the street are usually in the form of white powder, tablets or liquid in capsules. Ice is sold as transparent crystals. They can be swallowed, injected, smoked, or inhaled.
Effects of methamphetamines vary from person to person, depending on factors such as dosage, the way it is used, characteristics of the user, mood, previous experience with the drug and the setting.
Headaches and dizziness;
Dry mouth;
Increased heart rate and blood pressure;
Reduced appetite;
Sleeplessness;
Increased talking
Anxiety and panic attacks;
Aggressiveness and threatening behaviour;
Become sensitive and easily irritated;
Hallucinations.
Malnutrition;
Insomnia;
Reduced resistance to infection;
Skin lesions appear on body;
Irregular heart rate and high blood pressure;
Panic;
Depression;
Aggressiveness and threatening behaviour;
Hallucinations;
Psychosis (leading to schizophrenia in serious cases;
Tolerance;
Dependency.
Institute of Mental Health Castle Peak Hospital
Narcotics Division, Security Bureau: Anti-drug Information and Resources
Narcotics Division, Security Bureau: Anti-drug Resources for Teachers and Social Workers
Hong Kong Police Force: Types of Drugs
Street name: Coke, C, Big C, Crack
Appearance: Cocaine comes from the leaves of the coca bush. The leaf extract is processed to produce three different forms of cocaine. Firstly, cocaine hydrochloride, a fine white powder. Secondly, freebase, a white powder that is purer with less impurity than cocaine hydrochloride. Thirdly, crack, crystals ranging in colour from white or cream to transparent with a pink or yellow hue.
Medical Use: Cocaine was once used as an anesthetic agent. Nowadays, other safer synthetic compounds have replaced cocaine as anesthetics.
Category: Cocaine is a strong stimulant drug.
Method of use: User primarily administer cocaine by inhalation. Cocaine can also be heated and smoked. It has the street name ‘crack’ because it makes a cracking or popping sound when heated.
Effects of cocaine vary from person to person depending on factors such as dosage, the way it is used, characteristics of the user, mood, previous experience with the drug and the setting.
Narcotics Division, Security Bureau: Anti-drug Information and Resources
Narcotics Division, Security Bureau: Anti-drug Resources for Teachers and Social Workers
https://www.nd.gov.hk
Hong Kong Police Force: Types of Drugs
Ketamine is a dissociative anaesthetic which means that the drug causes a person to feel that their mind is detached from their body. It has similar properties to phencyclidine, also known as PCP, or angel dust. Ketamine was initially developed to be used as an animal anaesthetic and a human sedative. Recently, however, this drug has become common in the nightclub scene. Ketamine’s street names include K, Special K, and Vitamin K. It has the properties of both a hallucinogen and a depressant.
Ketamine usually comes in the form of a white powder wrapped in paper, but it can also come as a clear liquid. It can be swallowed, but most people snort ketamine through the nose.
Feeling of the separation between body and mind (some users call this a “near-death experience”);
Hallucinations and/or paranoia;
Disassociation with reality;
Blackouts;
Loss of coordination and/or temporary paralysis;
Slurred speech;
Confusion;
Anxiety;
Nausea and/or vomiting;
Inability to feel pain.
The combination of numbness, hallucinations and the inability to feel pain can lead to serious accidents.
Recent reports in medical literature link the use of ketamine with a serious reduction of bladder function. As a result, users end up needing to go to the bathroom every 15 minutes or even more often.
Frequent use of ketamine can cause disruptions in consciousness and lead to neuroses or other mental disorders. Other effects include:
Impaired memory and concentration;
Quick tolerance of ketamine;
Psychological dependence;
Flashbacks (users experience the effects of the drug even when it is not used);
Mood swings;
Nosebleeds;
Depression;
Psychotic symptoms (e.g. lack of self-awareness, hallucinations, confusion).
Institute of Mental Health Castle Peak Hospital
Narcotics Division, Security Bureau: Anti-drug Information and Resources
Narcotics Division, Security Bureau: Anti-drug Resources for Teachers and Social Workers
Hong Kong Police Force: Types of Drugs
