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The US taxpayers fund the overwhelming majority of addiction research in the world. Every year, Congress channels about $1 billion to the National Institute on Drug Abuse (NIDA). An additional almost $0.5 billion is separately given to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), my own workplace for the past decade.

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ये खबर आपको विचलित कर सकती है…. विवादित बयानों की राजनीति चाहे नेताजी के बडबोले बोल हों या  न्यूज चैनल पर दिखाई जाने वाली तरोडी मरोडी खबरें खबरे ना सिर्फ हमारी मानसिकता पर असर डालती है बल्कि हमारा नजरिया भी बदल देती हैं कल तीन खबरों ने मुझे तो हैरत में ही डाल दिया. सुबह […]

The post ये खबर आपको विचलित कर सकती है appeared first on Monica Gupta.

The relationship between wine and the vineyard earth has long been held as very special, especially in Europe. Tradition has it that back in the Middle Ages the Burgundian monks tasted the soils in order to gauge which ones would give the best tasting wine, and over the centuries this kind of thinking was to become entrenched. The vines were manifestly taking up water from the soil.

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The past two decades have seen globalization of the world's wine markets proceed like never before, in both speed and comprehensiveness. There was a degree of trade expansion in the five decades to World War I but, until the late 20th century, interactions across continents involved little more than the exporting of vine cuttings and traditional production expertise.

The post Wine globalization set to continue appeared first on OUPblog.

Many people have influenced the world of wine over the course of the last 400 years. They have changed, developed, and perfected the winemaking process, introduced grapes and viticulture to different continents, and left their mark on an industry that has been with us since the dawn of civilization.

The post Twelve important figures in the modern history of wine appeared first on OUPblog.

Now that PDI/DreamWorks is shutting down, who will save the studio's Pirate Bar?

Alcohol misuse among the retired population is a phenomenon that has been long recognized by scholars and practitioners. The retirement process is complex, and researchers posit that the pre-retirement workplace can either protect against—or contribute to—alcohol misuse among retirees.

The prevalence of alcohol misuse among older workers is staggering. In the United States, the rate of heavy drinking (i.e., more than seven drinks per week or two drinks on any one occasion) among those aged 65 and older is calculated to be at 10% for men and 2.5% for women, with some studies estimating the frequency of alcohol misuse among older (i.e., age 50 and older) as 16% or higher. Yet another study makes the case that 10% of all alcoholics are over 60. As a point of reference, the incidence of frequent heavy drinking in the workforce (US) is 9.2% and rate of alcohol abuse is 5.4%.

Estimates of future problem drinking and predictions of how prevalence rates may rise may be underestimated, not only because of the aging of the population, but also because of shifting societal and cultural norms. There is evidence that individuals follow relative stable drinking patterns as they age. If this is the case, the Baby Boomer generation may show a higher prevalence of alcohol problems as they enter later life than their parents and grandparents. Moreover, some research suggests that the frequency and severity of alcohol misuse may increase in aging populations, especially among individuals with a history of drinking problems.

Recent research has suggested that retirement drinking may be influenced by workplace factors.

Richman, Zlatoper, Zackula, Ehmke, and Rospenda (2006) investigated the role of aversive workplace conditions that could influence drinking behavior among retirees: sexual harassment, generalized workplace abuse, and psychological workload. The analysis of a longitudinal study of employees at a Midwestern university shows that retirees who had experienced high levels of stress drank more than their counterparts who were still employed (and who were still experiencing a stressful workplace). This pattern held even in relation to a comparison between stressed and non-stressed workers. The study suggests that for those still employed, workplace norms and regulations may inhibit the use of alcohol as a means of self-medication in response to highly stressful experiences, retirement removes the social controls that curtailed drinking while the individual was in the workforce.

Bacharach, Bamberger, Biron, & Horowitz-Rozen (2008) examined the role that positive work conditions might have on the retirement-drinking relationship, positing that pre-retirement job satisfaction might interact with retirement agency to affect retirees’ drinking behavior. Using data from a NIH-funded ten-year study of retirement-eligible and retired workers, the research team found a positive association between “push” perceptions and both the quantity and frequency of drinking (though not drinking problems), and an inverse association between “pull” perceptions and both drinking frequency and drinking problems (though not quantity). The study also found that greater job satisfaction amplified the positive association between “push” perceptions and alcohol consumption, and attenuated the inverse association between “pull” perceptions and unhealthy or problematic drinking. This moderating effect of pre-retirement job valence suggests that people who are most satisfied with their jobs are likely to fare worst in response to the stress of a retirement that is unplanned or undesired. Even when retirement is the result of personal volition, it may still be associated with a sense of loss and negative emotions for which alcohol may serve as a coping mechanism.

Bacharach, Bamberger, Doveh and Cohen (2007) examined how the social availability of alcohol in and around the workplace prior to retirement may have divergent effects on older adult drinking behavior. Bacharach et al. found that problem drinkers—after retiring from a workplace with permissive drinking norms—drank less over the first two years of retirement. This population not only left the workplace, but they also dropped their regular association with coworkers who supported and encouraged drinking behavior. The findings suggest that for those with a history of problem drinking, retirement may be linked to a net decline in the severity of drinking problems.

To assess the degree to which this decline in problem drinking may be attributed to separating from a permissive workplace drinking culture, the team examined shifts in the extent of the problem-drinking cohort’s social support networks during the study period. Findings suggest that the decline in problem drinking severity was apparent among those whose social networks became smaller in retirement. Conversely, for the small number whose social networks expanded in retirement, problem drinking severity increased. The nature of the retirement-problem drinking relationship, at least for baseline problem drinkers, may be contingent upon the social availability of alcohol in the work environment from which they disengage.

While there is a lack of research demonstrating the role of strain as a mediator linking these stressors to shifts in older adults’ drinking behavior, a substantial body of evidence examining the role of stress in the origin and intensification of alcohol use and misuse suggests that strain is likely to serve as the intermediary mechanism. To the extent that strain plays such a mediating role, the same network factors are likely to also operate as vulnerability or protective moderating factors in this second stage of the mediation. As suggested by Bacharach et al. (2007), the impact of disengagement-related strain on older adults’ drinking behavior is likely to vary depending upon whether they exit into a non-work social network with more or less permissive drinking norms than those associated with their workplace or occupation.

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By Mark Lawrence Schrad

If Ukraine is a volatile tinderbox of political instability, the situation in its Russian-speaking east is even more dangerous: a tinderbox drenched in vodka. Aspirations and allegiances aside, the most striking contrast between the pro-European protests on Kyiv’s Maidan square and the pro-Russian, anti-Maidan protests in the east is not simply that the latter tend to be armed and forcibly occupying government buildings (rather than protesting outside of them), but also that they have a higher likelihood of being drunk and disorderly, making the situation dramatically more volatile.

Especially amidst revolution, vodka and AK-47s don’t mix, especially in Russia and Ukraine.

Lost amidst all the talk of ethnic, linguistic, and cultural ties between Ukrainians and Russians at play in the Donbass area of southeastern Ukraine, the culture of alcoholism seems almost too cliche to garner mention; yet perhaps it explains all too well the different political trajectories in Ukraine’s east and west.

By Andreas Argirakis, CC BY-SA 3.0 via Wikimedia Commons

Today, both Russia and Ukraine consistently rank atop of the world’s heaviest drinking nations. Unlike moderate wine- and beer-drinking countries, they also share a “traditional vodka drinking culture,” marked by heavy intoxication, binge drinking of hard liquor, and a general acceptance of the public drunkenness that results. These patterns are not hard-wired into the DNA of Russians or Ukrainians. Instead, they are the result of centuries of autocratic rule under the Russian empire and its Soviet successor, both of which used vodka to debauch society at the expense of the state. Unfortunately, the revolutionary experiences that both the Russians and Ukrainians shared as part of those empires—most notably in 1917 and 1991—were heavily influenced by alcohol, in conditions that bear eerie similarities to the present circumstances in Ukraine.

*   *   *

Already three years into total war, and suffering widespread desertions from the front, in early 1917 Tsar Nicholas II was rapidly losing control of his country. Hearing word that his military would no longer follow orders—which included firing on its own unarmed civilians protesting in the streets—Nicholas hurried from the front line back to Petrograd to reassert control. He never made it. His train was stopped by mutinous soldiers and railway workers, who forced the tsar’s abdication in the February Revolution of 1917.

With the police in hiding or defying orders, Petrograd mobs laid siege to police stations and government ministries. Armed gangs looted homes, shops, and liquor stores. Some commandeered motor cars—which they promptly crashed, since few knew how to drive, especially through a haze of pilfered vodka. Hundreds died, and thousands more were injured in the February Revolution, yet there was a sense that things could have been much worse, were it not for the tsar’s prohibition decree at the outset of the war. “If vodka could have been found in plenty, the revolution could easily have had a terrible ending.”

With the tsar gone, political power lay with a weak Provisional Government led by Aleksandr Kerensky, while de facto power lay with the self-organized councils of workers and soldiers who manned the streets. With more demoralizing drubbings at the front, continued economic chaos, and the inability to broadcast power much beyond the walls of the Winter Palace, by October 1917, virtually no one was willing to defend the Provisional Government against the growing power of Vladimir Lenin and the Bolsheviks.

The night of 24-25 October 1917 was relatively quiet, as the Bolsheviks discreetly took control of strategic assets: government offices, train stations, and telegraph posts. The Winter Palace itself was stormed by a relatively small and disorganized group of revolutionaries, many of whom bypassed the priceless artworks and looted instead the imperial wine cellars. Loud pops punctuated the Petrograd night—more often champagne corks than gunfire—while the snows snows were stained red: not with blood, but with burgundy wine.

Understanding that vodka was the means by which the old capitalist order enriched itself while keeping the worker drunk and subservient, Lenin and the early Bolsheviks were steadfast prohibitionists. Their equation of alcohol with “counterrevolution” was only reinforced by a series of drunken riots and pogroms in the streets of the capitol, which threatened their own tenuous hold on power. “What would you have?” the exasperated People’s Commissar of Enlightenment, Anatoly Lunacharsky, told a reporter. “The whole of Petrograd is drunk!”

“The bourgeoisie perpetuates the most evil crimes,” Lenin wrote to Felix Dzerzhinsky in December 1917, “bribing the cast-offs and dregs of society, getting them drunk for pogroms.” Lenin ordered that Dzerzhinsky’s newly formed All-Russian Extraordinary Commission for Combatting Counterrevolution and Sabotage—the “Cheka”—confront the vodka threat by any means necessary. All alcohol stores were to become property of the state, bootleggers were to be shot on sight, and wine warehouses were to be blown up with dynamite. And they were.

“The very nearest future will be a period of heroic struggle with alcohol,” proclaimed Leon Trotsky, the firebrand ideologue and founder of the Red Army. “If we don’t stamp out alcoholism, then we will drink up socialism and drink up the October Revolution.” Red Guard and Cheka detachments sworn to be “sober and loyal to the revolution” fought pitched street battles against unruly mobs and drunken military detachment—with heavy casualties on both sides—not only in in Petrograd and Moscow, but Saratov, Tomsk, Nizhny Novgorod, and beyond. Russia paid a heavy price for its drunkenness and disorder in the throes of revolution. Other legacies were even more nefarious: Dzerzhinsky’s Cheka security force was subsequently rebranded the NKVD and later the KGB—the secret police force complicit in the darkest days of Soviet totalitarianism.

*   *   *

While prohibition in the Soviet Union died with Vladimir Lenin, the KGB and the Soviet dictatorship endured another seven decades. While 1989 saw the peaceful end of the Cold War and the euphoric toppling of the Berlin Wall, the communist autocracy lurched ahead for another two years in the Soviet Union itself. Amid economic chaos and political dissatisfaction, the liberation of the East European satellite states emboldened nationalists in the Soviet Baltic, Caucasus, Ukrainian, and even Russian republics. With pressures for national self-determination threatening to tear the Soviet Union apart, Mikhail Gorbachev proposed a new treaty that would remake the USSR into something of a confederation, bequeathing sovereignty to the autonomous national republics. For Soviet hardliners this was too much to bear.

On 19 August 1991—the day before the new treaty—a hard-line “State Emergency Committee” led by Vice President Gennady Yanayev staged a coup d’etat: imposing martial law and putting Gorbachev under house arrest at his Crimean retreat.

The previous night, both Yanayev and Prime Minister Valentin Pavlov had been out drinking with friends when they were summoned to the Kremlin by KGB chairman Vladimir Kryuchkov, who set the plan in motion. “Yanayev wavered and reached out for the bottle,” Gorbachev later wrote in his Memoirs. Along with the other conspirators, it is doubtful that Yanayev was sober at any time during the bungled three-day coup.

Co-conspirator Defense Minister Dmitry Yazov later confirmed that not only was Yanayev “quite drunk,” but so too were other plotters: KGB head Kryuchkov, Interior Minister Boris Pugo, and even Yazov himself. After chasing his blood pressure medications with alcohol, Prime Minister Pavlov had to be pulled unconscious from the bathroom. After that, “I saw him two or three times, and each time he was dead drunk,” Yazov testified. “I think he was doing this purposefully, to get out of the game.”

Drunk or not, the conspirators somehow forgot to neutralize their primary rival: the populist Boris Yeltsin, who’d just been elected president of the Russian republic—the largest and most important of the fifteen republics that constituted the USSR.

Yeltsin—whose own intemperance later became the stuff of legend—rallied his supporters at the legislature of the Russian Republic (the “White House”), where protesters were busy constructing protective barricades. Nonviolent protestors convinced the Soviet tank troops surrounding the White House to defect and instead defend Yeltsin and the Russian republic. In an iconic moment captured by the global news media, Yeltsin—defying threats of sniper fire—courageously clamored atop a tank turret to address the crowd, denouncing the coup and calling for a general strike. In those delicate moments when the whole country teetered on the brink of civil war, Yeltsin sternly rebuked offers of vodka, claiming “there was no time for a drink” at this moment of supreme crisis.

Yeltsin’s sober command stood in stark contrast to the coup leaders in the Kremlin—just a few miles to the east—where the irresolute putschists confronted a restive media at an ill-fated press conference. “A sniffling Gennady Yanayev, his face swollen by fatigue and alcohol, had a tough time fielding the combative questions,” recalled Russian history professor Donald J. Raleigh. “His trembling hands and quivering voice conveyed an image of impotence, mediocrity, and falsehood; he appeared a caricature of the quintessential, boozed-up Party functionary from the Brezhnev era.” That’s precisely who he was.

In the face of growing opposition and a military unwilling to follow orders, the coup collapsed on 21 August. Rather than surrender to the police, Interior Minister Pugo chose to shoot his wife before turning the gun on himself. Others sought refuge in the bottle: Prime Minister Pavlov was drunk when the authorities came to arrest him, “but this was no simple intoxication,” attested Kremlin physician Dmitry Sakharov, “He was at the point of hysteria.” When the incoherent Yanayev was carried out of his Kremlin office—its floor strewn with empty bottles—he was too drunk to even recognize his one-time comrades who had come to arrest him. Hours later, when President Gorbachev returned safely to Moscow, he’d effectively landed in a different country. Thanks to Yeltsin’s leadership in bringing down the hardline coup, legitimacy lay with Russia and the other union republics rather than Gorbachev’s USSR. The subsequent legal dissolution of the Soviet Union was only a formality.

*   *   *

What does this drunken history lesson have to do with the ongoing crisis in Ukraine? Quite a bit, actually. Both 1917 and 1991 demonstrate how political protests instantly become more complex and dangerous when mixed with a culture of extreme inebriation and general apathy toward public drunkenness. Moreover, given their shared imperial/Soviet cultural inheritance (including alcohol abuse) Ukraine is only slightly less immune from these revolutionary dynamics than is Russia.

While much ado has been made of Ukraine’s (arguably overblown) ethnic and linguistic divisions between the pro-EU, Ukrainian west and the pro-Russian east; there are palpable demographic divisions between east and west Ukraine. While on the whole, Ukraine’s health indices are lower than its European neighbors, the demographic situation deteriorates as you move from west to east across the country. Ukraine’s western provinces—which spent less time under the sway of the Russian/Soviet empires—generally have higher rates of fertility, lower rates of mortality, and higher average life expectancy than those eastern regions that have longer history of Russian domination. Perhaps not surprisingly, the eastern Donbass regions exhibiting the highest mortality and lowest life expectancy are also by far the hardest-drinking regions of an already hard-drinking nation, with cultural acceptance of inebriation most aligned with the Russian “norm” to their east. It may be only a rough approximation, but the further east you go in Ukraine, the more dangerous this revolutionary stage becomes.

So is it any surprise that—in Ukraine’s ongoing struggles between east and west—we should see different approaches to vodka, and the potential for destabilization that it presents first in Kyiv, then in Donetsk?

For context: in 2004, a horribly rigged election favoring the pro-Russian, Donetsk-based Viktor Yanukovych prompted a backlash of popular opposition, which culminated with massive protests on Kyiv’s Independence Square, or Maidan Nezalezhnosti. Building an encampment on the Maidan, the nonviolent protesters—often in excess of 100,000—endured the brutal winter to rally for free elections. Relenting to the popular demands of this so-called “Orange Revolution,” new elections swept in triumphant, pro-European factions. Unfortunately for Ukraine’s lackluster economy, these once allied political factions squabbled and split, while succumbing to Ukraine’s chronic corruption. The split in the pro-European bloc opened the door for the once-vanquished Yanukovych to emerge victorious in the freely-contested presidential election of 2010.

While in the long term the Orange Revolution may have ended in failure, in the short term, it provided perhaps the best exemplar of an effective, nonviolent, post-Soviet political protest, not the least because alcohol was explicitly forbidden in the sprawling tent cities as a bulwark against the easily foreseen drunken disturbances that were sure to result.

When the pro-European protesters again took to the Maidan against Yanukovych’s corrupt presidency in November 2013, their self-organized security forces put a premium on maintaining tranquility through sobriety. “If someone is drunk, he is out of here,” explained Evgeni Dudchenko, a security volunteer on the square, “Alcohol is forbidden here, and we don’t need any hooligans.”

That the Euromaidan protests—like those a decade earlier—remained peaceful for as long as they did can partly be attributed to this enforced sobriety. Even when the movement turned violent in the face of ever-tighter government crackdowns, culminating in the indefensible slaughter of civilian protesters by government gunmen on 22 February, there is a sense that—as with Russia’s February of 1917—Ukraine’s February Revolution could have been much, much worse. A mob of inebriate protesters meeting a drunken security battalion armed to the teeth could have multiplied the carnage many times over.

Following the government’s spilling the blood if its own people on that fateful day, the Ukrainian parliament impeached President Yanukovych, who by that time had already fled the country. Filling the leadership void in Kyiv was a weak interim government that is effectively unable to broadcast political power across the country, as evidenced by Russia’s subsequent non-invasion invasion of Crimea, and the destabilization of the Donbass and the Russian-speaking east.

Even after Yanukovych had been toppled and the regime’s police and military forces had melted away, the major confrontations—and even shootouts—between competing, armed Maidan factions had their roots in drunken disagreements. Still, at the very least, in the midst of a potentially revolutionary situation, the protesters on the Maidan acknowledged, confronted, and mitigated the potential destabilization from vodka, making the protests there far less dangerous than they could have been.

Unfortunately, the same cannot be said of the more recent armed occupations in Ukraine’s heavy-drinking Donbass region that constitute the “anti-Maidan” movement. Beginning 6 April 2014 in the eastern cities of Kharkiv, Donetsk, and Luhansk, small numbers of violent activists—armed with everything from homemade clubs to firearms—clashed with local police, stormed and occupied regional administration buildings and other strategic installations, demanding greater political autonomy from Kyiv, and in some cases outright annexation by Russia in a repeat of the scenario in Crimea.

These protests differed not only in terms of aims and means, but also temperament. In Kharkiv, local residents complained that the protesters were not local, but rather that they were drunken hooligans dispatched from Russia to infiltrate and destabilize their town and intimidate their residents. Ukrainian special forces succeeded in clearing the separatists there, but not before they vandalized and torched the place, leaving behind a mess of garbage and empty liquor bottles. Yet the most noteworthy confrontations came further south in Donetsk—the former stronghold of ousted president Yanukovych.

In Donetsk, violent protesters fought their way into the local administration building, and displaced the Ukrainian flag with the black, blue and red tricolor of their newly declared “People’s Republic of Donetsk.” In a scene eerily reminiscent of the accounts of the drunken State Emergency Committee back in 1991, the organizers of this self-proclaimed mini-state in Donetsk appear to have done so while staggeringly drunk.

From the first clashes with police outside the building, many in the pro-Russian mob were drunk, in stark contrast to the sobriety of the Maidan. The party, it seems, continued once the separatists occupied the building, where thirty protesters were found completely drunk, and empty bottles of vodka, whisky, and tequila littered the stairways to the meeting rooms where the independent Donets Republic was proclaimed.

Manning the barricades outside the occupied Donetsk City Hall: armed protesters wandered freely, “while people lit fires in the street and drank beer and vodka.” Both outside the building and within, secessionists accosted the media while visibly drunk.

In his series of incredible reports from the region, Vice News reporter Simon Ostrovsky noted that at the beginning of “day two of the People’s Republic of Donetsk, it smells like there’s been a huge frat party here.” In something of a throwback to the press conference of the shaky State Emergency Committee, Ostrovsky then interviewed the leader of the Donetsk “Coordination Council” Vadim Chernyakov, who slurred through his speech, visibly hung over and slurring his speech—even admitting as much,  apologizing for his “headache” as his eyes rolled back in his head.

It didn’t take long for the separatists to re-learn the historical lesson that alcohol and guns don’t mix in a revolutionary scenario: after recovering from their hangovers, the leadership decreed that the defenders of the building should dump all of their vodka and “follow a prohibition law” to maintain some semblance of order in such tumultuous times.

Still, in dispelling the false equivalence between the Maidan and anti-Maidan forces, the cultural context cannot be overlooked. “Unlike the pro-Europe protest movement in Kiev,” reports the New York Times, “the stirrings in Donetsk have so far attracted little support from the middle class and seem dominated by pensioners nostalgic for the Soviet Union and angry, and often drunk, young men.”

Whether or not discipline holds in Donetsk and throughout the Ukrainian east is yet to be seen, as Kyiv tries—in fits and starts—to reassert control over violent Russian-minded secessionists and local pro-autonomy protesters. Yet the task of all sides looking to bring stability to the region is made infinitely more difficult by the unpredictability generated by the region’s alcoholic inheritance. Recent events have demonstrated as much, as Vasily Krutov—the head of Kyiv’s counter-terrorism operation in the Donetsk region—was almost torn apart by a mob of Kramatorsk locals, some who were visibly intoxicated. Even more troubling—in one of his last dispatches before being kidnapped by the pro-Russian separatists in Slovyansk—Ostrovsky chronicled how a handful of the most drunken and agitated anti-Maidan protesters stumbled onto the Kramatorsk airbase, manned by heavily armed and understandably jittery soldiers. Such drunken provocation could easily have ended in tragedy—one that could have provoked even greater backlash locally, and even a pretext for greater Russian intervention in Ukraine.

The lamentable reality is that—in such times of revolutionary change and political crisis—we overlook that “cliche” of vodka only at our own peril.

Mark Lawrence Schrad is Assistant Professor of Political Science, Villanova University and author of Vodka Politics: Alcohol, Autocracy, and the Secret History of the Russian State.

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It’s hardly a secret that artists who work in animation love to drown their sorrows in alcohol. Some like it so much that they drink themselves to death. While we’re not aware of any Pixar artists having done so, they certainly have enough alcohol at the studio should somebody decide to pursue that path. Here’s a photo tour of the Pixar studio’s private bars, with evocative names like Ye Olde Knife & Fiddle, The Love Lounge, and The Lucky 7. The good news is that if any of the establishments ever runs dry, they can just call on their boss John Lasseter who runs a booze-production facility on his sprawling estate.

By Mark S. Gold, MD

Public health officials and academics identified cigarette smoking and related disease as the nation’s number one killer and foremost driver of health costs in the 1980s. At that time overeating and obesity were not major problems, yet they may soon cause more disease, deaths, and health care costs than cigarettes. Food addiction, which may explain part of the epidemic, is slowly and finally  “catching on”. It’s been controversial, with some scientists dismissing it out of hand, so like any hypothesis, it needs additional tests.

If overeating is due to food acquiring drug-like or tobacco-like brain reinforcement properties, then the current globesity and overeating-related health crisis might have lessons to learn from tobacco. For example, taxes on tobacco products have been the single most important prevention tool in reducing smoking. Based on food addiction hypothesis, higher prices might also reduce soda consumption. A review suggested that for every 10% increase in price, consumption decreases by 7.8%. An industry trade publication reported even larger reductions; as prices of carbonated soft drinks increased by 6.8%, sales dropped by 7.8%, and as Coca-Cola prices increased by 12%, sales dropped by 14.6%. It follows that a tax on sweetened beverages might help consumers switch to water or more healthful beverages. Such a switch would lead to reduced caloric intake, and less weight gain.

Changing the attitudes and behaviors of the public combined to reduce smoking and smoking-related health care costs and suffering. Changing access to cigarettes by elimination of cigarette vending machines, raising the price per pack to decrease numbers of cigarettes or packs/day smoked, crafting PSAs to reduce smoking initiation, and training medical professionals to intervene and not look the other way, all helped reduce smoking.

Age of onset and exposure can change genes, and make use and addiction more likely. We know that early exposure to tobacco via second-hand-smoke, either in utero or in early life greatly increases the risk of life-long tobacco use and addiction. In the 1990s, children’s intake of sweetened beverages surpassed that of milk. In the past decade, per capita intake of calories from sugar/HFCS-sweetened beverages has increased by nearly 30%. Beverages now account for 10–15% of the calories consumed by children and adolescents. It is likely that food addiction models can be used to explain early exposure and changes in preference becoming fixed and persistent for life.  An extra can or glass of sugar or HFCS sweetened beverage consumed per day increases the likelihood of a child’s becoming obese increases by 60%.

Our efforts to manage and treat overeating and obesity might benefit from addiction methods and experience. We could develop realistic food addiction models and test new treatments. Would animals self-administer food or food constituents, avidly, with bingeing and loss of control? Yes. Our work (and Bart Hoebel’ s before) clearly demonstrates that sucrose and fructose corn syrup are self-administered as if they were drugs and that an opiate-like abstinence syndrome could be produced by detoxification or antagonist administration. Sugar stimulates its own taking  causes craving, wanting, withdrawal, and can motivate and change our behavior.. If the food addiction hypothesis were relevant to the human condition, these animal models could be used to test new medications. New treatments developed for overeating and obesity were previously shown to be effective in addiction medicine.

These new treatments approved by the FDA include phentermine plus topiramate and bupropion plus naltrexone. Topiramate has been used with success in alcohol dependence, bupropion in nicotine dependence, and naltrexone in opiate and also alcohol dependence. While early, these treatments are important tests of the addiction hypothesis and harbingers of more progress in the future. With addiction medicine and food addiction model systems, we may develop treatments which change food preference and not just appetite.

Food addiction may explain some, but certainly not all obesity. The Yale Food Addiction Scale may be used to screen patients for addiction-like pharmacological and psychological interventions. Medically-assisted smoking cessation efforts were enhanced once treatment advanced from simple nicotine replacement or detoxification, to the brain and the neurobehavioral attachment to cigarettes. With an addiction hypothesis that included dopamine, we discovered the efficacy of bupropion and then Chantix. Thus, rather than a successful short term treatment rate of less than 20%, we routinely helped 30% of smokers. Still, addiction-inspired public health measures rather than medically-assisted treatment were responsible for most of the successful cessation efforts, early intervention, and prevention.

Smoking-related disease caused 400,000 deaths per year in the USA plus an additional 40,000 deaths due to second-hand smoke. Until recently little effort was directed at preventing smoking or treating smokers, although we treated the lung cancers, stroke, erectile dysfunction and other diseases caused by smoking. With all this progress, all of the health savings related to smoking cessation will soon be replaced by obesity-related costs. Are these two events related? As smoking and addiction is associated with decreases in eating and weight, a nation detoxifying from smoking addiction should be expected to become overweight. Until recently, with the scientific support provided by food and addiction models, we have not applied the same lessons learned from tobacco to overeating and obesity.

Proposals for food taxes have been made and calculations formulated of revenue-benefits based on our experiences with tobacco taxation. Even when these fail, the public and health experts have to think through the idea that fruits and vegetables are more costly than fatty, sweet, fast foods. Using taxes on ingredients such as added sugar and fructose corn syrup would decrease exposure according to addiction models. This might make Coca-Cola and other sodas return to sucrose as in Mexican or Kosher Coke. Reducing portion size, while supported by cigarette experience with numbers of cigarettes per pack and purchase limits, is a weaker intervention than other approaches. Now we see food labels and calorie postings. This educates everyone as they consider is it worth the calories and do they have the time and energy to exercise away the calories ingested. Exercise is important, and promotes health, but is not a stand-alone obesity treatment or management strategy. Stigmatizing the overweight with added health premiums and workplace incentives has not worked well in the past. Blaming the patient, creating shame and guilt, doesn’t do much to inspire treatment efficacy.

Obesity has changed the width of the seats in airplanes, dress, and trouser sizes. It has also made high cholesterol, high blood pressure, high blood sugars, knee and joint pain, and other obesity-related problems routine in medical practice and treatment. Over the past three decades, rates of obesity have increased in the United States and elsewhere, so that now more people are obese and in need of treatment than ever. New approaches, evidence-based approaches, like those that have been used successfully to develop novel public health and treatment approaches for tobacco, alcohol, and other addictions are needed.

Mark S. Gold, MD is the co-editor of Food and Addiction: A Comprehensive Handbook with Kelly D. Brownell. He is the Donald Dizney Eminent Scholar, Distinguished Professor and Chair of Psychiatry at the University of Florida. Dr Gold is a teacher of the year, researcher and inventor who has focused for much of his career on the development of models for understanding the effects of tobacco, cocaine, opiates, other drugs, and also food, on the brain and behavior. He began his work on the relationship between food and drug addictions while at Yale working with addicts in withdrawal. He has worked for 30+ years trying to understand how to change food preferences, make eating and drugs of abuse less interesting or reinforcing at the brain’s dopamine and other reinforcement sites. Kelly D. Brownell, PhD is professor of psychology, epidemiology, and public health at Yale University and is director of Yale’s Rudd Center for Food Policy & Obesity. Dr. Brownell does work at the intersection of science and public policy. The Rudd Center assesses, critiques and strives to improve practices and policies related to nutrition and obesity so as to inform the public and to maximize the impact on public health.

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Image credits: (1) Young mother and her baby, sleeping in bed. Photo by SvetlanaFedoseeva, iStockphoto. (2) Shrimp cocktail elegantly served in a martini glass accompanied by a glass of white wine. Photo by sbossert, iStockphoto.

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So glad to have Nicole O’Dell with us as she shares a special ministry devoted to connecting teens, their parents and God. Here’s what she has to say about “Hot Buttons:”

What are Hot Buttons?

Well, in the broader sense, the phrase Hot Buttons means a lot of different things, anything really, that can get a rise out people. Something that charges them up and receives an intense reaction. For the purposes of Choose NOW Ministries, I’ve defined hot buttons as those tough issues that teenagers face–the things parents are often more afraid of and most hesitant to talk about.

Some examples include:

• Drugs
• Alcohol
• Sex
• Friendships
• Racism
• Internet Activity
• Faith Matters
• Divorce
• Dating
• Bullying
• Occult
• and more

Why press the Hot Buttons?

Why not just leave it alone and let the kids figure it out? We can pray for them and trust it all to work out in the end. In some ways it does work itself out, true. Circumstances happen, pressure hits, relationships change. . .and your teens gets to figure it all out. In the heat of the moment. On their own. Hopefully they’ll make the right choice, but it’s really hard to know what will happen when the prep work isn’t done.

Take an issue like dating–we talk about the boundaries. We set rules for curfew and other things. We even make sure we apprrove of the date and talk about saying no to sexual advances. Right?

And that’s great. It really is. But there’s something missing. Our teens need to know what to do and what not to do, and what we expect of them, but they also need to understand why that’s going to be difficult for them. How does the body respond in ways that make it tough to say no? What will the feelings be like that make it difficult to leave the room or douse the proverbial flames?

You see, if we don’t hit those truth head on before they become an issue, our teens will think it’s a secret, it’s specific to them, and we really don’t know what we’re asking them to say no to. But, if we press those hot buttons in advance, if we have the difficult conversations, then our teens will enter those pressure-filled situations armed with understanding and equipped with the words to say to stay true to their commitments.

With every hot button issue, someone is feeding your tweens and teens information–do you really want that someone to be anyone other than you?

How do I press the Hot Buttons?

Now that you’ve made the decision to be proactive about helping your tweens and teens battle peer pressure, I love to share the principles behind the Hot Buttons book series and the method of communicating with your teens it prescribes.

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