The biggest killersAlcohol and tobacco are legal, but pose as much danger as anything else
This is the sixth story in a multi-part series about drugs and addiction in Haywood County.
The smoke break and the after-work drink have been commonplace in much of the country, including Haywood County, for decades, even centuries.
For many, it’s relatively easy to control those vices, but for some, the most addictive substance in their life is purchased legally, without any prescription, in gas stations and liquor stores.
Tobacco use in North Carolina is a bit heavier than in the rest of the country, and the western-most counties outpace much of the rest of the state. While about 19 percent of North Carolinians smoke (compared to about 18 percent in the rest of the country) 24 percent of Haywood County residents smoke, and that’s in addition to the 11 percent who use smokeless tobacco products.
“I would say nicotine is the most addictive substance, but it takes longer to do you in,” said Cecil Yount, retired addiction specialist.
The cost of smoking is astronomical, and the $5-a-pack burden doesn’t just fall upon tobacco users. In North Carolina, $3.81 billion is spent annually on health care costs directly caused by smoking.
Haywood County residents’ state and federal tax burden from smoking-caused government expenditures is $860 per household per year, according to a study by Campaign for Tobacco Free Kids, a nonprofit organization advocating for public policies to reduce the impact of tobacco on the nation.
All the while, the tobacco industry spends an estimated $379.9 million on marketing each year in this state alone.
To make matters worse, there is no substance that causes more health issues and kills more people every year than tobacco. Long-term tobacco use — smoking or smokeless — increases the probability that a person will be diagnosed with Type II diabetes, reduces fertility of both men and women, and reduces a person’s general health.
And then there’s cancer. Those who smoke cigarettes have up to four times the risk of coronary heart disease or stroke and 25 times the chance of getting lung cancer, according to the U.S. Department of Health and Human Services.
Smokers have an increased risk of other cancers, such as stomach, bladder, blood, liver and colon cancers. These all often end in death.
In the United States, tobacco kills more people annually than illegal drugs, alcohol, traffic accidents and firearms accidents combined, according to the national statistics.
Haywood County statistics follow national ones except for one. The rate at which pregnant women in the Haywood use tobacco is just over 15 percent, compared to 9.3 percent in North Carolina. The dangers of smoking while pregnant are premature birth, stillbirth, low birth weight and even sudden infant death syndrome long after birth.
As bad as tobacco can be on long-term health, alcohol can cause more immediate problems.
Alcohol is the most commonly consumed intoxicating substance around, according to the 2015 National Survey on Drug Use and Health (NSDUH). The survey indicated 86.4 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime; 70.1 percent reported that they drank in the past year; 56.0 percent reported that they drank in the past month.
And although not everyone who consumes alcohol will become addicted, those who do have as hard of a time quitting as those who get hooked on about any other drug.
Doug, whose last name is withheld due to his involvement in Alcoholics Anonymous, said that the societal stigma associated with addiction makes people reluctant to get the help they need. With just a little bit of community understanding, he said, we could begin combating the problem.
“It’s very hard to explain to a nonalcoholic what it’s like to overcome alcoholism,” Doug said. “What we believe is, and I think it’s been proven by science, is that we have what we call a physical allergy. Once you want one drink, you have to have more. It becomes an obsession.”
Yount said more often than not, the underlying cause of alcoholism has to be addressed for a person to kick the habit.
“Alcohol-use disorders are highly co-occurring with mental health disorders such as depression and bipolar disorder,” he said.
Yount added that many who find themselves addicted to alcohol can also be drawn into addiction to other substances, including opioids.
“In combination, they’re more lethal than either by themselves,” he said.
Long-term health issues aren't the only risk with drinking. Doug said that especially those who binge drink can be more dangerous than alcoholics because they can be unpredictable.
“They are sometimes more of a hazard than someone who drinks on a regular basis,” he said.
In 2015, 26.9 percent of people ages 18 or older reported that they engaged in binge drinking in the past month; 7.0 percent reported that they engaged in heavy alcohol use in the past month. According to Alcoholics Anonymous, while the number of people in North Carolina with an alcohol addiction or abuse problem is 457,000, 1.3 million people are binge drinkers.
One of the biggest risks for both consistent drinkers and binge drinkers alike are alcohol-related traffic accidents.
In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths nationwide (31 percent of overall driving fatalities), according to the Centers for Disease Control.
Waynesville Police Chief Bill Hollingsed said that although he doesn’t believe the number of driving while intoxicated citations are going up, he has seen other changes in drunk driving habits.
“We are seeing increased numbers of blood alcohol content, and we also now see impairment at all times of the day,” he said.
Hollingsed added that he thinks the majority of domestic violence cases are fueled by alcohol consumption by at least one party.
“A lot of times, there’s a situation where domestic violence wouldn’t occur if one or both individuals didn't have alcohol,” he said.
Like with tobacco, drinking while pregnant comes with serious consequences. Although alcohol use among expecting mother isn’t quite as prevalent as that of tobacco, it still happens in Haywood County and carries devastating consequences. Fetal alcohol syndrome can cause significant complications, from miscarriages to lifelong physical and mental developmental disabilities.
Yount said that although alcohol and tobacco are legal, they still need to be treated as the dangerous substances they are.
“These are much more acceptable drugs in our society," he said. "But that doesn’t minimize the damage they do."