Active IQ Level 2 Certificate in Promoting Community Health and Wellbeing (sample manual)

Manual 

Level 2 Certificate in 

Promoting Community 

Health and Wellbeing 

Version AIQ004323

Figure 1.3: Determinants of health and well-being adapted from Dahlgren and Whitehead (1991). 

Determinants that have a negative impact on health 

There are many social and environmental risk factors and lifestyle behaviours that negatively affect health and 

well-being and offer a risk to health status. Some of these are listed in table 1.2 (Labonte. 1998). 

Table 1.2: Risk factors and behaviours that negatively influence health and well-being 

Psychological Behavioural Physiological Social and Environmental 

Lack of social support 

Smoking 

Altered levels 

of biochemical 

markers 

Poverty 

Isolation 

Physical inactivity 

Genetics 

Shelter 

Poor social networks 

Substance abuse 

High blood 

pressure 

Low social status 

Pollution 

Low self-esteem 

Poor hygiene 

High cholesterol 

Natural resource 

depletion 

Low perceived power 

Loss of meaning or 

purpose in life 

High self-blame 

Being overweight 

Unsafe sexual 

activity 

Release of stress 

hormones 

Disease and 

chronic health 

conditions 

Discrimination 

Crime (Murder, rape, theft, 

property damage etc) 

War, riots, terrorism 

Abuse 

Poor nutritional intake 

Malnutrition, 

starvation, 

obesity 

Steep power hierarchy 

within a community or 

workplace 

Copyright Active IQ Ltd. Not for resale 5

An average bottle of wine used to be around 9% alcohol by volume (ABV) with six units in a bottle, but now 

it is more likely to be double that volume at around 13.5% or higher and may contain at least ten units. The 

same applies to beers, lagers and ciders; the latter of which is also cheaper. The impact of this is that many 

people are unwittingly drinking in excess of the recommended guidelines and increasing the risk factors for 

their health (Lawrence and Bolitho. 2011). For example: 

• A pint of high-strength lager (strength 5.2%) = 3 units. 

• A standard can of lager, beer or cider (strength 5%) = 2 units. 

• A standard glass of wine (175ml, strength 12%) = 2 units. 

• A small measure (single shot) of spirits (25ml, strength 40%) = 1 unit. 

Drinks of Britain 

Figure 2.3: Alcohol content and units in popular drinksUnits. They all add up. 

Pint cider: ABV 5.3% 

3 UniTs 

red wine (125ML): ABV 12.5% 

1.6 UniTs 

SAMBucA Shot: ABV 42% 

1 UniT 

BottLe LAGer: ABV 5.2% 

1.7 UniTs 

ALcoPoP: ABV 5% 

1.4 UniTs 

hALf Pint cider: ABV 5.3% 

1.5 UniTs 

SinGLe Gin & tonic: ABV 40% 

1 UniT 

douBLe coGnAc: ABV 40% 

2 UniTs 

chAMPAGne (175ml): ABV 11.5% 

2 UniTs 

douBLe whiSky & coke: ABV 40% 

2 UniTs 

hALf Pint LAGer: ABV 5.2% 

1.5 UniTs 

coSMoPoLitAn cocktAiL 

2 UniTs 

Pint Bitter: ABV 5% 

2.8 UniTs 

ALcoPoP: ABV 5% 

1.4 UniTs 

PiMMS: ABV 25% 

1.3 UniTs 

douBLe whiSky: ABV 40% 

2 UniTs 

Excessive intake and use of alcohol is linked as a contributory factor for many accident and emergency 

hospital admissions, a number of health conditions and other causes of morbidity, including: 

• cirrhosis of the liver 

white wine (175ml): ABV 13% 

Pint LAGer: ABV 5.2% 

• cardiovascular disease 2.3 UniTs (coronary heart 3 UniTs disease and stroke) 

• weight gain 

• depression and anxiety 

• pancreatitis 

• osteoporosis 

• stomach ulcers 

• dementia 

• various cancers (mouth, throat, liver, breast) 

• suicide 

• risk of falls (in older adults) 

• house fires 

• car accidents 

• domestic violence 

• crime-related deaths (murder). 

BottLe of wine: ABV 13.5% 

10 UniTs 


Physical activity recommendations in weight management 

The CMOs report ‘Start Active, Stay Active’ states that reaching guidelines will bring significant health benefits 

for all, but for those who are overweight or obese achieving a healthy weight is likely to require a greater level 

of activity than the 150 minutes recommended. Any programme of increase physical activity should also be 

accompanied by dietary changes to reduce calorie intake. 

Guidelines for early years 

Children under five have now been included in the CMOs’ guidelines, which reflects concern over the levels 

of habitual physical inactivity and sedentary behaviour among young children. Key points to note regarding 

this group are: 

• Children of school age who can stand and walk need opportunities to play that will allow them to 

develop fundamental movement skills and master their physical environment. 

• Physical activity, especially in the form of play, is a basic and essential behaviour that must be encouraged 

in the first five years of life, while sedentary behaviours should be limited. 

• Children also need the freedom to create their own opportunities for active play, lead their own activities, 

direct their own play and engage in imaginative play. 

• Physical activity mainly comprises unstructured, active play and learning locomotor, stability and objectcontrol 

skills. 

Typical activities providing health and developmental benefits 

Active play: activities that involve movements of 

all major muscle groups, i.e. the legs, buttocks, 

shoulders and arms, and translocation of the trunk 

(movement of the trunk from one plane to another). 

Development of locomotor, stability and objectcontrol 

skills. 

Everyday activities 

• Climbing frame or bike riding 

• More energetic sessions of activity, e.g. running 

and chasing games 

• Water-based activities 

• Running, jumping, hopping, galloping and 

skipping 

• Balancing, riding and climbing 

• Kicking, catching, throwing, striking and rolling 

• Dance, gymnastics or water-based activities 

• Walking/skipping to shops, a friend’s home, a 

park or to and from a nursery 


The brain 

Cerebral cortex 

Processes 

thoughts 

Reduces inhibitions (including fear, a safety 

response). 

Increases self-confidence. 

User becomes more chatty and talkative. 

Affects judgement and reduces the speed at 

which information can be processed. 

Can affect visual and auditory senses (seeing and 

hearing). 

Numbs physical pain. 

Limbic system 

Controls 

emotions and 

memory 

Emotions tend to become exaggerated, i.e. 

everyone becomes the person’s best friend or 

maybe their worst enemy (aggression). 

Cerebellum 

Coordinates 

body 

movement 

Movements become uncoordinated. 

Balance may be affected (depending on the 

quantity of alcohol consumed, the person may 

be unable to stand or walk), their speech may be 

slurred. 

The heart 

Pumps blood 

around the 

body 

The blood vessels relax and dilate increasing 

blood flow to the skin and tissues. 

Blood pressure lowers. 

Heart rate increases to compensate for reduced 

blood pressure. 


Effects of Alcohol Misuse on the Body 

Brain 

Headaches, Blackouts, Delusions, 

Paranoia, Forgetfulness, Impaired 

Judgement, Decline in IQ, Dementia, 

Epilectic fits, Wernickes disease (due 

to vitamin deficiency), Haemorrhage, 

Peripheral neuritis, Korsakoff’s 

psychosis & Death 

Lungs 

A small amount of alcohol escapes unused 

via the breath 2-4% 

Liver 

Fatty cells, tissue scarring jaundice, 

hepatitis, irreversible cirrhosis- the liver 

breaks down 90% of alcohol consumed. 

Kidneys 

A small amount of alcohol 

escapes unused via urine 

2-4% 

Pancreas 

Bad digestion, malnutrition, 

early diabetes 

Sweat Glands 

A small amount of alcohol escapes unused via 

sweat glands 

Sex Organs 

Nervous System 

Male 

Depressed testicular production, impotence, breast 

growth due to female homones not brown down by liver 

Peripheral neuritis- degeneration of the 

nervous system supplying limbs 

Throat 

Pressure on portal circulation- risk of 

haemorrage. Increased incidence of 

cancer- 40x if smoker 

Gullet 

Corrosive effect- risk of cancer 

Intestines 

Muscles 

Heart 

Fingers 

Nervous System 

Bones 

Degeneration, weakness, pain 

Weak & ‘fatty’ heart, weakening 

of heart muscles, high blood 

pressure. Anaemias due to 

decreased absorption of vitamins 

Stomach 

Gastritis, peptic ulcer 

(direct corrosive effect) 

Pins and needles 

Inflammation (corrosion from alcohol) 

Malfunctions, shakiness, tremors 

Degeneration- risk of fracture 

Female 

Failure to ovulate, spontaneous abortion 

Physical and emotional effects of withdrawing from alcohol 

Not all drinkers experience withdrawal symptoms when they stop using alcohol, but for those who do, the 

experience is very unpleasant. Withdrawal symptoms mostly affect people who are highly dependent on 

alcohol. Alcohol dependent drinkers will sometimes have a drink to avoid experiencing these symptoms, 

which is known as ‘relief drinking’ (Alcohol Concern, 2010). 

Withdrawal symptoms usually commence three to six hours after the last drink and can last for up to a 

week (Davies, 2009). They are relieved when alcohol is consumed. Table 3.1 summarises the physical and 

psychological withdrawal symptoms. 

Physical symptoms include: 

• headaches 

• nausea 

• vomiting 

• sweating 

• hand tremors (the shakes) 

• convulsions (Grand mal). 


Figure 1.2: Map of health inequalities in England 

Smoking is more common in 

Wales (24%) and Scotland 

(24%) than in England (19%). 

Smoking rates also vary by 

region in England. The map of 

health inequalities (figure 1.2) 

reflects where the higher rates 

of premature death, linked 

to socioeconomic status and 

incidence of smoking, can be 

found. For example, smoking 

prevalence was higher in 

Yorkshire and the North West 

(both 21%) than it was in 

London (16 %). 

Smoking is the leading cause 

of preventable disease and 

premature death in the UK. 

Over 100,000 people die 

annually in Britain as a result 

of smoking. This equates to 

18% of all deaths in adults 

aged 35 and older. 

Revenue earned from tobacco tax 

In 2011-2012, the Treasury received £9.5 billion in revenue from tobacco tax (excluding VAT). Including VAT 

(at an estimated £2.6 billion) total tobacco revenue was £12.1 billion. This is equivalent to around 2% of total 

Government revenue. The price of a pack of 20 premium brand cigarettes currently costs around £7.45, of 

which £5.80 (78%) is tax. 

According to the Office for National Statistics (ONS) ‘Consumer Trends’ report, the total UK household 

expenditure on tobacco has more than trebled from 1980 to 2011. In 2011 £18.3 billion was spent on 

tobacco. Tobacco smuggling costs the treasury and, although it is estimated to have dropped since 2008, 

it is estimated that smuggling of illicit cigarettes accounts for 10% of the market (about £1 billion tax loss 

annually). Smuggling is far higher for hand rolled tobacco and is estimated to account for almost half of the 

loose tobacco smoked in the UK. 


Section 3: Key components of tobacco products and their 

effects on the body 

Substances and chemicals found in tobacco products 

It is frequently cited that over 4000 different chemicals are found in tobacco smoke. One research study 

(Rodgman and Perfetti, 2009) found 7357 chemical compounds. The content of each cigarette varies slightly 

by component, but there are likely to be over 7000 different chemicals in a cigarette. Of these chemicals the 

number quoted to be carcinogens also varies (from 40-70) depending on the source of information. 

Tobacco smoke is a complex chemical system comprised of gas and particulate components, the mixture of 

chemicals in each phase varies according to the way a cigarette is smoked. Some of the chemicals and their 

other uses are neatly summarised in figure 3.1. 

Figure 3.1: Some chemicals in tobacco smoke and their other uses 

Cadmium 

Batteries 

Stearic Acid 

Candle Wax 

Hexamine 

Barbecue Lighter 

Toluene 

Industrial Solvent 

Nicotine 

Insecticide 

Butane 

Lighter Fluid 

Ammonia 

Toilet Cleaner 

Acetone 

Paint Stripper/Nail 

Varnish 

Acetic Acid 

Vinegar 

Methane 

Sewer Gas 

Arsenic 

Poison 

Carbon 

Monoxide 

Methanol 

Rocket Fuel 

Effects of nicotine on the body 

Nicotine is the main drug compound found in tobacco. Nicotine is an alkaloid compound; a type of chemical 

often found in plants as a natural defence against being eaten by insects and mammals. Once in the human 

body, nicotine mimics the common neurotransmitter chemical acetylcholine giving it a psychoactive effect. It is 

this same effect which makes it highly addictive. All of the nicotine inhaled in a puff of smoke can be absorbed 

across the lung fluid membranes into the blood. The nicotine passes into the bloodstream and reaches the 

brain within seconds of inhaling the smoke.

Active IQ Level 2 Certificate in Promoting Community Health and Wellbeing (sample manual)

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