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

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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


Altered levels

of biochemical




Physical inactivity



Poor social networks

Substance abuse

High blood


Low social status


Low self-esteem

Poor hygiene

High cholesterol

Natural resource


Low perceived power

Loss of meaning or

purpose in life

High self-blame

Being overweight

Unsafe sexual


Release of stress


Disease and

chronic health



Crime (Murder, rape, theft,

property damage etc)

War, riots, terrorism


Poor nutritional intake




Steep power hierarchy

within a community or


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

Copyright Active IQ Ltd. Not for resale 19

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


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


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


• 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

Copyright Active IQ Ltd. Not for resale 76

The brain

Cerebral cortex



Reduces inhibitions (including fear, a safety


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


Numbs physical pain.

Limbic system


emotions and


Emotions tend to become exaggerated, i.e.

everyone becomes the person’s best friend or

maybe their worst enemy (aggression).





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


The heart

Pumps blood

around the


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.

Copyright Active IQ Ltd. Not for resale 112

Effects of Alcohol Misuse on the Body


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


A small amount of alcohol escapes unused

via the breath 2-4%


Fatty cells, tissue scarring jaundice,

hepatitis, irreversible cirrhosis- the liver

breaks down 90% of alcohol consumed.


A small amount of alcohol

escapes unused via urine



Bad digestion, malnutrition,

early diabetes

Sweat Glands

A small amount of alcohol escapes unused via

sweat glands

Sex Organs

Nervous System


Depressed testicular production, impotence, breast

growth due to female homones not brown down by liver

Peripheral neuritis- degeneration of the

nervous system supplying limbs


Pressure on portal circulation- risk of

haemorrage. Increased incidence of

cancer- 40x if smoker


Corrosive effect- risk of cancer





Nervous System


Degeneration, weakness, pain

Weak & ‘fatty’ heart, weakening

of heart muscles, high blood

pressure. Anaemias due to

decreased absorption of vitamins


Gastritis, peptic ulcer

(direct corrosive effect)

Pins and needles

Inflammation (corrosion from alcohol)

Malfunctions, shakiness, tremors

Degeneration- risk of fracture


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).

Copyright Active IQ Ltd. Not for resale 121

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.

Copyright Active IQ Ltd. Not for resale 144

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



Stearic Acid

Candle Wax


Barbecue Lighter


Industrial Solvent




Lighter Fluid


Toilet Cleaner


Paint Stripper/Nail


Acetic Acid



Sewer Gas






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.

Copyright Active IQ Ltd. Not for resale 154

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