Alcohol and Drinking Problems

It is popularly believed that alcohol problems are a direct result of consumption levels: the higher the consumption, the more the problems. However, the experience of societies and other social groups belies this assumption. Beliefs, attitudes and norms about alcohol are very powerful in either causing or preventing problems.

See Also

Nine Western countries have generated large-scale sustained temperance movements in the 19th or 20th centuries (United States, Canada, Great Britain, Australia, New Zealand, Finland, Sweden, Norway and Iceland) and 11 have not (Austria, Belgium, Denmark, France, Ireland, Italy, the Netherlands, Portugal, Spain, Switzerland, and West Germany).

As can be seen in the chart,1 societies with a prohibitionist tradition consume much less alcohol but have much greater problems associated with that consumption.

Prohibitionist Tradition Countries Moderation Countries
Alcohol Consumption in liters per capita 8.7 14.1
Alcoholics Anonymous groups per million population 167.1 40.9
Heart Disease death rate for men aged 55-64 775 410

Similarly, consumption rates are high among Italian, Chinese, Greek, and Jewish Americans, but the incidence of drinking among these groups is very low. On the other hand, Abstention rates among the Irish are among the very highest in the Western world, but they experience a very high rate of drinking problems both in Ireland and the United States. 2

Americans of higher socio-economic status are more likely to drink, but less likely to experience drinking problems than are those of lower socio-economic status, 3 and the southern and mountain regions of the US, with their "dry" traditions, have high levels of both abstinence and individual excess. 4

In short, higher alcohol consumption levels don't necessarily mean more drinking problems.


  • 1. Data adapted from Table 1 in Peele, S. The conflict between public health goals and the temperance mentality. American Journal of Public Health, 1993, 83, 803-810.
  • 2. Glassner, B., and Berg, B. How Jews avoid alcohol problems. American Sociological Review. 1980, 45, 647-664; Greeley, A. M., McCready, W. C., and Theisen, G. Ethnic Drinking Subcultures. New York, Praeger, 1980; Hanson, D. J. Preventing Alcohol Abuse: Alcohol, Culture and Control. Westport, Connecticut: Praeger, 1995; Cahalan, D., and Room, R. Problem Drinking among American Men. New Brunswick, New Jersey: Rutgers Center of alcohol Studies, 1974; Vaillant, G. E. The Natural History of Alcoholism. Cambridge, Massachusetts: Harvard University Press, 1983; Peele, S. Utilizing culture and behaviour in epidemiological models of alcohol consumption and consequences for Western nations. Alcohol & Alcoholism, 1997, 32, 51-64; Barnett, M. L. Alcoholism in the Cantonese of New York City: An Anthropological Study. In: Diethelm, O. (Ed.) Etiology of Chronic Alcoholism. Springfield, Illinois: Charles C. Thomas, 1955. Pp. 179-227; Heath, D. B. An Anthropological View of Alcohol and Culture in International Perspective. In: Heath, D. B. (Ed.) International Handbook on Alcohol and Culture. Westport, Connecticut: Greenwood Press, 1995. Pp. 341-342.
  • 3. Hilton, M. E. Demographic characteristics and the frequency of heavy drinking as predictors of self-reported drinking problems. British Journal of Addiction, 1987, 82, 913-925.
  • 4. Peele, S. Alcohol and Society: How Culture Influences the Way People Drink. San Francisco, California, Wine Institute, 1996; Hilton, M. E. Regional diversity in the United States drinking practices. British Journal of Addiction, 1988, 83, 519-532.

Filed Under: Alcohol Abuse