Reducing Alcohol-Related Problems: What We can Learn from Others

Interview with Dwight B. Heath, Ph.D.

Insights on how we might reduce drinking problems have been developed by Dr. Dwight Heath through his understanding of how the various drinking patterns of different cultures around the world are related to the prevalence (or absence) of such problems. In this interview, Dr. Heath shares some of his knowledge and insights.

Dr. Hanson--

Dr. Heath, your work has demonstrated amazing variability in how people think about and use alcohol around the world. Could you give an example of how attitudes toward alcohol differ from country to country?

Dr. Heath--

I'd be glad to. Attitudes toward drink are very important because they greatly influence drinking behaviors. In France, because wine is considered a food rather than an alcoholic beverage, it is available in school cafeterias, and airline pilots historically had it with their meals. Children are taught how to drink wine in their family and can buy it easily at grocery stores. In contrast, in Sweden until recently no one could buy alcohol except by written request, and all alcohol was sold in a state monopoly store.

Further, it has been repeatedly demonstrated that members of religious groups that prohibit alcohol are disadvantaged if they experiment with it; the lack of guidelines leads to a high proportion of problems among those who do consume. If alcohol is forbidden but said to be empowering, sexually arousing, and disinhibiting, is it any wonder that they, or college students, away from home and parental supervision, often drink heavily and then behave obnoxiously?

Dr. Hanson--

You raise a significant point: what people think and believe about alcohol influences their drinking behavior. Could you elaborate?

Dr. Heath--

Yes. Expectations -- what people expect alcohol either to do to or for them -- influence how they behave when drinking. There is overwhelming cross-cultural evidence that people learn how to be affected by drink -- how they are to feel and act. Additionally, numerous experiments conducted under strictly controlled conditions (double-blind, with placebos) on a wide range of subjects and in different cultures have demonstrated that both mood and actions are affected far more by what people think they have drunk than by what they have actually drunk. That is, when people consume a non-alcoholic beverage that they think contains alcohol, then they tend to become "intoxicated." But when they consume an alcoholic beverage that they think is non-alcoholic, they tend to act "sober."

Furthermore, if people think that drinking leads to violence, then they tend to become violent when drinking. If they think that it makes people sexy, they tend to become amorous. And if they think that alcohol disinhibits, then they tend to become disinhibited when drinking. Because behavior reflects expectations, a society gets the kind of intoxicated behavior that it expects of intoxicated people.

Dr. Hanson--

So teaching that the consumption of alcohol, even in moderation, leads to inappropriate behaviors would tend to be counterproductive?

Dr. Heath--

That's right. People tend to conform to expectations. Such a negative approach tends to create a self-fulfilling prophesy -- it tends to bring about the very behaviors that it seeks to prevent.

Dr. Hanson--

It would appear that we should be careful not to stigmatize alcohol and the people who consume it in moderation.

Dr. Heath--

Indeed, we have to be very careful in the messages that we send. It isn't helpful to stigmatize a product that, when used in moderation, is associated with better health and greater longevity than is either abstaining or drinking heavily. This is especially the case when to do so tends to increase those problems that do exist.

Dr. Hanson--

But isn't it necessary to warn young people about the dangers of abusing alcohol?

Dr. Heath--

Yes. It's essential that we teach everyone the dangers of abusing alcohol, but in doing so we must be careful to distinguish between drinking in moderation and drinking abusively. Societies that have few alcohol problems tend to view drinking in moderation as entirely acceptable behavior, while they view abusive drinking as totally unacceptable behavior for anyone under any circumstances at any time.

Dr. Hanson--

What else can we learn from other societies?

Dr. Heath--

In societies that successfully control alcohol abuse, young people usually learn how to drink at home from their parents. In learning how to drink, they are also learning how not to drink. This helps promote moderation and reduces abuse. Importantly, this learning occurs in a caring, safe, supportive environment - - not in a raucous fraternity house or military barrack. Again, perhaps ironically, groups that promote abstinence as the only option tend to experience more problems among those who do drink.

Dr. Hanson--

Thank you for sharing your experience and observations, Professor Heath.

Dr. Heath--

You're very welcome.

 

Dwight B. Heath, Professor of Anthropology (Research) at Brown University, earned his A.B. at Harvard and his Ph.D. at Yale. He is the world's leading anthropological authority on the subject of alcohol, and he has authored over 200 articles or chapters in scientific books and journals around the world. Dr. Heath has also written or edited over a half dozen books, the most recent being his authoritative International Handbook on Alcohol and Culture.

References

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