A Cause of Alcohol Problems (It May Surprise You)

People commonly think that high consumption levels are a cause of alcohol problems are a direct result of consumption levels. That is, the higher the consumption level, the more the problems. However, the experience of societies and other social groups shows this isn’t so. In short, drinking levels aren’t the cause of alcohol problems.

In fact, beliefs, attitudes and norms about alcohol are very powerful. They can either cause or prevent alcohol problems.

Nine Western countries have had large-scale sustained temperance movements in the 19th and/or 20th centuries. They are Australia, Canada, Finland, Great Britain, Iceland, New Zealand, Norway,      Sweden,  and the U.S.

On the other hand, 11 have not. They are Austria, Belgium, Denmark, France, Ireland, Italy, the Netherlands, Portugal, Spain, Switzerland, and Germany.

This chart1 shows that societies with a prohibitionist tradition consume much less alcohol. However, they have much greater problems from that lower consumption.

Prohibitionist Tradition CountriesModeration Countries
Alcohol Consumption in liters per capita8.714.1
Alcoholics Anonymous groups per million population167.140.9
Heart Disease death rate for men aged 55-64775410

cause of alcohol problemsSimilarly, consumption rates are high among Italian, Chinese, Greek, and Jews. But alcohol-related problem rates 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 have a very high rate of drinking problems both in Ireland and the U.S. 2

Americans of higher socio-economic status are more likely to drink, but less likely to have drinking problems. That’s in comparison with those of lower socio-economic status.3 Also, the southern and mountain regions of the U.S. have “dry” traditions. As a result, they have high levels of both abstinence and alcohol-related problems. 4

In short, higher drinking levels aren’t the cause of alcohol problems.


  • 1. Data adapted from Table 1 in Peele, S. The conflict between public health goals and the temperance mentality. Am J Pub Health, 1993, 83, 803-810.
  • 2. Glassner, B., and Berg, B. How Jews avoid alcohol problems. Am Socio Rev, 1980, 45, 647-664. Greeley, A. et al. Ethnic Drinking Subcultures. NY, Praeger, 1980. Hanson, D. Preventing Alcohol Abuse. Westport, CT: Praeger, 1995. Cahalan, D., and Room, R. Problem Drinking among American Men. New Brunswick, NJ: Rutgers, 1984. Vaillant, G. The Natural History of Alcoholism. Cambridge: Harvard U Press, 1983. Peele, S. Utilizing culture and behaviour in models of alcohol consumption and consequences for Western nations. Alco Alco, 1997, 32, 51-64. Barnett, M. Alcoholism in the Cantonese of New York City. In: Diethelm, O. (Ed.) Chronic Alcoholism. Springfield, IL: Thomas, 1955. Pp. 179-227. Heath, D. A View of Alcohol and Culture. In: Heath, D. (Ed.) Handbook on Alcohol and Culture. Westport, CT: Greenwood, 1995. Pp. 341-342.
  • 3. Hilton, M.  Demographic characteristics and the frequency of heavy drinking as predictors of drinking problems. Brit J Addict, 1987, 82, 913-925.
  • 4. Peele, S. Alcohol and Society. How Culture Influences the Way People Drink. San Francisco: Wine Inst, 1996. Hilton, M. Regional diversity in U.S. drinking practices. Brit J Addiction, 1988, 83, 519-532.

Filed Under: Alcohol Abuse