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

In this interview, Dr. Dwight Heath shares some of his knowledge and insights on reducing alcohol-related problems. He is the world’s leading anthropological authority on alcohol and drinking. He has studied studied cultures around the globe. As a result, he understands how drinking patterns are related to the prevalence (or absence) of alcohol problems.  He is interviewed by your host, David Hanson.

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 —

reducing alcohol-related problems
Dr. Dwight B. 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 shown that members of religious groups prohibiting alcohol are disadvantaged if they drink it. The lack of guidelines leads to a high proportion of problems among those who do consume. Alcohol is forbidden but said to be empowering, sexually arousing, and disinhibiting. So is it any wonder that they often drink heavily and then behave obnoxiously?

Hanson —

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

Dr. Heath —

reducing alcohol-related problemsYes. 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. That is, how they are to feel and act.

Also, many experiments have been done under strictly controlled conditions (double-blind, with placebos) in different cultures. What they show is clear. People are affected far more by what they 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.

Hanson –

So teaching that drinking alcohol, even in moderation, leads to bad behaviors would tend to be counterproductive?It would appear that we should be careful not to stigmatize alcohol and the people who drink it in moderation.

Dr. Heath —

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

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. That is, in comparison with either abstaining or drinking heavily. This is especially the case when to do so tends to increase those problems that do exist.

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. However, they view abusive drinking as totally unacceptable behavior for anyone under any circumstances at any time.

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, groups that promote abstinence as the only option tend to experience more problems among those who do drink.

Hanson —

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

Dr. Heath —

You’re very welcome.

Dwight B. Heath is Professor Emeritus of Anthropology (Research) at Brown University. 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. He is an expert on reducing alcohol-related problems

Readings

Peele, S. Addiction Proof Your Child. NY: Three Rivers, 2007.

______. Don’t Panic!: a Parent’s Guide to Understanding and Preventing Alcohol and Drug Abuse. Minneapolis: CompCare, 1983.

Heath, D. Cultural Variations among Drinking Patterns. In: Grant, M., and Litvak, J. (Eds.). Drinking Patterns and their Consequences. Washington: Taylor & Francis, 1998. Pp. 103-125.

______. (Ed.) International Handbook on Alcohol and Culture. Westport, CT: Greenwood, 1995.

Field, P. A Cross-Cultural Study of Drunkenness. In: Pittman, D., and Snyder, C. Society, Culture, and Drinking Patterns. NY: Wiley, 1962.

Bales, R. Cultural differences in rates of alcoholism. Q J Stud Alco, 1946, 6, 480-499.