Promoting Positive Drinking: Alcohol, Necessary Evil or Positive Good? - Drinking as a Part of a Regulated Health Program

Written by Stanton Peele

The United States typifies a modern society with a highly developed and educated consumer class characterized by an intense health consciousness. Bromides, vitamins, and foods are sold and consumed widely on the basis of their supposed healthfulness. There are few cases, if any, in which the healthfulness of such folk prescriptions is as well established as in the case of alcohol. Indeed, the range and solidity of the findings of medical benefits of alcohol rival and exceed the empirical basis for such claims for many pharmaceutical substances. Thus, a basis has been built for drinking as a part of a regulated health program.

Yet, residual attitudes in the United States—a temperance society—conflict with a recognition and utilization of alcohol's health benefits (Peele, 1993). This environment creates conflicting pressures: Health consciousness presses towards consideration of the healthfulness and life-prolonging effects of drinking, but traditional and medical antialcohol views work against presenting positive messages about drinking. Bradley, Donovan, and Larson (1993) describe this failure of medical professionals, out of either fear or ignorance, to incorporate recommendations for optimal drinking levels in interactions with patients. This omission both denies information about life-saving benefits of alcohol to patients who might benefit and fails to take advantage of a large body of research that shows that "brief interventions," in which health professionals recommend reduced drinking, are highly cost-effective tools for combating alcohol abuse (Miller et al., 1995).

Who Gives Drinking Messages and What Do They Say?

Government or Public Health

The view of alcohol presented by government, at least in the United States, is almost entirely negative. Public announcements about alcohol are always of its dangers, never of its benefits. The public health position on alcohol in North America and Europe (WHO, 1993) is likewise strictly negative. Government and public health bodies have decided that it is too risky to inform people at large of the relative risks, including the benefits, of drinking because this may lead them to greater excesses of drinking or serve as an excuse for those already drinking excessively. Although Luik (1999) views the government's discouragement of pleasurable activities (such as drinking), which he accepts as being unhealthy, as paternalistic and unnecessary, in fact, in the case of alcohol, such discouragement is counterproductive even as far as health goes. As Grossarth-Maticek and his colleagues have shown (Grossarth-Maticek & Eysenck, 1995; Grossarth-Maticek, Eysenck, & Boyle, 1995), self-regulating consumers who feel they can control their own outcomes are healthiest.

Industry Advertising

Nongovernmentally supported, non-public health advertising, that is, commercial advertising by alcohol manufacturers, frequently advises drinkers to drink responsibly. The message is reasonable enough but falls far short of encouraging a positive outlook towards alcohol as part of an overall healthful lifestyle. The industry's reticence in this area is caused by a combination of several factors. Much of the industry fears making health claims for its products, both because of the potential for incurring governmental wrath and also because such claims could expose them to legal liability. Thus, industry advertising does not suggest positive drinking images so much as it seeks to avoid responsibility for suggesting or supporting negative drinking styles.

Schools

The absence of a balanced view of alcohol is as noteworthy in educational settings as in public health messages. Elementary and secondary schools simply fear the disapprobation and liability risks of anything that might be taken to encourage drinking, particularly because their charges are not yet of the legal drinking age in the United States (compare this with private schools in France, which serve their students wine with meals). What may be even more puzzling is the absence of positive drinking messages and opportunities on American college campuses, where drinking is nonetheless widespread. Without a positive model of collegiate drinking to offer, nothing appears to counterbalance the concentrated and sometimes compulsive nature (termed "bingeing," see Wechsler, Davenport, Dowdall, Moeykens, & Castillo, 1994) of this youthful imbibing.

Family, Adults, or Peers

Because contemporaneous social groups provide the greatest pressures and supports for drinking behavior, families, other present adults, and peers are the most critical determinants of styles of drinking (Cahalan & Room, 1974). These different social groups tend to affect individuals, particularly young individuals, differently (Zhang, Welte, & Wieczorek, 1997). Peer drinking, among the young in particular, connotes illicit and excessive consumption. Indeed, one reason to allow young people to drink legally is that they then are more likely to drink with adults—related or otherwise—who as a rule tend to drink more moderately. Most bars, restaurants, and other social drinking establishments encourage moderate drinking, and thus such establishments and their patrons can serve as socializing forces for moderation.

Of course, social, ethnic, and other background factors influence whether positive modeling of drinking will occur in these groups. For example, young people with parents who abuse alcohol would do best to learn to drink outside the family. And this is the central problem with instances in which the family provides the primary model for drinking behavior. If the family is unable to set an example for moderate drinking, then individuals whose families either abstain or drink excessively are left without adequate models after which to fashion their own drinking patterns. This is not an automatic disqualification for becoming a moderate drinker, however; most offspring of either abstinent or heavy-drinking parents gravitate towards community norms of social drinking (Harburg, DiFranceisco, Webster, Gleiberman, & Schork, 1990).

Not only do parents sometimes lack social-drinking skills, those who possess them are often under attack from other social institutions in the United States. For example, totally negative alcohol education programs in schools liken alcohol to illicit drugs, so that children are confounded to see their parents openly practicing what they are told is a dangerous or negative behavior.