I Alcohol problems are not simply a result of how much people drink.

One popular approach to reducing drinking problems is to reduce the overall amount of alcohol a society consumes. However, it is remarkable how little correspondence there is between the amount of alcohol consumed (per person) in different societies and the problems this alcohol consumption generates.

"Such efforts at increasing controls [on the availability of alcohol] are explicitly rationalized and recommended on the premise that alcohol-related problems occur in proportion to per capita consumption, a theory that we have disproved at least in France, Italy, Spain, Iceland, and Sweden, as well as in several ethnographic studies elsewhere."

Heath, D.B., "An Anthropological View of Alcohol and Culture in International Perspective," pp. 328-347 in Heath, D.B., ed., International Handbook on Alcohol and Culture, Greenwood Press, Westport, CT, 1995, pp. 341-342.

In a comprehensive study of alcohol consumption patterns and outcomes in European and English-speaking countries, none of the 10 countries with a history of Temperance movements (showing a concern with the destructive consequences of drinking) had as high a per capita alcohol consumption as any of the countries without Temperance movements.

Peele, S. "Utilizing Culture and Behaviour in Epidemiological Models of Alcohol Consumption and Consequences for Western Nations ," Alcohol & Alcoholism, 1997, Vol. 32, 51-64 (Table 1).

II Enormous differences can be observed as to how different ethnic and cultural groups handle alcohol.

"...In those cultures where drinking is integrated into religious rites and social customs, where the place and manner of consumption are regulated by tradition and where, moreover, self-control, sociability, and `knowing how to hold one's liquor' are matters of manly pride, alcoholism problems are at a minimum, provided no other variables are overriding. On the other hand, in those cultures where alcohol has been but recently introduced and has not become a part of pre-existing institutions, where no prescribed patterns of behavior exist when `under the influence,' where alcohol has been used by a dominant group the better to exploit a subject group, and where controls are new, legal, and prohibitionist, superseding traditional social regulation of an activity which previously has been accepted practice, one finds deviant, unacceptable and asocial behavior, as well as chronic disabling alcoholism. In cultures where ambivalent attitudes toward drinking prevail, the incidence of alcoholism is also high."

Blum, R.H., and Blum, E.M., "A Cultural Case Study," pp. 188-227 in Blum, R.H., et al., Drugs I: Society and Drugs, Jossey-Bass, San Francisco, 1969, pp. 226-227.

"Different societies not only have different sets of beliefs and rules about drinking, but they also show very different outcomes when people do drink.... A population that drinks daily may have a high rate of cirrhosis and other medical problems but few accidents, fights, homicides, or other violent alcohol-associated traumas; a population with predominantly binge drinking usually shows the opposite complex of drinking problems.... A group that views drinking as a ritually significant act is not likely to develop many alcohol-related problems of any sort, whereas another group, which sees it primarily as a way to escape from stress or to demonstrate one's strength, is at high risk of developing problems with drinking."

Heath, D.B., "Sociocultural Variants in Alcoholism," pp. 426-440 in Pattison, E.M., and Kaufman, E., eds., Encyclopedic Handbook of Alcoholism, Gardner Press, New York, 1982, pp. 429-430.

"One striking feature of drinking...is that it is essentially a social act. The solitary drinker, so dominant an image in relation to alcohol in the United States, is virtually unknown in other countries. The same is true among tribal and peasant societies everywhere."

Heath, D.B., "An Anthropological View of Alcohol and Culture in International Perspective," pp. 328-347 in Heath, D.B., ed., International Handbook on Alcohol and Culture, Greenwood Press, Westport, CT, 1995, p. 334.

The Duke of Wellington felt that Napoleon's French army had an advantage over his British troops. Whereas the French soldiers could be allowed to forage freely, the British soldiers, when they encountered alcohol, could be expected to drink to unconsciousness. "Wellington's opinion of his soldiers: `The English soldiers are fellows who have all enlisted for drink.... I remember once at Badajoz,' Wellington recalled at the end of that terrible siege, `entering a cellar and seeing some soldiers so dead drunk that the wine was actually flowing from their mouths! Yet others were coming in not at all disgusted...and going to do the same. Our soldiers could not resist wine.'"

Keegan, J., The Mask of Command, Viking, New York, 1987, pp. 126-128.