Those who are new to the field of alcohol studies are often surprised to find out how many people do not drink at all. In the United States, this is more than one-third of the adult population, up from the 1980s. Abstainers (defined as those who drink no more than once a year) are thus a substantial segment of the population who should be taken into account when one tries to evaluate such figures as per capita consumption, the proportion of drinkers who have problems with drinking (about 10% in the United States), and so forth. For some, abstinence is a matter of religious faith; for others, a matter of personal taste, a resolution to maintain one's distance from alcohol in order to maintain one's sobriety, or some other reason. An unusually high percentage of Australian Aborigines abstain; the same is true of Egyptians, Indians, Irish, Lutheran Icelanders, and fundamentalist Protestants wherever they may be. Although drink-
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ing and drunkenness have long been popular in Germany, some famous men have spoken out forcefully in favor of greater moderation there.
"Moderation" and "temperance" are buzzwords in relation to alcohol that have very different meanings in different contexts. "Moderation" or "moderate drinking" differs in terms of quantity and frequency, depending on cultural context (e.g., Chile's idiosyncratic terminology allows for much more drinking than does that in Egypt or India, where drinking at all is out of the ordinary), but the latest scientific advice is that one to two drinks a day constitutes an appropriate part of a healthful diet for most persons ( Ellison 1993). "Temperance" would appear to mean much the same as "moderation," but historically it has most often been used
by those who deplore drinking and would curtail it if they could. Although their aim is usually prohibition, most temperance advocates have, during the twentieth century, generally recognized that the frequent rapid repeal of prohibition demonstrates popular opposition to such forceful involvement of the state with respect to a habit that many enjoy--and consider beneficial for a variety of reasons--so, tactfully, they are now speaking out for gradual rather than abrupt restriction of drinking.
This is not just the paranoiac projection of a libertarian moderate drinker who does not want to be told by others that he has to quit. Although few people who are not engaged in the study of alcohol are aware of it, both the World Health Organization ( 1981, 1992) and the U.S. Department of Health and Human Services ( 1991) have made official pronouncements calling for a 25% reduction in overall alcohol consumption.
This is only the most recent of many temperance movements. In the early 1800s, Canada, the UK, and the Netherlands joined the United States in strongly religious temperance
movements. By the mid-1800s, Poland and Russia had their own such movements, and nearly half of the states in the United States had enacted local prohibition. By the late 1800s, those U.S. prohibitions had generally been repealed, but a strong wave of temperance sentiment swept over Australia, Sweden, and flourished again in Netherlands and the United States. In the early 1900s a temperance movement unexpectedly arose in Italy, and that in the United States gained momentum, culminating in nationwide prohibition (18th Amendment of the Constitution) in 1919, repeated by the 21st Amendment in 1933. Mexico, where one might not have foreseen a prohibition movement, had a brief one in the 1940s, and France had one in the 1960s. A "New Temperance Movement" has been influential not only in the United States but also throughout much of the world since the 1970s ( Heath 1989; Pittman 1991). At first couched in religious or moralistic terms, the rhetoric has shifted toward science and pseudoscience, sometimes even distancing itself from religion and emphasizing public health, economics, or social welfare to appeal to new and broader constituencies. In India, Poland, and Sri Lanka--all in different ways-temperance was linked with anticolonialism and the push toward independence. Abstaining was never popular in Denmark, but the local category of "wrong consumption" shows that there is a fundamental ethic of moderation.
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In the few countries where social historians have paid attention to temperance movements, there appear to be cycles of waxing and waning enthusiasm ( Musto 1987; Blocker 1990) that are reflected in "long waves of consumption" ( Skog 1986) and may be related to the
ambivalence that many people hold with respect to alcohol, viewing it as both a boon and a bane, enjoyable but potentially dangerous. The frequently ambivalent reaction to alcohol accounts for much of the confusion that young people have about it and for many of the discontinuities that are reported in the histories of the nations described here. A sociologically sophisticated discussion of such ambivalence as an important portion of the human
experience of alcohol is Room ( 1976). BENEFITS OF MODERATE DRINKING
In light of the negative evaluation of alcohol and drinking in many of the scientific and popular writings about them, stressing disease, death, and other costs to the individual and to society, it is remarkable that the attitudes, usages, proverbs, and experiences of the vast majority of the people and peoples dealt with in this book are positive. There are few cultures
in which the dangers of excessive drinking are not deplored or even feared, but virtually all of our authors indicate that in most of the cultures with which they are dealing, the primary image is a positive one. Usually drinking is viewed as an important adjunct to sociability. Almost as often, it is seen as a relatively inexpensive and effective relaxant, or as an important accompaniment to food. The symbolic importance of drinking as a way of differentiating members of one population from another is closely linked with other emotionally laden symbolic meanings. Among these are a sense of identification with or participation in a more modern or cosmopolitan way of life, an indication of financial success and social status, or even of assertive masculinity. Its use in religions is ancient, and reflects social approval rather than scorn. Even some of the major religions that many outsiders believe to be abstemious do not enforce prohibition, and no secular state has succeeded in such experiments, although partial prohibition for various segments of the population based on age, sex, caste, or other criteria have sometimes been imposed.
One generalization that emerges from these chapters is the somewhat surprising virtual unanimity with which the authors have cited a broad range of benefits of moderate drinking. This is gratifying, not because I have any vested interest in promoting drinking but because it replicates at the level of the nationstate many of the findings that I have reported in my cross- cultural writing about tribal and peasant populations around the world. Some colleagues have questioned the reliability and validity of anthropological research methods, and others have wondered whether "modern" cultures may not be so wholly different from "primitive" ones that deep-seated customs and attitudes about drinking have become not only obsolete but also dangerous, and what is good for them may be bad for us. There are a few respects in which that may be true, but this
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does not appear to be one of them. It is in this connection that Room ( 1984) took
ethnographers to task as "problem deflators"; however, few of those who commented on his article agreed with the charge.
But the contributors to this volume are not ethnographers, nor are they of the age, professional training, or cultural background that Room ( 1984) suggested prompted too many anthropologists to ignore the dangers of drinking while emphasizing its joys among other peoples. Almost every one of the contributing authors has described positive functions of drinking in his or her country-benefits that accrue to the social fabric as well as to
individuals--even when they have viewed with alarm certain risks, dangers, and harm that sometimes result from excessive drinking. This is a little surprising in light of the fact that most of our authors are professionally engaged in public health and social welfare activities that are aimed at preventing, treating, or otherwise ameliorating such damage. Most of them are not simply teachers or researchers who might be thought to enjoy the luxury of academic detachment; they are psychiatrists, physicians, and others who work daily in clinical settings, faced with the need for realistic decisions that affect the lives of the people they serve. These authors are not "problem deflators" who seek to put a happy face on native people, or to find theoretically satisfying functional interpretations for disruptive customs. This explanatory aside may appear to verge on overkill, but emotions run high on this subject, so I feel it is necessary to reassure readers who may be concerned that contributors were chosen, or their works cunningly edited, to show drinking in an unrealistically good light. Such is simply not the case.
For that matter, such a finding about the good aspects of drinking should not be surprising. In the United States, which has been labeled a prototypically "temperance culture" ( Room 1992; Levine 1992), national surveys--the same ones that tell us about drinking patterns and rates of problems--have repeatedly demonstrated that most of the serious drinking problems (of all kinds) occur in only about 10% of the drinkers (that is, less than 7% of the adult population), meaning that 90% of those who drink do so without such problems. Put another way, most people in the United States, Canada, and Sweden, when asked what emotions they associate with drinking, responded favorably, emphasizing personal satisfactions of
relaxation, social values of sociability, an antidote to fatigue, and other positive features, with little mention of violence, illness, or other harm ( Pernanen 1991). Without for a moment wishing to diminish the human suffering that is unquestionably associated with certain kinds of drinking by a minority of those who drink, it is worthwhile in this context to summarize what an international sampling tells us about the benefits of moderate drinking, a theme that has been eclipsed in recent years by the mass and shrillness of writing about the harm that is done by excessive drinking. In fact, the same author who deplored "problem deflation" on the part of ethnographers ( Room 1984) wrote a few years later: "We are definitely in a period of [problem] amplification when there are strong tendencies to overstate alcohol's role in health and social
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problems, to forget that its causation is usually conditional, and to overlook solutions to the problems that are not alcohol specific" ( Room 1990b, 1357).
Sociability and Hospitality
Drinking is fundamentally a social activity, and sociability is unquestionably the reason for drinking that is most cited in all of the countries that are described here. The same is true in almost all of the populations that have been studied by anthropologists around the world ( Heath 1975; Marshall 1979). Why this symbolism is so widespread is a complex question that involves an interplay of psychological and social variables, but the association is firmly established in most cultures ( Douglas 1987). We are told that alcohol is "indispensable" for sociability ( China, Denmark, Egypt). It is an integral part of "mateship" (male bonding) in Australia, Canada, and New Zealand; and "the regulars" are known and appreciated in pubs in Germany, Italy, and New Zealand. Drinking is "important to community solidarity" in Guatemala and among many of the tribal populations in India; it is said to be integral in relating to friends and general social participation in Spain and Mexico. Drinking games are a special expression of this in China, Germany, and Poland; drinking contests are common among men in France, Germany, and the UK. Almost every author speaks of an offer of alcohol as an important gesture of hospitality, even in countries that have relatively low overall consumption figures. Related to this is the recognition of drinking as a celebratory act, as is dramatically emphasized in the frequently elaborate secular ritual of toasting, which can go far to confirm one's acceptance within an alien group.
Relaxation and Recreation
Alcohol seems often to be used, in small amounts, for just those purposes to which it is pharmacologically best suited, as a nontoxic relaxant that is readily metabolized. As such, it reduces fatigue. This is explicitly recognized by most of our authors, with special emphasis on the symbolic importance of drinking to mark the transition from workplace to leisure (in
India, Malaysia, Zambia; see Gusfield 1987). It is a frequent adjunct to festivals ( China, Guatemala, Mexico), and is sometimes mentioned as providing refreshing diversion when there are few other opportunities ( Iceland, Nigeria). Specific recreational activities that focus on alcohol include drinking games ( China, Germany) and drinking contests ( France, China). Because socializing is often so integral a part of relaxation and recreation, it should also be considered in this connection.
Food and Its Enhancement
We have already mentioned that some alcoholic beverages are thought of and treated as foods in themselves, and a few are judged by nutritionists as fully
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deserving that label. Others are viewed as having a gustatory or aesthetic quality that makes them valuable adjuncts to food because they stimulate the appetite, enhance flavor, aid digestion, and so forth. Wine is often an important part of a meal ( France, Italy, Spain), and an elaborate sequence has evolved combining alcohol and food throughout the entire day (in Spain). This can involve elaborate ritualization, with a specialized vocabulary and matériel (as among wine connoisseurs), but it can also be simple and straightforward as an integral part of workaday eating. It is specifically noted that this is not a pattern in India, and it may also be absent in most of the settings where drinking takes place primarily in episodic binges, but it appears otherwise to be extremely widespread.
Status and Health
To a remarkable degree, people seem to focus on what or how a person drinks--even more than on what or how one eats--as a marker of social status. This is reflected in the frequency with which our authors mention drinking as a symbol of manliness or valor ( Chile, Denmark, France, Germany, Honduras, Mexico, Malaysia), and on people's changing their drinking habits as they achieve or aspire to upward social mobility ( India, Sri Lanka, Zambia). In a more role-specific way, the effectiveness of a shaman in tribal India can be enhanced by the use of alcohol to alter consciousness. As a symbolic adjunct to ceremonies that confirm the assignment of specific titles in Nigeria, alcohol confers a special power on traditional ritual activities. Drinking patterns are often described as important boundary markers between ethnic groups, just as the choice to drink or to abstain is often a symbolic marker of importance to different religions, endowed with considerable affect and emotion.
Alcohol has long been viewed as a drug in the beneficial sense of helping to prevent or to cure a wide range of physical maladies, whether we speak of disease (in the sense in which scientists diagnose and treat symptoms) or of illness (the subjective dis-ease that a patient experiences). Chinese and Russian physicians still recognize a number of specific problems for which alcohol serves as a medicine, and there is the widespread belief in many wine cultures that "wine strengthens the blood," is beneficial to a nursing mother, or helps people to stave off the cold. Considerable scientific research has focused on "the French paradox" ( Ford 1993; Perdue 1992), in which the French enjoy a relatively low rate of coronary heart disease (the leading cause of death for significant portions of the population in the United States and elsewhere) even though they eat far more saturated fats, exercise less, smoke more, and drink more. This is one of those instances where systematic research is confirming long-held popular beliefs, and wine turns out to be positively healthful in many respects. For
that matter, it is not only red wine (as some originally thought) but any form of ethanol that has all of these benefits: "alcohol lowers harmful LDL-cholesterol levels; raises protective HDL-cholesterol levels; decreases formation of blood
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clots in the arteries; increases coronary blood flow; [and] increases estrogen levels" ( Ellison 1993, 3).
Fully cognizant that any discussion of the benefits of moderate drinking is likely to be highly controversial, I owe it to my readers to provide some caveats. The notion of "moderate drinking" is by no means a culture-free one, since any drinking at all may be seen as
excessive by a devout Muslim or fundamentalist Protestant, or by a recovering alcoholic who fears that "failing off the wagon" could jeopardize his or her sobriety and do irreparable damage to physical health, mental stability, and social relations. Individuals vary enormously in their tolerance for alcohol (that is, how much reaction from a given dose)-just as they do in their tolerance for fava beans, sugar, salt, strawberries, lactase, or other substances. It is also clear that there are certain situations in which drinking can be inherently risky (such as prior to operating heavy equipment, or whenever immediate and substantial coordinated responses are requisite).
Otherwise, for most people, alcohol can serve all of the foregoing functions at levels that do no damage to the body, that are quickly metabolized, and that do not seriously impede the performance of normal daily activities. Following Ellison ( 1993), from whom these
important data about recent scientific advances in medicine are summarized, I am using two drinks a day as a cautious and convenient measure for "moderate drinking." Large-scale epidemiological research on various ethnic populations in many different parts of the world shows that people who have one or two drinks a day live longer than those who drink more-- and also longer than those who drink less. The J-shaped curve is remarkably consistent, showing that healthy abstainers (not confusing them with sickly former drinkers who abstain after damage has already been done) have more deaths from virtually all other causes than do "moderate drinkers," with rates rising rapidly as consumption increases beyond the
"moderate" level.
In all fairness, mention should be made of what is perceived by many to be a benefit of immoderate (or heavy) drinking. A simple measure of "heavy drinking" that relates more to the potential for physical damage than to local culture or customs, would be about six drinks a day. Incidentally, the acute impact of alcohol on the system is such that even a moderate drinker's one or two drinks a day would not be innocuous if they were "saved up" to allow a seven to fourteen-drink binge on the weekend.
With reference to heavy drinking, it must be admitted that drunkenness is often considered to be a positive value in its own right, quite apart from the act of drinking and whatever benefits may accrue from it. Drinking that might result in drunkenness (for most people, at least five drinks within an hour) could usually be considered "excessive"--except that the aesthetics of behavior differ markedly, as we have seen, and such heavier or faster drinking is not thought to be excessive by those who esteem and actively seek intoxication. In Chile, China,
Denmark, Germany, and Mexico, it is mentioned specifically as an affirmation of