Alcohol Consumption
GUNDULA BARSCH
HochschuleMerseburg,Merseburg, Germany
gundula.barsch@hs-merseburg.de
Definition
Different forms of alcohol have different functions: as
part of cleaners, fuel,medicine, etc.Worldwide the substance
ETHANOL is well known as a component of different
alcoholic beverages. These beverages differ not
only in taste, look and quantity of alcohol, but also within
various populations the forms of usage are very different
too. People use alcohol as a luxury, as part of
their lifestyle; integrated into daily life, to cope with
stressful situations for example. The general level of
alcohol consumption of a population depends on sociocultural
factors, availability, production, trade, the distribution
network and the regulations concerning sale.
Therefore, throughout the world, there is a wide variation
between countries and regions in forms and rates
of alcohol consumption. For national health planning it
is helpful to monitor trends of per capita production of
beer, wine and spirits in different regions as well as per
capita alcohol consumption of the population in general
and in social groups in particular.
At the individual level alcohol consumption can be distinguished
in three general forms: moderate drinking,
heavy drinking and excessive drinking that is linked
with dependence on alcohol. These different forms of
alcohol consumption are integrated into individual daily
lives, and misuse is connected with alcohol related
problems. The terms “alcohol-related problems” and
“alcohol problems” refer to the damaging consequences
of alcohol consumption and the various adverse effects
not only on the individual drinker but also on the family
and society at large.
Trends in Rates of Alcohol Consumption
There have been considerable increases in average rates
per capita alcohol consumption in recent years. Certain
countries show a high rate of increase in per capita
consumption of each category of alcoholic beverage. In
considering the changing trends of consumption within
a given population it is necessary to take account
of changing demographic structures (data collecting).
For instance, in many developed countries the population
is aging and the average consumption level is much
lower than in developing countries with a younger population,
and, whereas most females may not drink, the
average consumption level of adult males may be four
times that of the total population.
Although in alcohol-producing areas the dominant type
of alcoholic beverage consumed is the type produced in
that area and accounts for most of the increase in consumption,
the use of additional beverage types also contributes
significantly to the increase. In countries with
traditional wine drinking, for instance, there has been
a marked increase in consumption of beer and spirits,
whereas in countries where beer was the preferred
drink, the consumption of wine and spirit has become
more general.
Socio-Cultural Factors
Socio-cultural factors are involved in both the causes
and the consequences of moderate and heavy drinking.
Such factors also determine whether or not the consequences
of drinking are labeled as problems ( cultural
beliefs). Among the factors that have been studied
are the cultural beliefs about the value and symbolic
functions of alcohol and the consequences of drinking,
drinking contexts (such as use in rituals, functions, public
and family occasions) and use of alcohol by different
social and occupational groups.
Possible alcohol culture effects are:
• drinking is integrated into the community, not a banished
or discredited conduct;
• drinking is an act of common life and not a private
behavior;
• drinking is part of given rituals;
• drinking rules are made with common sense;
• drinking rules have a strong authority derived from
common knowledge and shared experiences;
• drinking rules give rhythm (quality, quantity, frequency)
and good order;
• drinking is not allowed everywhere and every time –
given a place and special time, so it has a start and
an end.
• drinking rules keep drinking in a frame and give orientation;
• drinking rules take no responsibility away but
demand it from everyone.
That is why in any population where alcohol is socially
acceptable there is a far higher percentage of moderate
drinkers than of heavy drinkers.
When a positive alcohol culture prevails, alcohol consumption
can be a beneficial experience within a supportive
and protective environment; physical and mental
health problems are minimized. With changing
socio-cultural conditions, resulting partly from the
impact of opposing cultures, many forms of sociocultural
control seem to be breaking down: alternative
customs are being followed, the limits of acceptable
behavior and drinking are no longer clear and rapid
increases in alcohol consumption are occurring in some
population groups.
Socio-Demographic Groups
To understand the effects of alcohol consumption within
a given population, consideration has to be given to
specific socio-cultural situations and variations between
population groups and the way social control is maintained
and strengthened. The relaxation of cultural controls
and emancipation of certain socio-demographic
groups probably account in part for the increasing number
of young people and women taking up drinking
and often running the risk of suffering from the adverse
effects of alcohol consumption and of causing alcohol
problems.
To understand the dominant patterns of drinking, for
instance in women and young people, it is necessary
to have a look at the specific functions that alcohol
consumption has in each of these socio-demographic
groups. Drinking patterns in youth groups are not comparable
with the drinking patterns in groups of adults,
and the risks and alcohol-related problems are not the
same.
Developmental factors affecting alcoholic consumption
in youths:
• Special motives to start: come together, have fun
together, feelings of social get-together.
• Special functions of drinking: access to peer-groups,
bonding rituals, mimicking adult behavior, feeling
male, feeling strong.
• The effects of strong drinking: often there is a standstill
in developmental progress.
It is known that alcohol problems disappear as development
progresses, so strong drinking is normally quit by
the time youngsters grow to adulthood. Finally addiction
seldom starts early in youth; that means help and
support for young drinkers is more educational than
therapeutic.
Alcohol Related Problems
Alcohol problems affect the health and development of
individuals and nations and have political, economic
and social implications. Alcohol problems may be the
consequence of either acute episodes of heavy drinking
or of prolonged drinking ( drug abuse). The development
of alcohol problems can be viewed in the perspective
of the public health model as complex interaction
between the agent (ethanol), the host (drinker) and the
environment (physical, mental and socio-cultural setting,
the family and the general community).
Consequences of Acute Episodes of Heavy Drinking
• Short-term impairment of functioning and control,
with aggressiveness and accident proneness
• Exposure to climatic conditions and physical disorders
• Arrest for drunkenness
• Alcohol poisoning
Consequences of Prolonged Heavy Drinking
• Increase risk of certain disorders, including liver cirrhosis,
certain cancers, cardiovascular diseases and
brain atrophy
• Aggravation of other physical disorders, e. g. malnutrition
• Prolonged impairment of functioning and control
with increased proneness to accidents and impairment
of working capacity
• Alcohol dependence syndrome
• Alcoholic psychosis
• Premature death
• Suicide
Possible Concomitants
Loss of friends, of family, of self-esteem, job, means of
support and liberty.
Evidence is accumulating that a number of pathological
conditions may however be related to the consumption
of a small amount of alcohol, and may cause a much
greater burden on the community than resulting from
the alcohol dependence syndrome (costs of illness –
utilities).
Preventing and Managing Alcohol
Related Problems
If health is to be looked upon as an integral part of economic
and social development measures to solve alcohol
problems must be part of general health programs
and must be planned with the primary care approach in
mind; responding to alcohol problems must be a joint
responsibility of people and government.
Prevention
• Reducing the availability of alcohol beverages (control
of distribution, price regulation)
• Reducing the demand for alcohol (information and
education on alcohol and alcohol problems, inform
about the upper “safe” level of daily consumption.
Restrictions on advertising, moral and religious
forces)
• Additional preventive measures (control measures
focus on limiting the amounts of alcohol available
to the drinker, educational measures concentrate
on building up the host’s resistance and reducing
demand for alcohol, measures might be developed
from consideration of links between the putative
drinker and his environment).
Treatment
• Treatment and management of persons identified as
being “alcoholics” and “heavy drinkers”
• Family support
• Management in occupational settings (initiated discussions
with key personnel in a range of occupational
settings to identify and reduce alcohol problems)
• Programs related to traffic safety (legislation regarding
drinking and driving, high-risk drivers).
Alcohol Policies in a Health Context
A policy statement concerning alcohol availability and
problemsmay be seen as an essential contribution to the
formulation of national health policies, strategies and
plans of action. It may be valuable to formulate at a high
level the principles that should underlie the action to
be taken and to establish priorities and strategies. The
following have to be considered:
• Value of policy statement
• Focus on substance abuse or on alcohol problems
• Participation in policy development (range of participants,
community involvement, coordinating bodies)
• Constraints on policy formulation and implementation
• Information needed for policy formulation
• Preparation to implement a national policy.
Cross-References
Cultural Beliefs
Data Collecting
Drug Abuse
References
Moser, Joy (1985): Alcohol Policies in National Health and
development Planning. WHO Offset Publication No. 89,
Geneva
Tags: adverse effects, alcohol consumption, alcohol problems, alcohol related problems, alcoholic beverage, alcoholic beverages, beer wine and spirits, different regions, distribution network, drinker, ethanol, excessive drinking, health planning, national health, per capita consumption, production of beer, social groups, sociocultural factors, stressful situations, wine and spirits