The study of primitive cultures sheds light on Western drinking. Anthropologists have frequently found that inferences can be drawn from simple cultures more readily than from complex ones, and that their conclusions then prove relevant to more differentiated societies. Only where the culture fosters drinking will alcoholism be widespread. Whatever the individual’s psychological difficulties may be, unless the social circumstances are right he will deal with these in another way than by excessive drinking.
Favourable cultural conditions for promoting alcoholism must obviously include availability of supplies. But this by itself is not enough. From a sociological standpoint everybody may be regarded as potentially alcoholic; in Ullman’s view, for instance, recourse to alcohol is no more than a means of relieving tension, and tension is universal.1
In simple cultures, where literacy does not exist, everyone has his place, with an importance and a dignity that the group recognizes. As social differentiation increases in complex cultures more rules are required. Those individuals who find themselves hard pressed to fulfil the requirements imposed on them become anxious because they must suppress and inhibit some of their urges in order to conform.
Rules check individual behaviour. As a society’s rules become more complex, and especially where their enforcement is harsh and punitive, the individual has to limit the extent to which he can act solely in accord with his own wishes. In practice, 1. Ultman, A. D. (1962). ‘First drinking experience as related to age and sex’. In Society, Culture and Drinking ‘Patterns, ed. Pittman, D. J., and Snyder, C. R. New York: John Wiley & Sons. restrictions are most stringent where they relate to aggressive and sexual behaviour. The threat of retaliatory punishment evokes anxiety in a person whenever sexual or hostile urges are aroused. Because these are vigorous urges, a powerful conflict situation is set up in the individual. From time to time recourse may be had to alcohol to facilitate release of these proscribed urges.
In very simple cultures drinking consolidates group cohesiveness and alcoholism is rare. The emotions aroused by alcohol are shared in the group setting and enhanced by singing and ritual. Drunkenness, too, is a shared behaviour. It takes the form of periodic revels; these enable the individuals to experience and express their close links with each other. In such societies anxiety and fear are significant not only as individual experiences but also as group phenomena. Horton, an anthropologist, records that the frequency with which drunkenness occurs in such societies is determined by the amount of anxiety and fear experienced by the group. In a study of 118 primitive cultures in Africa, Asia, and the Americas1 he was able to relate the frequency of drunkenness to two indices of social anxiety: insecurity about food supplies and, secondly, stresses from acculturation by contact with Western civilization which weakened social patterns and kinship ties. The more these factors operated, the more drunkenness there was.
The combination of the group fears and the individuals’ repressed urges becomes too great. Something has to give. These societies have evolved an adaptive pattern designed to relax their restraints from time to time. Popular festivities take place during which group drunkenness occurs. Then sexual and aggressive behaviour do not incur censure, and exposure, suggestive body movements and intercourse, arguments and brawls are permitted. Apart from these orgies drunkenness is rare and alcoholism does not occur.
I. Horton, D. (1943). ‘The functions of alcohol in primitive societies: a cross-cultural study ’.Quarterly Journal of Studies on Alcohol, 4, 199.
When the organization of society becomes still more complex, as in modern European societies, acting-out behaviour of this sort is no longer tolerated, even on the rare occasions when group drinking is still permitted. On such public days of celebration, although drunkenness is more excused than at other times, excesses of aggressive or sexual behaviour are not condoned. The excessive drinker in Western societies drinks against his society. Excessive drinking becomes almost a rebellious gesture. The conditions are right, the scene is now set, for some people to become alcoholics.
In different Western nations society has organized itself in diverse ways, and from country to country patterns both of drinking and of excessive drinking vary. Climate and geography, economics and local customs all influence national patterns of drinking.
The contrast between Italian and French drinking demonstrates well that differences in social attitudes play a very important part in determining the extent of alcoholism.
In France a third of the electorate gets all or part of its income from the production and sale of alcoholic drinks. These people are wholly or partly dependent on the wine and spirit industries for their livelihoods. In a quite literal sense they are supported by alcohol. It is understandable, therefore, that four fifths of French people replied, on being questioned, that wine was ‘good for one’s health’ and a quarter held that it was indispensable.1 Large quantities of alcohol are taken regularly by many Frenchmen without their considering that they are drinking too much or that they are misusing alcohol. Men who were asked the question how much wine a working man could drink daily ‘without any inconvenience’ gave answers which averaged two litres, slightly over three pints. The consumption of large quandties of wine was thought quite proper by the people surveyed. French drinkers consume wine steadily
1. Bastide, M. (1954). ‘Une enquete sur l’opinion publique a l’egard de l’alcoolisme’. Population 13. throughout the day so that these inveterate drinkers constantly have a high amount of alcohol in their bodies. They are chronically poisoned, although they rarely show very disturbed behaviour. Their drinking becomes a problem principally because of the insidious physical consequences. They develop bodily rather than mental diseases. Indeed, French psychiatrists disagree among themselves whether alcoholism should be regarded as a psychiatric problem at all.
Italy, too, has a considerable economic stake in alcohol production. Ten per cent of arable land is tinder viticulture, more than in France. Two million people earn their living wholly or partly from the production or sale of wine. Drinking throughout the day, in particular drinking during working hours, has traditionally not been part of the mores of Italian society. Indeed it has been intensely disapproved. In 1958 it was reported1 that less than a fifth of Italian men drank other than at meal times, and most of those only on infrequent, special occasions. More than a litre (1J pints) in a day was regarded as grossly excessive. Drinking took place in the family circle, and drunkenness was deplored. Consequently litde alcoholism presented either to psychiatrists or to general physicians.
The difference in the extent of alcoholism in these two wine-producing countries has to be understood in terms of the different attitudes to excessive drinking and drunkenness which prevailed.
More recently a rising rate of alcoholism has been reported from Italy. Industrial workers, especially those who are single or separated, make up the majority; 96 per cent of alcoholics still drink mainly or only wine.
In Britain and in North America drinking takes a different pattern. It is neither continuous throughout the day, nor is alcohol taken exclusively with meals as a shared family activity. Furthermore, a large amount of spirits is drunk. Beer and
1. Lolli, G. E., Serianni, G. M. G. and Luzzatto-Fegiz, P. (1958). Alcohol in Italian Culture. Glencoe, Illinois: The Free Press. spirits are the prevalent drinks in contrast to the wine of Continental countries. Moreover, drink is taken rapidly, either when work is finished or after the evening meal, to produce a sudden rise in the level of alcohol in the body. This method of drinking leads to drunkenness, which is the hallmark of Anglo-Saxon excessive drinking. The level of spirit drinking in Britain in 196 3 was the highest for forty years. Every adult on average consumed four bottles in the year, two of which were whisky.1
Five types of establishment are licensed to sell drink for consumption on the premises in Britain: hotels, restaurants, public houses, bars, and registered clubs. Other places, off-licenses, and, in Scotland particularly, licensed grocers, are permitted to sell drink for consumption away from the premises. The pub is the principal locus of drinking in Britain. In England the public house provides drink in a pleasant and convivial social atmosphere; in many a piano is part of the setting; games, darts, dominoes, and the like are available; in most pubs women are welcome. Many pubs have their own darts teams which compete with rival houses. A man often becomes so attached to one pub that he does not lightly go elsewhere for his drink. Each pub has its band of regulars who feel at home in each other’s company.
The encouragement of social activities is a comparatively recent development in English public houses. Tables and comfortable chairs are generally provided in the lounge, which has become the principal room. The publican frequently organizes entertainment on Friday and Saturday evenings. The old division into saloon and public bars is giving way as a result of a deliberate policy by the brewers (who own most public houses) to attract women into their establishments. A recent series of advertisements had as their slogan ‘Let’s all meet at the pub’; the accompanying pictures always showed equal numbers of men and women, thus indicating that the pub could and should x. Annual Report of the Commissioners of Customs and Excise, 1962-6). London: H.M.S.O. serve as a place for mixed social concourse. In Scodand the old pattern persists. Women are unwelcome; indeed some publicans contrive actively to discourage them. Many public houses in Scotland are still very much drinking shops whose customers are presumed not to want to do anything else. Few concessions are made to comfort: surroundings are dingy; seating is sparse and hard; ventilation is poor and sanitation woeful. Customers come to consume alcohol in a one-sex setting. The effects of this upon personal behaviour and group conduct have important implications for the development of alcoholism. The restraining influences of social conventions are weakened. Pathological drinking is more frequent in Scotland than in England.
For all its importance in British life the ways of the public house have received little attention from sociologists. Hopkin-son in The Pub and the People1 reports a survey by Mass Observation carried out during the war. Seebohm Rowntree and G. R. Lavers2 give an account in English Life and leisure which we cannot better:
The nature of any public house is largely determined by the locality in which it is situated, for that determines the type of customers, and the customers in turn determine the atmosphere of the house. Thus, in the centre of a large city, where there are practically no residents but only a heterogeneous crowd of passers-by, some of whom want a drink, public houses tend to be impersonal, ‘cold’, and often rather sordid. At the other extreme, in rural areas, and in some small towns and suburbs, public houses are not infrequently social institutions of considerable importance to the communal life of the neighbourhood. In between the two extremes there is an immense number of variations – ‘tough’ pubs in the docks, palatial houses complete with dining-rooms, usually in middle-class residential areas, public houses outside stations, catering mainly for travellers, public houses catering for factory
1. Hopkinson, T. (1945). The Pub and the People. London: Gollancz.
2. Seebohm Rowntree, B. and Lavers, G. R. (1951). ‘English Life and Leisure. London: Longmans. Quoted by permission of the publishers.
Workers or for white collar workers, or for both, in separate rooms of the same establishment, and so on. Broadly speaking there is somewhere a public house for almost every male taste. Taking public houses as a whole, their customers thus tend to be a cross-section of the male population.
Most public houses have a proportion of regular customers, varying from a small number in houses that cater mainly for passers-by to a high proportion in those houses that cater specifically for the requirements of one special locality, such as a village or a housing estate. Although the etiquette of town and country public houses varies a good deal, regular customers have much the same characteristics in both. They tend always to occupy the same seat or corner, and are annoyed if some other customer occupies it. They expect extra consideration, and minor privileges. the atmosphere of a public house is principally determined by its location and the type of persons from among whom, in consequence, it draws its customers, but whether a public house is a happy or friendly place, or the reverse, depends also largely on the publican and his assistants. It is strange that there should be so many morose publicans – only a minority, of course, but an appreciable minority.
A study by the Hulton Readership Survey1 carried out since the war is the most up to date about British drinking habits. It showed that, of the population over the age of 16, 32 per cent were regular beer drinkers, 10 per cent were regular spirit drinkers and 5 per cent were regular wine drinkers. (‘Regular’ here means at least once a week.) The percentages of those who drank every day were: 9 per cent, beer drinkers; i-j per cent, spirit drinkers; 1 per cent, wine drinkers. 21-5 per cent of men and 40 per cent of women did not drink at all.
The number of people engaged in the drink industry in Britain is far from inconsiderable. Seebohm Rowntree and Lavers2 made a very conservative estimate of 340,000. This
1. Hulton Readership Survey. Figures quoted by kind permission of The National Trade Press Ltd.
2. Seebohm Rowntree, B. and Lavers, G. R., op. cit.
Figure did not include those engaged in the wholesale distribution of alcoholic liquor. To give perspective to this total they pointed out that it was approximately 50 per cent more than the number of workers engaged in all sections of the gas, water and electricity supply industries.
In the United States alcoholism is rightly recognized as a very serious public health problem. Social concern about alcoholism is much greater than in Britain. Yet on the other hand social attitudes towards drinking have been responsible for the magnitude of the problem. From its earliest Puritan days, organized American public opinion has never been able to come to terms with alcoholics, but has oscillated between severe condemnation and frankly vicarious admiration. In 1919 the United States introduced prohibition. The effect of this harsh measure remains a disputed matter but there is little doubt that inability to enforce it, together with waning popular support, united to make it fail.1 Equally strong public attitudes in the United States led to the formation of the Nadonal Council on Alcoholism, and of Alcoholics Anonymous.
Alcoholism rates among Irish Americans are between two and three times higher than for any other nadonal group;2 the Irish had the highest rate of rejection from the U.S. army because of alcoholism during the Second World War. The greater liability of the Irish to alcoholism has been explained by Bales3 in terms of the Irishman’s close dependence on his mother, the father’s position in the family being insignificant and weak. The Irish mother keeps her son emotionally dependent on her. The immaturity so fostered seems more congruous in Ireland but, suggests Bales, renders the Irishman in the United States
1. McCarthy, R. G. and Douglass, E. M. (1949). Alcohol and Social Responsibility. New York: Thomas Y. Crowell and Yale Plan Clinic.
2. Hyde, R.W., and Chisholm, R. M. (1944). ‘Studies in medical sociology. III. The relation of mental disorder to race and nationality’. New England Journal of Medicine, 231, 612.
3. Bales, R. F. (1946). ‘Cultural differences in rates of alcoholism’. Quarterly Journal of Studies on Alcohol, 6, 482. poorly adapted to deal with the demands of adult life. By excessive drinking he seeks to allay the anxiety resulting from his inability to cope with the competitiveness of adult status. Furthermore he drinks in bars where women are excluded; in this all-male setting social controls are reduced.
A different immigrant group in the United States, the Italians, has a lower alcoholism rate than the national average. All the same, Lolli found it to be eight times as high as among Italians in Italy and the comparison is instructive. Changes in social attitudes and patterns of drinking account for it. As we have already seen, in Italy drinking accompanies meals and is mostly in the form of wine; but in the United States less than 10 per cent of second generation Italian immigrants drank exclusively with meals, and it was rare to find men who drank only wine. Intoxication occurred oftener than in Italy especially among women (males: 84 per cent of Italo-Americans compared with 60 per cent of Italians; females: 51 per cent compared with 16 per cent). These figures refer to the percentage of people who reported one or more episodes of intoxication. More striking was the fact that 20 per cent of Italo-American women reported five or more experiences of being intoxicated, compared with none of the Italian women. Lolli and his co-workers1 who carried out this survey write: ‘Their American cousins, adopting American familial, occupational and recreational customs, and drinking patterns, begin to lose the protection of the Italian drinking tradition, and demonstrate new drinking problems.’
Mormons will expel a member because of drinking, so it is interesting that among Mormon college students there is a high incidence of drinking to intoxication with socially harmful results. Their excessive drinking expresses a rebellion against cultural trends, church pressures in particular.2 Methodists are
1. Lolli, G. E., Serianni, G. M. G. and Luzzatto-Fegiz, P., op. dt.
2. Straus, R. and Bacon, S. D. (1953). Drinking in College. New Haven: Yale University Press.
Brought up in constant awareness of the evil consequences of drinking. Total abstinence is enj oined upon their members. Yet during their student days they had more drinking problems than either Jews or Episcopalians. It was found that those students who drank generally concealed the fact from their fathers.1
Jews have a low incidence of alcoholism. They number 15 per cent of the white population of New York State, but contribute only 1 per cent of all white first admissions to State mental hospitals with alcoholic psychoses.2 This low rate has been explained on the basis that Jews have no taboos against the moderate use of alcoholic beverages, which indeed play an integral part in social and ceremonial activity. Drinking to excess has always been sternly disapproved by Jews. Because the outlet of normal social drinking is permitted and approved, Jews seeking to express their personal conflicts do not turn to excessive drinking.
Our review of drinking in more primitive cultures and our study of drinking habits in Western cultures both permit the same generalization. When a society approves drinking and tolerates drunkenness, whether all the time or on special occasions, then many people will drink to excess. Because they will not be doing anything proscribed, will not be acting anti-socially, they will feel no guilt. Consequently, psychological abnormalities will not frequently be found in the excessive drinkers. If, however, the society disapproves of drinking, it will be especially critical of those who drink to excess. The population of excessive drinkers will consist mainly of two groups: those who seek to rebel against the social group and those whose inner tensions are so great that they must obtain the relief afforded by alcohol, regardless of society’s censure.
1. Skolnick, J. H. (1957). The Stumbling ‘Block. Doctoral Dissertation, Yale University.
2. Malzberg, B. (i960). The Alcoholic Psychosis. Glencoe, Illinois: The Free Press.
These two groups are mostly maladjusted people with psychoneurosis or personality disorder. By their fellows, excessive drinkers are judged to be morally weak and self-indulgent. Being products of their society they share this estimate of themselves. They experience much guilt. The condemnation by society and their own sense of shame conspires to bring about their isolation.