Cultural Factors in the Etiology of Alcoholism: A Prospective Study

In Western societies one of the most obvious but least useful means of combating alcoholism has been to forbid drinking. Stated differently, proscriptions against alcohol use have rarely been as effective as social prescriptions for alcohol use. First, cultures that teach children to drink responsibly, cultures that have ritualized when and where to drink, tend to have lower rates of alcohol abuse than do cultures that forbid children to drink. Second, how a society socializes drunkenness is as important as how it socializes drinking. For example, both France and Italy inculcate in their children responsible drinking practices; but, in fact, public drunkenness is far more socially acceptable in France than in Italy-and France experiences a higher rate of alcohol abuse. Because of an abundance of confounding variables, cross-cultural observations of this kind do not usually permit etiologic conclusions. Cultures and countries differ from each other in many ways besides socialization of alcohol use. They differ enormously in their means of reporting alcohol abuse and in the kind of alcohol available and its price structure. There may be racial differences that affect metabolism; there may be alternative recreational drugs. Finally, many of the anecdotal descriptions used to illustrate alcohol-related differences in other countries are not based upon longitudinal study. For example, what really happens to the 3-liters-of-wine-a-day French “social drinkers”? Does the “explosive relief drinking” by Finns never lead to alcohol dependence? Answers to these questions are not yet known. By chance, the Core City sample originally studied in the 1940s by Sheldon and Elanor Glueck (Glueck and Glueck, 1950) offered unique controls for many of the confounding variables. Virtually all of the Core City men lived in an urban environment (Boston) where alcohol was readily available and was the principal recreational drug of choice. The Core City men shared the same schools and legal system; and they shared the same ethnically diverse peer group. The Core City men differed from one another in the cultural background of their parents. Sixty-one percent of their parents had been born in foreign countries, and ethnic intermarriage by their parents was rare.