My, it can be a heavy burden.
I am in Florence, where I was the only non-Italian participating in a program on alcohol organized by the Italian Drug Forum. My topic was how temperance forces in the world are stealing the pleasure and health from use of alcohol, and particularly wine consumption.
People have long noted the very different styles of consuming alcohol in Europe -- the excess and binge drinking that characterize English-speaking and Nordic (i.e., Norway, Finland, Sweden, Iceland) countries, which are together called temperance cultures. At the opposite extreme are Mediterranean cultures -- Spain, Italy, Portugal, Greece, Italy. Recently, these impressions have been confirmed by cross-cultural research. An international study found that, on 40 percent of drinking occasions, British men binge drink as do 33 percent of Swedes and 29 percent of Finns, compared with 13 percent and 9 percent of Italian and French men.
These different tendencies towards binge drinking have tremendous impact on the health effects of alcohol. For example, the same study found, 18 men per 100,000 die each year due to alcohol-related causes in Northern European countries, compared with 3 per 100,000 men in Southern European countries -- a ratio of 6:1.
But that's not the amazing part of the story. The amazing part of the story is that temperance nations totally dominate the world of alcohol research and policy. In other words, the world's alcohol policies, as propagated by the World Health Organization, originate in the United States and other English-speaking countries, along with Sweden and other Scandinavian countries. This -- turning to the worst-drinking nations for leadership in dealing with alcohol -- sounds like one of those jokes involving an English chef, an Italian chauffeur, and so on .
Mediterranean cultures teach children to drink at home at an early age. There is a systematic campaign worldwide to cast this practice into disrepute by claiming that the earlier children drink, no matter what the context -- drinking in the woods with friends or at home with family -- the more likely the young person is to become an alcoholic. This is coupled with the idea that any differences in drinking that may have ever existed among the young in different countries have disappeared.
These ideas are demonstrably and utterly false. For example, an annual tracking study of youth binge drinking throughout Europe found that, in the past month, 49 percent of Danish 15-16-year-olds have been drunk, 33 percent of British youths, and 12 percent of Italian and Greek kids.
At the Florence conference, Dr. Franca Beccaria presented data she and Finnish colleagues collected comparing the initiation into drinking by Italian and Finnish youths. While Italian youths couldn't remember specifically when they first drank, when pressed, they guessed it was about age seven at home. Finnish youths could be much more specific -- they first drank at ages 15-16 with peers, when they became intoxicated. Even older Italians and Finns recollected these early drinking experiences, and indeed tended to replicate them throughout their lives.
These differences have been much discussed lately since in Southern Europe, unlike their parents, young people now often congregate to drink beer in public places. But the research shows that, although the locale of the drinking and the beverage have changed, Southern European young people drink for pleasure, unlike the intoxication their Northern cohorts seek. In Florence, people have noted with alarm for years that the American young people who come here - where the drinking age is 16 - drink until the alcohol spurts out their noses, in utter contrast to the native Italian youths' way of handling alcohol.
These self-evident differences are intentionally slighted so that temperance forces can claim that all alcohol consumption is equally bad, and to try to curtail it in any way possible. One policy with this goal is to press parents not to give their children alcohol - the style shown to be most effective for preventing both teen and adult problem drinking. Recently, the European Charter on Alcohol, led by temperance nations, has pushed for a zero-tolerance goal that no parent give a child alcohol in any form or setting before the age of 16.
At dinner with a male colleague and two highly-educated women not involved in the field, we asked the women - both mothers of 20-something boys - when and how they first gave their children a taste of alcohol. True to Beccaria's research, neither could say exactly when this occurred. But when pressed, each independently guessed at age 7-8, when they gave their children some wine diluted in water. When we explained that a public health movement was afoot to prevent Italians from doing this until their children were 16, the women were incredulous, and correctly predicted the consequences of such a policy observed with Finnish youth.
And, so back to the conference. Present was the leading Italian representative of the World Health Organization alcohol movement, who presented a PowerPoint package showing the damage caused by alcohol worldwide. Nowhere did he mention any of the differences across Europe in how alcohol is consumed, and how these impact health outcomes. Instead, he implied that Italy was equally as badly impacted by drinking as all other European nations. I ran into this man the night before my presentation, and as if to prove his Italian bona fides, he told me that he drank daily, and that he disagreed with the recommendation that children not be allowed alcohol before the age of 16. We agreed that kids should not drink regularly before 16, even at home. He approved, however, that they should be given tastes of alcohol at younger ages on special occasions - which is simply to say that he is Italian.
But if he said this in an effort to impress me, he was so barking up the wrong tree. For I saw his backing the European alcohol initiative as indicating that he was a Quisling, in this case a man who repudiates his own culture in order to curry favor with the powers-that-be in Geneva.
And, so, the next day I teed off on him and his ilk. I do so regularly on an Internet list for alcohol policy specialists, as well as conferences where they congregate. Southern Europeans are sparsely represented on this list and at such conferences, which are conducted in English, due partly to their language difficulties (Scandinavians speak excellent English as a rule), and because the major research institutions are congregated in English-speaking and Scandinavian countries. I often stand alone in these places, therefore, in defending the pleasure, the power, and the principle of home-schooling in alcohol consumption.
Although this conference was an exception in that I was not alone in my position, both the conference organizer and I felt the full onus of Europe's alcohol public health masters the next day, as they apply pressure towards the goal of eliminating the pleasurable use of alcohol. Neither the Italian bureaucrat, nor World Health Organization specialists, EVER mention pleasure as a reason people drink. It is not a part of the international public health vocabulary. Oh, except that virtually every alcohol policy specialist I know - like the Italian bureaucrat - consumes alcohol copiously.
Beccaria, F. Alcol e Generazioni. Rome: Carocci; 2010. (English-language CD available)
Hibell, B. et al. The 2007 ESPAD Report: Substance use among students in 35 European
countries. Stockholm: The European School Survey Project on Alcohol and Other Drugs; 2009
Norström T. editor. Alcohol in Postwar Europe: Consumption, drinking patterns, consequences and policy responses in 15 European countries. Stockholm: National Institute of Public Health; 2002.
Peele, S. Alcohol as evil - Temperance and policy. Addiction Research and Theory, August 2010; 18(4): 374-382.
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