Review of David Hanson, Preventing Alcohol Abuse: Alcohol, Culture, and Control

In this book, Hanson, a sociologist, contrasts two positions on alcohol control: the socio-cultural model and the control-of-consumption model. The socio-cultural model, of which he is a strong advocate, says that that most people in most cultures most of the time drink alcohol responsibly and in moderation. This seems to be especially true in cultures or groups that accept drinking, and provide strong moral codes for its responsible use starting from a young age and with parental consent and teaching.

The contrasting (neo-prohibitionist) view holds that alcohol itself is bad, that any use risks spiraling out of control and therefore any intervention—preferably complete abstinence—that reduces the mean consumption in a population is necessarily good.

The first chapter reviews the history of alcohol use. The second chapter describes cultural variations in alcohol use (and problems) in both pre-literate and modern groups. The third chapter reviews the American experience with alcohol over history with a special emphasis on the Prohibition and neo-prohibitionist movements. He presents the control-of-consumption (aka public health or single distribution) model and its weaknesses. The last chapter summarizes his argument for the socio-cultural model, with some very brief, general policy recommendations.

This book is short and easy to read. It's heavily referenced—the references allow you to check his reasoning. In spite of the explicitness with which he cites his sources, one is left wondering whether their selection is biased by his promotion of the socio-cultural model, and his use of primarily qualitative and historical data. Overall, though, this book presents a coherent and important argument that anyone working in alcohol control (or prevention or research) should be forced to read and attempt to rebut. The social and historical data should be studied carefully by those who think that alcoholism is a simple, medical disease due entirely to brain dysfunction.