The day before the federal tax on a bottle of whiskey made its 19 percent leap last week, the liquor stores filled with customers determined to stock up at the low, low prices of yesteryear. There wasn't much of a public uproar about the price increase. America has always borne its penalties for indulgence without complaining overmuch. On the other hand, there wasn't a lot of gratitude expressed, either.
Not even by the handful of men and women in the Washington metropolitan area who will not die of accidents or cirrhosis of the liver or murder or suicide or alcohol overdoses in the next couple of years, because the increased price of a drink means they're likely to drink less or not at all.
They don't even know who they are, but they are out there, and their existence is documented in a classy little study, "Alcohol in America," coincidentally published last Tuesday, the day of the liquor tax increase, by the National Academy Press, an affiliate of the National Academy of Sciences.
Adding up all the fatalities related to excessive drinking, the study finds alcohol involved in possibly 150,000 deaths a year, or about one of every 13 deaths in the United States. The study estimates that 50,000 of these deaths are preventable, and has some figures to back it up.
In the decade 1961 to 1971, the per capita consumption of alcohol in the United States rose 26 percent. The increase was attributed to the fact that alcohol prices had not had not kept pace with other consumer commodities, people began to have more liberal attitudes toward drinking, and personal incomes increased. With cheaper booze and higher consumption came an increase in the death rate due to cirrhosis from 11.3 to 15.4 per 100,000 people. If no alcohol were consumed, the assumed cirrhosis death rate would be three or four per 100,000 people, the study said.
The report cited direct tests during those years by Philip Cook at Duke University, who looked at liquor tax increases in 39 states and found "There is considerable statistical evidence that a liquor tax increase causes an immediate and substantial reduction in cirrhosis mortality." The report found the same linkage between raised taxes and highway deaths.
Written by science writer Steve Olson and Dean R. Gerstein, a study director at the National Research Council, another arm of the National Academy of Sciences, the study summarizes two previous National Research Council studies, which culminated in the publication last year of a book, "Toward the Prevention of Alcohol Problems: Government, Business and Community Action."
That book already has become what is being called a "landmark" in the field of alcoholism and alcohol abuse, Gerstein says, and the new report, which bears the subtitle "Taking Action to Prevent Abuse," likely will wind up on the bookshelves of counselors, politicians, judges, medical professionals and law enforcement officials throughout the country.
"Chances are good that higher prices will mean fewer lives lost because of excessive drinking," Gerstein said in an interview last week, just after the federal tax increase went into effect.
The study concentrates solely on the means of preventing alcohol abuse not only by alcoholics and heavy drinkers but by social drinkers, those who could not be classified as alcoholics or even heavy drinkers. The report finds, for instance, that a third of the adult population drinks 95 percent of all the alcohol consumed. Moreover, 5 percent of the population drinks half the alcohol consumed.
On the average, Americans consume the equivalent of 2.75 gallons of pure alcohol a year, which is just under an ounce a day, Gerstein and Olson write. "The most remarkable result of these surveys is how much of the adult population does not drink or drinks very little," they note. About a third of all adults report not having drunk any alcohol in the previous year, and at that the number who drink is still higher than in Canada or any nation in western Europe.
For the nation as a whole about 27 percent of men don't drink, and 42 percent of the women, which means, as the figures show, a handful of people are having a headful of hangovers.
In this sort of analysis, "Alcohol in America" becomes a sort of De Toqueville of booze in this country, letting us see the development of drinking here from the earliest days to the present. They bring in the numbers and historical perspective to give credibility to any number of points of view, including the concept of alcoholism as a disease, which they cite as the latest phase through which public attitudes have passed.
In Colonial society drunkenness was seen as a personal failing, while heavy drinking was normal; for 150 years after the Revolutionary War alcohol came to be viewed as an addicting and poisonous drug, so that the drunkard was not a moral weakling but the victim of an alien substance, and it was this view that led to the temperance societies that, in turn, led to Prohibition.
Today's view holds that excessive drinking is a chronic disease known as alcoholism, based on body chemistry and carrying no moral overtones. The new study calls this the "alcoholism perspective," says it is relatively new and that in 15 years has shown itself capable of building a powerful institutional base. The study finds this concept likely to remain strong, but implies that the jury is still out on the exact nature of the relationship between human beings and ethyl alcohol.
The prevention factors discussed and, from time to time, advocated in the report include several public policies of prevention. Not treatment, which focuses on specific people (alcoholics), but prevention.
The alcoholic or determined heavy drinker will not be deterred from drinking liquor by the kind of tax increase that went into effect last week. But the tax increase also applies across the board to those who might be drinking just what they can afford and those who might be just starting to drink. And also to those whose drinking, not at the addictive, compulsive stage, just might be curbed by the extra cost of the package goods.
Alcoholics, the study finds over and over again, are frequently in serious trouble, and cost America's medical/legal/social apparatus billions of dollars a year. But they are not the only people who have car wrecks and accidents when they drink.
Prevention measures need not be "either/or," the study concludes, but should incorporate all of the big three: limiting price and availability (as in the tax increase, a higher drinking age, fewer liquor licenses), education and persuasion (in schools and the media), and "actions that make the world a safer place in which to drink," such as teaching alcoholic beverage servers, such as bartenders, how to get a patron a cab and how, even, to tell when a patron is intoxicated and what to do in such cases.
Madison, Wis., that municipal laboratory for liberal experiments, is one of the jurisdictions that make it mandatory for servers to undergo this kind of training before a liquor license is granted.
This is a sane acceptance of alcohol in this country: it is with us, will be with us, and we have tried (in Prohibition) to get rid of it, and this is an approach to living with it. The preventive measures, some of which may even be politically viable, will not eliminate alcohol-related problems, but any one person who is not killed by a drunken driver or won't die of cirrhosis next year won't care that the problem isn't solved totally. Resource
"Alcohol in America" is available for $9.95 direct from the National Academy Press, 2101 Constitution Ave. NW, Washington, D.C. 20418. Copies are also available at a bulk rate.