Secretary of Health, Education and Welfare Joseph A. Califano Jr. yesterday declared alcoholism "Preventable Public Health Enemy No. 2," second only to smoking.

He announced a "major new administration initiative" against it - one that will add only $22 million to HEW's current $175 million anti-alcoholism effort, but one that will also ask thousands of doctors and other workers to join an enlarged public and private effort.

Among other measures, Califano said:

He will start a program to aid alcoholics working for HEW, and urge other Cabinet officers - and all governors and mayors - to start or strengthen efforts among government employees. "We will begin by putting our own house in order, and boy, does it need to be put in order," he said.

He will ask every high school stuperintendent to step up antialcoholsim education. One high school student in five has admitted getting drunk at least once a month.

Surgeon General Julius Richmond will ask every doctor before prescribing any sedatives or tranquilizers, to quiz any patient on how much he or she drinks. "Not enough doctors ask that question today," Califano said, though there is more and more "combination abuse" - abuse of legal and illegal drugs together with alcohol, with sometimes fatal results.

Amidst many figures on alcohol's toll - its annual $40 billion economic cost and the nation's 12 million to 14 million problem drinkers, including 3 million teen-agers - the HEW chief found one bright spot.

Incidence of cirrhosis of the liver, as often deadly ailment that can be caused by excessive drinking, has dropped by nearly half since 1960, Califano said in his speech to a National Council of Alcoholism meeting here.

This is partly the result of a decline in per capita alcohol use, from an average of 2.9 gallons of pure ethyl alcohol in the mid-1970s to 2.75 gallons in 1977. But even the 1977 consumption equals 28 gallons of beer plus 2.4 gallons of wine plus 2.6 gallons of whiskey and other hard spirits for everyone 15 and older.

"Doctors are also doing a better job of preventing and treating cirrhosis," said HEW's Dr. Gerald Klerman. "But the main factor is the leveling off in drinking, which is a result of inflation. People just have to spend more on food, shelter and fuel."

Califano also promised special efforts among women, workers in general, the elderly, American Indians and veterans.

So many pregnant women drink so much, he said, that fetal alcohol syndrome has become the third leading cause of birth defects, and No. 1 preventable cause. Last year, one in 2,000 babies had a physical or mental impairment caused by his mother's drinking, he said.

The alcoholism crusade is the second for Califano, who started HEW's current war against cigarettes - and quit smoking. He takes "a drink before dinner" and sometimes wine, and has not drunk any more or less since become HEW secretary, he told the meeting.

"Our effort isn't against moderate drinking," he said. "It's against abuse."