Alcohol and Alcoholism Vol. 35, No. 4, pp. 411-412, 2000
© 2000 Medical Council on Alcoholism
Book Reviews
Alcohol and Emerging Markets (Patterns, Problems and Response).
The second volume in the International Centre for Alcohol Policies series on Alcohol in Society explores in a unique way how a balance may be achieved between public health and commerce; giving a good indication how in practice different disciplines like governments, scientists, scholars and public health experts, non-governmental groups and bodies, as well as the beverage alcohol industry, all need to have a place at the table.
The book indicates that any policy on the topic of alcohol drinking should have a balance between governments' regulation, industry self-regulation, and individual responsibility. This book contains 14 chapters and is in two parts. In the first part, it discusses contemporary trends of the patterns and consequences of drinking in developing areas like Africa, Asia, South East Asia, China, India, and also central and eastern Europe, Russia, Latin America, and Mexico. The second part discusses encouraging better practice. Different authors have contributed, thus giving various perspectives on alcohol-related issues in different countries.
It has always been difficult to collect detailed and accurate information, and reliable data, to achieve a proper conclusion in most developing and Latin American countries. In the sub-Sahara and Africa, there is an enormous diversity of cultures in the whole continent, as well as rapid social changes. The influence of these, as well as other factors, on patterns of drinking, which cannot easily be described in simple terms, like quantity and frequency are so diverse that a multidisciplinary approach towards understanding of alcohol drinking would be the better proposal.
The book also states that each country in Africa aims to develop policies on alcohol, to enable the inhabitants to enjoy the benefits and pleasures of drinking, while also taking appropriate measures to protect against all the ill effects of alcohol.
All Asian countries are experiencing an increase in the demand for alcohol. This is initiated by changing lifestyle, culture, and exposure to more sophisticated advertising in a context where people have the right to choose from different options. Alcohol policies need to be formulated in these countries taking into account the social, religious, cultural, economic, political, and public health dimensions of alcohol use and abuse. A more holistic approach, based on objective and long-term prospectives would be ideal, rather than ad-hoc policy-making. Most Asian countries may be approaching alcohol use and abuse from a narrow, short-term perspective, without adequate consultation from different disciplines.
The chapter on The Alcohol Drinking Pattern in India is also interesting. The findings and observations are very close to my own findings from a similar research project in West Bengal and Punjab about a decade ago; the chapter compares the drinking habits of Indians with Asians in the UK. The pattern of drinking is definitely changing very fast, with major changes in economic policies, the liberational market, the steady introduction of a market economy, and growing consumerism in India. Other factors are also bringing about various changes, such as the break up of the traditional joint family system and changes in values and attitudes, including attitudes towards the consumption of alcohol. Cultural and religious controls, that prevented people from drinking alcohol, are weakening steadily and alcohol drinking has been spreading to all classes of people. Alcohol drinking is also increasing amongst groups who were traditionally abstainers, such as women, teenagers, and the rural rich, and I agree that there is an urgent need for the country to review its alcohol policies, especially in some parts of India where alcohol drinking is becoming more prevalent.
In central and eastern European countries, there has been a long and rich tradition in the production, trade, and consumption of alcoholic beverages. In Russia, it is said that extreme political, social and economic changes, within a short time, and the fall of socialism, have created a difficult context in which to formulate and implement government policy, suggesting that the task that lies ahead, at least in the short term, is likely to prove very difficult.
China has experienced tremendous social and economic changes, from the 1980s onwards, and the prevalence of drinking alcohol and of alcohol-related problems has also increased significantly, which is posing a challenge to medical workers, particularly in the mental health field.
In Mexico and other Latin American countries, the culture does not limit the drinking of alcohol and so the habit is quite widespread. Another real danger is the production and sale of non-drinkable alcohol, which is 96% proof alcohol, or the consumption of home-made beverages which have been produced with no health controls, as a possible result of restrictions on availability. I found a similar picture in India when I carried out an alcohol-drinking survey. There is definitely an urgent need for research designed to support the national programme and to answer questions about different aspects of alcohol drinking and alcohol production.
In a later chapter, quite a few important points are made in identifying the most appropriate role for the beverage alcohol industry, mentioning the industry structure as a whole, improving the data on patterns and level of consumption, responsible promotional and advertising practices, alcohol education, and also suggesting a framework for responsibility and a checklist for related activities.
The concluding chapter by Marcus Grant is well written. On the whole this book is well presented and gives a new dimension to the pattern of alcohol drinking in many countries of the world.
I am sure that it will be very useful for research workers, health visitors and other health professionals, and also for alcohol producers and policy-makers on alcohol drinking in many countries.
FOOTNOTES
Edited by Marcus Grant. Taylor and Francis, London. 1998, 384 pp., £33.00. ISBN: 0 87630 978 3.
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