Pleasures of Drinking: A Cross-Cultural Perspective

transcript

Pleasures of Drinking: ACross-Cultural Perspective

Karin Helmersson BergmarkHerve Kuendig

ABSTRACT. The purpose of this study was to evaluate how drinkingis related to positive expectations of the effects of drinking. Dataemanates from Gender, Alcohol and Culture - An International Study(GENACIS), a collaborative project in which surveys from all includedcountries utilized the same core questionnaire. Three indicators for posi-tive expectations were used, representing a social, relational, and inti-mate dimension. Cross-country comparisons of positive expectancyreports were conducted, as well as exploratory multiple regressionanalyses of the relationships between expectations and drinking.Volume and binge drinking were used as two indicators for drinkingpattern. The share of current drinkers varied between countries andgenders. In all countries, men reported on expectancies more often thanwomen. Regression model results are variable and not directly inter-pretable into cultural patterns, across countries and continents.

KEYWORDS. Cross-culture, gender, positive expectancies of drinking

Karin Helmersson Bergmark is affiliated with the Department ofSociology, Stockholm University, Stockholm, Sweden; Herve Kuendig isaffiliated with the Swiss Institute for the Prevention of Alcohol and DrugProblems, Lausanne, Switzerland

Address correspondence to Karin Helmersson Bergmark, Department ofSociology, Stockholm University, S-10691 Stockholm, Sweden. E-mail:karin.bergmark@sociology.su.se

Journal of Ethnicity in Substance Abuse, Vol. 7(2) 2008Available online at http://jesa.haworthpress.com

INTRODUCTION

Of all alcohol research produced within the social sciences,research about drinking problems constitutes a vast majority ofstudies. But although alcohol rightly has proven to constitute oneimportant source for ill health (Room, Babor, & Rehm, 2005), mostpeople seem to enjoy drinking and do not experience alcohol-relatedproblems. In many cultures, alcohol is present in the daily course oflife. Alcohol is used as a tool for social life, as a part of everydaymeals, and to emphasise festivities and celebrate special events(Beccaria & Guidoni, 2002; Douglas, 1987). The Muslim worldconstitutes the major exception from this (Rehm et al., 2003), but insome other cultures (e.g., Hindu cultures) alcohol drinking is less usualcompared to the situation in the Occidental world. In the Hindu-dominated India, a minority of men and less than 5% of women drinkalcohol (Benegal, Nayak, Murthy, Chandra, & Gururay, 2005).

Among the many factors that have been proposed to explain thedifferences in this matter, some refer to the alcohol-related culturalbackground of each country (e.g., the existence of religious ‘‘lawsof abstinence’’ or traditional norms related to alcohol use) thatinfluence the degree of integration of alcohol in everyday life. Somereligions stipulate abstention from alcohol, but others do not.For example, within the Christian context there have been consider-able differences in drinking and alcohol related norms (Douglas,1987; Rehm et al., 2003). Within the confines of surveys from twelveEuropean countries (Bloomfield et al., 2005a), there were apparentdifferences between European ‘‘regions’’ both regarding consumptionand drinking context. The prevalence of abstinence was higher inNorthern countries, whereas the frequency of drinking was higherin Southern Europe (abstinence rates, however, did not co-vary withfrequency of drinking).

Drinking patterns are also related to production and economicfactors, and alcohol consumption levels tend to increase with econ-omic development (Room et al., 2003). Europe, followed closely byother developed regions of the world like the United States andJapan, is the part of the world where alcohol consumption levelsare the highest (Room et al., 2003), whereas fewer people drink inother parts of the world, such as Latin America. For example, inArgentina, few abstain from drinking alcohol, but reports ofalcohol-related problems are low (Room & Hradilova Selin, 2005).

132 JOURNAL OF ETHNICITY IN SUBSTANCE ABUSE

Generally, two dimensions of drinking are included in alcoholrelated surveys. Average volume of consumed alcohol and patternof drinking (e.g., binge drinking or drinking to the point of intoxi-cation) are both regarded as central elements in alcohol cultures(Room & Makela, 2000) but also as variables with explanatory powerfor alcohol-related problems (Rehm et al., 2003). Overall volumeof consumed alcohol has proven to be the best indicator whenmeasuring harms from drinking (Room et al., 2003).

Most alcohol research is problem oriented but also is based on datafrom only European countries or the United States. Drinking habitsand drinking cultures of the rest of the world are sometimes coveredby anthropological research but less frequently present in compara-tive analyses. As a part of the GENACIS project, the current studyforms an exception to this. In GENACIS, data sets from surveysconducted in thirty-six countries have been collected and unified, allow-ing for comparative analyses of many aspects relating to drinking.

This study is based on data about the positive aspects of drinking,such as expectancies of positive alcohol-related events. Positiveexpectancies for three life dimensions (social, relational, andintimate) are used. The aim for the study is to analyze data fromeleven countries—Nigeria, Uganda, India, Japan, the Czech Republic,Spain, Sweden, the United Kingdom, the United States, Argentina,and Costa Rica—from different cultures and continents in regardto two main research questions. The first research question to beanswered is how drinking is related to positive expectancies ofdrinking in different countries as well as in different drinking cultures.The second research question is focused on gender differences andwe aim to determine in a gender perspective whether the relationshipbetween positive expectancies and drinking is culturally dependent.

DRINKING CULTURES

There have been many efforts to categorize countries into drinkingcultures. Room and Makela (2000) discussed previous typologies andthe limitations from which they all suffer. The authors suggest atypology based on several dimensions: degree of drinking regularity,prevalence of intoxication, the cultural position or ‘‘use-values’’ ofalcohol, behavior when under the influence of alcohol (i.e., degreeof integration with other aspects of social life), and modes of social

Karin Helmersson Bergmark and Herve Kuendig 133

control. Room and Makela (2000) suggested that the first two dimen-sions for use in typology emphasize the significance of both overallvolume of alcohol consumed and incidences of risky single occasiondrinking (i.e., binge drinking).

Another way to classify countries in terms of predominantdrinking cultures was proposed by Pittman (1967) and differenti-ates between abstinent, ambivalent, tolerant, and over-tolerantdrinking cultures. In abstinent and ambivalent cultures, the generalalcohol consumption level tends to be low and attitudes towardalcohol and drinking tend to be negative. The author refers toIndia as abstinent and the United States and the Nordic Europeancountries (Sweden, Norway, and Finland) as ambivalent. In toler-ant cultures, alcohol is apt to be incorporated in everyday life.Consumption levels are high and attitudes toward drinking (butnot to inebriety) are positive or indifferent. Spain and Japan areclassified as ‘‘tolerant’’ countries. In over-tolerant cultures, con-sumption levels are high and so is also the frequency of inebriety.Here, attitudes are favorable to both drinking and intoxication.Pittman’s examples of over-tolerant cultures are France and theCamba society in Bolivia.

African nations would probably be referred to as abstinent coun-tries, but few studies on drinking and drinking patterns in Africa haveyet been carried through (Obot, 2000). For example, in the traditionalNigerian society, alcohol was a male privilege (Ikuesan, 1994) andintoxicated women were unheard of. Few women drank and intoxi-cation was a ‘‘masculine feature’’ (Ikuesan, 1994, p. 942). However,eleven years later, the prevalence of drinking in Nigeria is describedas ‘‘common in all the cultural groups in the country’’ (Ibanga,Adetula, Dagona, Karick, & Ojiji, 2005, p. 144). Similarly, inUganda, alcohol is consumed and accepted in most groups (exceptfor Muslim and reformed Christian groups) even though womenare not expected to drink in public (Tumwesigye & Kasirye, 2005).

The dichotomy of dry=wet cultures (Room & Makela, 2000) isanother typology often used for comparisons within a European con-text (Allamani, Voller, Kubicka, & Bloomfield, 2000; Norstrom, 2002;Room & Bullock, 2002). In the European Comparative AlcoholStudy, the participating European countries were classified as dry orwet according to the prevalent patterns of alcohol use; southern coun-tries were tendentiously classified as wet and northern countries asdry (Norstrom, 2002). Concerning the European countries included

in the current study, the United Kingdom, where beer dominatesamong alcoholic beverages and binge-drinking is ‘‘currently com-monplace’’ (Miller, Plant, & Plant, 2005, p. 462), is categorized aswet. The United Kingdom is one of the countries where alcoholproblems are recognized as significant social problems. The CzechRepublic and Spain are also labelled as wet countries, whereas Swedenis labelled as dry because the consumption level is low and weekdaydrinking less usual. In a global context, this dichotomy is less useful.

GENDER AND ALCOHOL

In contemporary social life, alcohol and drinking have important,particular, and gender specific symbolic values. Eriksen (1999) indi-cates how shifts in gender roles have led to modifications of genderedalcohol cultures. For example, the female Scandinavian ‘‘role model’’is no longer is a non-drinker. The symbolic value of alcohol for ‘‘thefree’’ European woman has also been described by Bergmark (2004)and Papagaroufali (1992).

Especially during the post-war era, extensive changes in drinkingpatterns, family structure, social life, and gender roles occurred.Family and gender roles are different today compared to the situationone generation ago. Extensive changes in both legislation and normsystems have occurred. One way to study such changes is via thesocial life of women and men. In western life, alcohol and contem-porary drinking patterns form important and symbolic tools forsociability, (liberated) social roles, and modern life styles.

Previous research points at great cultural variation in patterns ofalcohol use among women and men (Holmila & Raitasalo, 2005).Outside the industrial world, women have access to alcohol becausethey often control the production process and the distribution ofalcoholic beverages (Heath, 1991). However, drinking norms in thesecultures often imply modest alcohol consumption—or abstention—for women.

There has been a certain convergence between sexes, at least in theWestern world (Holmila & Raitasalo, 2005), but women generallystill report less drinking, intoxication, and alcohol-related experiencescompared to men (Wilsnack & Wilsnack, 1997). The gender differ-ences in drinking patterns and levels have partly been described asbased on biological and social factors, but they still remain largely

unexplained (Holmila & Raitasalo, 2005). Findings from previousreviews and major studies in this field of research (Heath, 1991;Wilsnack & Wilsnack, 1997) indicate gender based norms, values,attitudes and expectancies as probable explaining factors.

In a European comparative study of drinking levels among womenin nine countries between 1961 and 1997, countries displayed lessdispersion in the late 1990 s (Allamani et al., 2000). In a study ofthe reunited Germany, Bloomfield et al. (2005b) found convergencetendencies both between regions and between genders. From a pers-pective of globalization, convergence processes on a global leveltoward more similar drinking patterns would be expected. Therefore,an important question remains in this perspective: Is Pittman’s (1965)classification of countries drinking styles still accurate and relevantfor discussions about alcohol-related expectancies when consider-ing gender differences?

ALCOHOL-RELATED EXPECTANCIES

Many women and men appear prepared to tolerate some negativeexperiences as the price they pay for enjoying their drinking (Plant,Plant, & Mason, 2002). People are motivated to bring about effectivechanges through the use of alcohol to the extent that they do not havesatisfying positive incentives to pursue and enjoy (Cox & Klinger,2002). In some cases, the value of drinking may lay in avoidingthe negative consequences of excessive drinking rather than inthe inherent pleasure obtained from drinking a limited amount.Previous research makes obvious the relationship between alcoholconsumption levels and alcohol-related experiences or expectancies(Hauge & Irgens-Jensen, 1990). For example, advanced drinkersmore often report on alcohol-related experiences (Mustonen &Makela, 1999; Nystrom, 1992) and expectancies of alcohol inducedeffects (Leigh, 1989).

In this study, we use indicators for positive expectancies. Inprevious studies, these positive expectancies have proven to be morerelated to immediate effects from drinking, whereas negative expec-tancies deal more with what happens the following day and later(Noar, Laforge, Maddock, & Wood, 2003). Positive expectancieshave also proven to be more closely related to drinking and drinkingproblems when compared to records of negative expectancies (Noar

et al., 2003). Leigh (1989) relates negative expectancies to abstentionbut refers positive expectancies to decisions on drinking levels.

HYPOTHESES

The aim for this study is to analyse data from eleven countries fromdifferent continents and cultures. One main question to be answeredis how drinking is related to positive expectancies on drinking. Inprevious studies, a positive relationship has been at hand so that moredrinking is related to more alcohol-related expectancies. We wouldalso expect cultures where high drinking levels are prevalent to displayhigh frequencies of reports of positive expectancies on drinking.Furthermore, we will analyze the relationship between gender andalcohol-related expectancies. Based on previous research, we expectmen in all countries to report more frequently about positive expec-tancies on drinking compared to women in the same country.

STUDY DESIGN

GENACIS is a collaborative project developed through the workof the International Research Group on Gender and Alcohol, aninternational group of alcohol researchers affiliated with the KettilBruun Society for Social and Epidemiological Research on Alcohol(Wilsnack & Wilsnack, 2002). During the first few years of the newmillennium, a database comprising data sets from national surveysfocusing on drinking behavior, drinking context, and drinking con-sequences was created. In 2005, there were thirty-six data sets in thedatabase. For this study, data from eleven countries (Table 1) was used.

In five of the countries included in this study, nationally represen-tative surveys were carried through. In six of the countries—Nigeria,Uganda, India, Spain, Argentina, and Costa Rica—regional sampleswere used for reasons of practical nature (limited availability offunding or interviewers). In Nigeria and Uganda, sub-regionswere selected so that the different drinking cultures in the countrieswould be represented. In Argentina and Costa Rica, predominantlyurban areas covering about 50% of the population constituted thesampling frame.

ristics

Countr

ies’O

Countr

eria=re

Face-t

956=1,1

Uganda=re

Face-t

758=721

India=re

Face-t

71=1,5

Japan=national

Questionnaires

38=1,1

20–69

Republic=national

Face-t

82=1,2

18–64

Spain=re

Face-t

956=894

eden=national

16=2,6

United

gdom=national

Face-t

38=963

merica

United

tes=national

Face-t

26=0�

entina=re

Face-t

598=402

18–65

Face-t

857=416

Face-to-face interviews were utilized in nine of the countries. TheJapanese survey was completed with postal questionnaires, whereasthe data from Sweden were collected via telephone interviews.Weights were constructed according to information given by nationalsurvey leaders (Gmel, Graham, Kuendig, & Kuntsche, 2006) for allsurvey data except for Nigeria (sufficient information was lacking)and the Czech Republic (weighting was not needed because simplerandom sampling based on population registry).

MEASURES AND ANALYSIS

Two dependent variables—drinking measures—were used for theanalyses. Volume of alcohol (in grams) consumed by day (annualvolume divided by 365 days) was calculated via beverage specific data(beer, wine, spirits, and local beverages such as cider in Sweden orburukutu in Nigeria). Frequency of drinking a specific beveragewas multiplied with usual quantity of that specific beverage perdrinking occasion. Drink sizes and alcohol contents (provided bynational survey leaders) were transformed into grams of pureethanol. Beverage specific volumes were then summed to a measurefor total annual alcohol consumption.

Risky single occasion drinking, or binge drinking, frequencyconstituted the other indicator. For this indicator, frequency ofintense drinking (drinking five drinks or more at the same occasion)was measured. One drink corresponds with twelve grams of pureethanol, with the exception of the Czech Republic, where one drinkcorresponds with twenty grams of pure ethanol.

Because this study focuses on positive attitudes toward drinking,three indicators were chosen as independent variables aimed atmeasuring positive expectancies related to drinking. The three indi-cators are on different levels. On a general social life level, respon-dents were asked whether drinking alcohol made it easier for themto be open with others (social). On a more secluded level, respon-dents were asked whether drinking made it easier for them to talkto their partner (relational). On a private=intimate level, respon-dents were asked whether drinking made sexual activity morepleasurable (intimate). Gender, age, and family status (engagedin romantic relation=living with partner versus no partner) wereused as control variables for the analyses. Descriptive analyses

were made using simple linear regression models stratified bygender and by country.

RESULTS

Abstinence

From Table 2, it is obvious that drinking patterns vary betweenthe included countries. In Japan, the Czech Republic, Sweden, theUnited Kingdom, and Argentina, a majority of respondents drinkalcohol. In the other countries, drinking tends to be less common.In all countries, fewer women drink alcohol than men. The genderdifference is larger in countries where fewer respondents drink. InIndia, very few women drink at all.

Drinking patterns

Turning to volumes of alcohol, the results are somewhat unexpec-ted. In African and Asian countries, where relatively few men drinkalcohol, those men who do drink alcohol tend to drink as much or

TABLE 2. Survey Data Sets

Country No.

Women=Men

(Unweighted)

Consumers %

Women=Men

Mean Daily

Volumea, g,

Women=Men

RSODb %

Women=Men

Africa Nigeria 900=1049 23.0=42.9 26.25=31.37 48.8=58.3

Uganda 703=678 39.7=51.8 13.92=44.32 34.3=64.7

Asia India 1319=1366 6.0=35.2 18.43=35.62 55.7=66.9

Japan 1016=1009 80.3=92.6 5.39=18.57 39.2=75.0

Europe Czech Republic 1201=1172 80.6=91.0 8.89=29.58 43.6=74.3

Spain 689=688 51.4=73.1 8.06=19.94 –=–

Sweden 708=673 85.6=92.1 3.74=7.16 41.6=69.7

United Kingdom 811=775 84.2=91.6 7.92=18.00 –=–

North America United States 1002=– 73.6=– 4.09=– –=–

Central=South

America

Argentina 561=367 76.8=92.5 2.92=15.20 12.4=59.8

Costa Rica 713=354 43.3=67.4 3.06=10.43 26.7=51.4

RSOD ¼ risky single occasion drinking (also known as binge drinking).aDrinkers only.bMonthly or more frequent RSOD drinkers only.

more than men in the other countries. Among female respondents,the situation is the same. The highest mean drinking levels amongdrinking women are found in Nigeria, Uganda, and India.

A completely different drinking pattern is found in some of theEuropean countries. In the Czech Republic, Sweden, and the UnitedKingdom, almost all respondents drink alcohol but on different levels.Czech women and men drink more than United Kingdom women andmen, who in turn drink more than Swedish women and men.

Binge Drinking

Risky single occasion drinking, otherwise known as binge drink-ing, is more common in countries were drinking levels are high. InIndia, more women report binge drinking than those in any othercountry. The reader should, however, bear in mind that few womenin India drink alcohol at all. Swedish women and men score relativelyhigh on reports of binge drinking but very low on consumption levels.Respondents from Africa, Japan, and the Czech Republic also reportmore often than other respondents on binge drinking.

All in all, the countries included in the analyses can be groupedinto three discernible groups. Low frequency drinking countries arethe United Kingdom, the United States, Argentina, and Costa Rica.High frequency drinking countries are Nigeria, Uganda, India, theCzech Republic, and Spain. Low frequency drinking countriesinclude Japan and Sweden, but the frequency of binge drinkingis high.

Alcohol Expectancies

Reports of expectancies on the effects of alcohol vary betweencountries (Table 3), but the three indicators form similar patternswithin our countries. Expectancies that drinking makes it easier tobe open to others (social), makes it easier to talk to a partner (rela-tional), and makes sex more pleasurable (intimate) were included asindicators. Respondents (both women and men) from Latin countriessay that they never have such expectancies more often than respon-dents from other countries. In countries where binge drinking is morecommon, more respondents also have these positive expectanciesrelated to drinking.

We expected cultures where high drinking levels are prevalentto display high frequencies of reports of positive expectancies on

Tabula

Expecta

Drinkers

Countr

(Socia

imensio

tionalD

imensio

(Intim

Countr

Usually

45.8=38.8

30.8=34.5

23.4=26.8

52.5=43.3

29.5=32.8

18.0=23.9

53.3=44.4

29.6=36.9

17.1=18.7

Uganda

29.3=24.9

37.8=24.9

33.0=50.1

41.9=30.4

29.2=31.3

28.8=38.3

52.3=43.6

22.9=26.9

24.8=29.5

41.8=29.6

26.6=25.6

31.6=44.8

44.9=35.7

25.6=28.2

29.5=36.1

81.0=60.3

16.5=27.6

2.5=12.1

37.6=23.5

46.7=54.4

15.7=22.1

47.0=37.3

40.7=46.8

12.3=16.0

73.4=65.7

23.5=28.2

3.0=6.1

19.8=13.9

48.7=45.4

31.5=40.6

40.1=40.6

45.1=41.9

14.8=17.5

53.5=50.4

34.3=37.2

12.2=12.4

67.9=66.2

23.0=24.4

9.0=9.4

82.6=81.9

13.4=14.6

4.0=3.5

84.1=86.6

12.8=11.3

3.1=2.1

35.3=29.1

37.7=36.0

27.1=34.9

78.0=76.6

16.6=16.8

5.4=6.6

71.5=74.8

23.8=20.2

4.8=5.0

United

29.7=24.0

37.7=37.2

32.5=38.9

73.5=66.8

17.4=21.1

9.1=12.1

66.6=65.0

26.1=27.8

7.4=7.2

United

42.4=-

39.4=-

18.3=-

entina

83.2=63.4

11.2=15.1

5.6=21.4

92.6=88.8

4.6=7.3

2.8=3.9

95.2=86.6

4.1=8.9

0.8=4.5

a59.7=51.0

26.8=29.4

13.4=19.7

70.8=67.7

17.7=16.9

11.5=15.4

66.1=61.2

21.1=21.9

12.8=16.9

drinking and vice versa. Even though results do not point in onedirection only, the hypothesis proved to be true for three of the five‘‘high frequency’’ countries—Nigeria, Uganda, and the Czech Repub-lic. Also in India, men and the few women who do drink tend to reportabout social and relational positive expectancies related to drinkingmore frequently. Spain, however, seems to be more similar to the lowfrequency consumption Latin countries (Argentina and Costa Rica)in that respondents in these countries report less often of positive expec-tancies on drinking. As expected, few United States (women only),Japanese, Swedish, and United Kingdom respondents report on posi-tive expectancies, with the exception of Swedish and United Kingdomrespondents reporting high on the social dimension of expectancies.

Drinking Patterns & Alcohol Expectancies Association

The next step for the analysis was to enter the variables into aregression model, aiming at analyses of links between drinking pat-tern and expectancies. A few reservations should be presented first.In India, there are too few women drinkers (Table 2) to permit anyconclusions about statistical significance, so coefficients for Indianwomen are presented for preliminary descriptive purposes only andwill not be discussed. As countries applied different sampling pro-cedures, coefficients for the factors included in the models foreach country are not exactly comparable to one another and willnot be compared directly, but overall trends can be stated and willbe discussed. In spite of this, we argue that the data permit compar-isons of directions of associations, hence giving a broad picture of therelationships between variables in different countries.

Results from the multiple regression analyses are presented inTables 4–7, separate for genders and the two indicators of drinkingpattern (volume and occurrence of binge drinking). Only currentdrinkers are included in the analyses. Age and family status were usedas control variables.

A Women’s World

There are different patters found in different countries. Women inJapan and the United States who expect alcohol to make it easier tobe open to others and talk to their partner drink more than otherwomen in these countries (Table 4). Nigerian and Czech womenwith expectancies on alcohol making general social life easier drink

Multip

rinkin

Positiv

xpecta

rinkin

imensio

tionalD

imensio

Countr

United

Republic

�0.0

�0.9

entina

United

Uganda

�0.0

�0.1

�0.0

�0.4

Multip

odelfo

Drinkin

Positiv

xpecta

rinkin

imensio

tionalD

imensio

Countr

––

United

––

Republic

�0.0

�0.9

�0.0

�0.1

�1.9

entina

�0.0

United

––

Uganda

�0.0

Multip

rinkin

Positiv

xpecta

Drinkin

imensio

tionalD

imensio

Countr

�0.0

�1.1

United

Republic

�0.0

�0.9

entina

�0.0

�0.7

United

––

Uganda

�0.0

�1.0

Multip

odelfo

Drinkin

Positiv

xpecta

rinkin

en Socia

imensio

tionalD

imensio

Countr

––

United

––

Republic

�0.0

�1.1

entina

United

––

Uganda

�0.0

�0.1

�0.0

�0.3

�0.0

�1.3

�0.1

more than other native women. United Kingdom women whoexpect alcohol to make it easier to talk to their partner also drinksignificantly more than other United Kingdom women. On themore intimate level respondents were asked whether drinkingmade sexual activity more pleasurable. Women in Spain, the UnitedKingdom, the Czech Republic, and Costa Rica who admit tohaving such expectancies drink significantly more than other womenin these countries.

Similar inconclusive results are at hand for the binge-drinking indi-cator (Table 5). Women from Sweden, Nigeria, Argentina, andUganda who expect alcohol to make general social life easierbinge-drink significantly more than other women from those coun-tries. Women from Argentina and Japan who expect alcohol to maketalking to their partner easier, also binge-drink significantly morethan other native women. Czech women who expect alcohol to makesex more pleasurable binge more frequently than other Czech women,while Nigerian women who hold these expectations binge less oftenthan other Nigerian women. Age and family status was significantlycorrelated with binge drinking for Swedish and Japanese women.

A Man’s World

Men in general, including those Latin countries, Japan, and theCzech Republic who expect alcohol to make it easier to be open toothers, drink more than other men in these countries (Table 6).Men in Uganda and the United Kingdom who expect alcohol tomake it easier to talk to their partner also drink significantly morethan other native men. Men in three of the Latin countries (Spain,Argentina, and Costa Rica) and the Czech Republic who admit tohaving expectancies of alcohol making sexual activity more pleasur-able drink significantly more than other men in these countries.

For the binge-drinking indicator (Table 7) and male respondents,men from Nigeria who expect alcohol to make it easier to be openalso engage in binge-drinking significantly more than other men fromthese countries, whereas Indian men with these expectancies binge-drink less often than other Indian men. Men from Nigeria, Uganda,Japan, and India who expect alcohol to make talking to their partnereasier binge significantly more often than other native men. Menfrom Costa Rica and India who expect alcohol to make sex morepleasurable also binge more frequently than other native men.

DISCUSSION

The aim of this study was to examine how drinking is related topositive expectancies on drinking. In previous studies, a positiverelationship has been found, so that more drinking is related to morealcohol-related expectancies. The results from the current study arenot easy to interpret. In some countries, indicators of alcohol-relatedexpectancies proved to be related to drinking pattern, but in no coun-try, and for no subgroup studied, were all three indicators of alcoholrelated-expectancies significantly related to drinking patterns whenother expectancy indicators, age, and family were controlled. Notonly are the tables inconclusive and the power of the models (asexpressed in the value of adjusted R2) low, but this is to be expectedfrom a database such as this because many other individual andsocio-economic factors influence alcohol consumption. The evidencein these data of a clear impact on drinking patterns of positiveexpectancies seems inconsistent across countries. However, a generaltrend is observed because we only detect two significant ‘‘negative’’associations.

Furthermore, the aim was to analyze the relationship betweengender and alcohol-related expectancies. Based on previous research,we expected men in all countries to report more frequentlyabout positive expectancies on drinking compared to women in thesame countries. This hypothesis was confirmed in the data fromall GENACIS countries included in this study. Gender differencesin some countries are so large that it would be more correct todescribe the drinking culture as two separate cultures—one femaleand one male.

We expected cultures where high drinking levels are prevalentto display high frequencies of reports of positive expectancies ondrinking. However, the countries where drinking is commonplaceare not the same countries where drinking is frequently done in highvolumes. In India, few respondents drink at all, but those who dodrink a lot and often in excess (binge drinking), and current drinkerrespondents (female and male) more often have positive expectan-cies of alcohol compared to most other countries. African countries(Nigeria and Uganda) also display high levels of (female and male)drinking and high levels of positive alcohol-related expectations.

In these three countries, only a minority of women drink alcohol.This is an indication of drinkers in these countries being more out

of the ordinary compared to drinkers in countries where drinking isthe norm. Another interpretation is that some women in these coun-tries choose to abstain rather than to be ‘‘low’’ level drinkers. Thechoice of abstention can be due to economic or religious reasons,resulting in the fact that women drinkers are mostly regular drin-kers and, thus, the mean drinking level is higher than in countriesin which a larger proportion of the women population do drink.The relationship between expectancies and alcohol consumptionlevels is thus more related to high level drinkers, and countrieswhere drinkers are more equitably distributed between low and highconsumption levels are displaying weaker associations between alco-hol use and expectancies.

Latin countries (Argentina, Costa Rica, and Spain) in which drink-ing is prevalent among men but does not result in high volumes ofconsumption display a fairly uniform pattern. In these countries,positive expectancies related to alcohol are less often reported. Thiscan be interpreted as related to alcohol’s position as a part of thedaily meal rather than as an intoxicant.

LIMITATIONS

The GENACIS database forms a unique opportunity for com-parative analyses. At the same time, a database such as this hasseveral problems. First, datasets are not identical. Some countriesincluded all questionnaire items whereas others delete some ofthem. Some countries construed alternative responses to items.Modes for data collection and response rates varied between coun-tries (Table 1). Apart from this, there might also be differences inhow respondents from different cultural settings interpret questionsposed to them. Furthermore, we use three indicators for positiveexpectancies related to drinking. These three indicators are meantto measure different aspects of these expectancies, social, relational,and intimate. In an ideal world, we would have access to a large num-ber of indicators, but this is not currently realistic. In India, there arefew women drinkers (Table 2) (too few for any conclusions aboutstatistical significance) so coefficients for India are presented forpreliminary descriptive purposes only. Another limitation is seen inthe fact that the explained variances (adjusted R2) from the regressionmodels appear as moderate to low. However, it is important to

consider that many other individual and socio-economic factors arerelated to alcohol consumption to higher extent than expectancies.

1. These data form part of the project Gender, Alcohol and Culture: An International

Study (GENACIS). GENACIS is a collaborative international project affiliated with the Kettil

Bruun Society for Social and Epidemiological Research on Alcohol and coordinated by GEN-

ACIS partners from the University of North Dakota, the University of Southern Denmark, the

Free University of Berlin, the World Health Organization, the Pan American Health Organiza-

tion, and the Swiss Institute for the Prevention of Alcohol and Drug Problems. Support for

aspects of the project comes from the United States National Institute on Alcohol Abuse

and Alcoholism=National Institutes of Health (Grant Numbers R01AA04610 and

R21AA12941, Sharon C. Wilsnack, principal investigator), the European Commission (Quality

of Life and Management of Living Resources Programme, Contract QLG4-CT-2001-0196; Kim

Bloomfield, coordinator), the World Health Organization (Isidore Obot, coordinator), the Pan

American Health Organization (Maristela Monteiro, coordinator), the German Federal Minis-

try of Health, the German Federal Ministry of Health, and Swiss national funds (BBW

01.0366). Support for individual country surveys was provided by government agencies and

other national sources. For this study, financing for the participation of K. H. Bergmark

was provided by the Alcohol Research Council of the Swedish Alcohol Retailing Monopoly.

Data coordinator for the GENACIS project is Gerhard Gmel, Swiss Institute for the Prevention

of Alcohol and Drug Problems, Lausanne, Switzerland.

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Pleasures of Drinking: A Cross-Cultural Perspective

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