Rethinking drinking cultures: A review of drinking cultures and a reconstructed dimensional approach

Article Outline

• Summary
• Introduction
• Methods
• Results
  • Drinking cultures: the importance of sociocultural contexts
  • Drinking cultures: variations
  • Drinking cultures: homogenization
• Discussion
  • Drinking cultures: a new typological order
  • Drinking cultures: research needs
  • Review limitations
• Conclusions
• Ethical approval
• Funding
• Competing interests
• Acknowledgments
• References
• Copyright

Summary 

Objectives

This paper presents the synthesis of findings from a literature review study of drinking cultures across five West European countries (France, Germany, Spain, Sweden and the UK), examining the nature and features of drinking typologies before proposing a new dimensional approach.

Study design

The study incorporated a systematic literature search covering the period 1980–2010 for literature from each of the five countries.

Methods

Researchers reviewed abstracts and selected relevant material, leading to the inclusion of 203 articles from database searches plus 26 records from other sources. A summary of key findings are presented here. Intercoder reliability checks were performed to ensure consistency in inclusion in the review according to pre-ordained selection criteria. The review was further supplemented by the inclusion of gray literature including policy documents obtained from a range of sources.

Results

It was found that sociocultural contexts have a major influence on drinking cultures, and this is an area in which there have been dramatic changes over the past 30 years. Differences were found between the countries in terms of drinking cultures, the way in which alcohol is viewed, and how alcohol-related policy and practice operates. However, there seems to be an increasing homogenization of drinking cultures across many countries, strongly influenced by Anglo-US cultural zeitgeist. Modern drinking patterns have emerged, offering a complex and often overlapping schema of drinking typologies.

Conclusions

The study suggests that the wet–dry dichotomy is no longer relevant and that a revised version of a more recent dimensional approach featuring three dimensions – hedonism, function and control – may be better placed to describe and measure contemporary drinking cultures.

Keywords: Alcohol, Drinking, Cultures, Literature review, Countries, Typology, Dimensions

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Introduction 

In many cultures, alcohol, as a Kulturdroge (cultural drug), is used to facilitate social interactions and is seen to have many other benefits.¹, ², ³ However, alcohol consumption is also associated with a broad range of health and social problems,⁴, ⁵, ⁶, ⁷ with binge drinking patterns becoming progressively more embedded in some Western European cultures.⁸, ⁹, ¹⁰ Consequently, there is a need to better understand the role of alcohol in different social and cultural contexts so that lessons can be drawn about how to influence consumption patterns with a view to minimizing harm associated with excessive consumption.¹¹

This paper presents a synopsis of learning from key texts identified in a review which examined different drinking patterns and cultures in five West European countries chosen in consultation with the research funder (France, Germany, Spain, Sweden and the UK). For the purposes of this review, the focus in terms of drinking patterns was on variables including drinking status or abstinence, frequency of drinking, amount consumed, drinking location (pubs/home/workplace), drinking context (such as with meals or special occasions) and beverage preference (beers/spirits/wine). In relation to drinking cultures, the focus was on factors influencing drinking including cultural mores and norms, demographics and socio-economic factors. However, it should be acknowledged that the concept of drinking patterns can include other variables. Furthermore, the question of what constitutes drinking cultures is somewhat abstract and open to interpretation. Key themes influencing drinking cultures identified in the literature, and their nature and function are reviewed, along with the importance of sociocultural contexts for drinking cultures. In addition, variations across countries in relation to drinking cultures are examined, and the issue of the extent to which drinking cultures are becoming more homogenized across Western Europe is assessed. Distinct from taking an epidemiological approach to alcohol issues, this study utilizes a consumer orientation perspective to gain insight on factors influencing drinking and the role of alcohol in society. Understanding some of the factors that influence drinking cultures can offer insight into the reasons why people drink the way they do, and inform intervention strategies. Finally, the implications of the review findings on established typologies of drinking, and opportunities and challenges for future research are discussed.

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Methods 

The article presents a synthesis of a literature review commissioned with the aim of summarizing current understanding of different drinking patterns and cultures in Western Europe.¹² The review explored recent changes in drinking cultures and any correlates and influencing factors for these changes. The review also informed a qualitative study of drinking cultures in Scotland.¹³

The search parameters included: primary research (focusing on cultures rather than individual level behaviors); national level policy documents including alcohol strategies and analytical commentaries; and international studies and publications such as World Health Organization (WHO) reports, systematic reviews and reviews conducted by groups of experts.

A list of relevant search terms was created, including, although not restricted to: alcohol, drink, society, culture, consumption, patterns and the target countries. A series of five electronic databases was searched. Table 1 lists the databases used and the types of literature they contained. This was augmented by a series of German language databases.

Table 1. Electronic databases used.

Searches were conducted in March 2008 and again in March 2010, and were limited to records dated from 1980 to 2010. Language limits were set to English, French, German, Spanish and Swedish. Table 2 details an example search strategy used.

Table 2. Example search strategyDatabase: International Bibliography of the Social Sciences (IBSS)Host: WebSPIRS, Ovid TechnologiesYears covered: 1951 to dateYears searched: 1980–2010On: 25 January 2010Results downloaded: 294.

Note: #8 and #9 make up a descriptors filter (subject and geographic descriptors), #13 uses an alternative geographic filter.

From this, a list of abstracts were obtained and two researchers read a proportion of abstracts to select relevant articles. Intercoder reliability checks were conducted, with each researcher reviewing a sample of 20% of the other researcher’s inclusions to check for consistency. Inclusions were not assessed for quality. Two hundred and three articles, books or book chapters were identified for retrieval from these searches. All of these were retrieved except six which were unavailable. In addition, 36 records consisting of gray literature including policy documents, other national and international documents and publications, and journal articles were obtained from in-house collections, Google searches and following up of references. Data extraction was then performed and, in the case of literature concerning multiple countries, data relevant to the five countries included in the scope of this review were extracted. It should be noted that there are occasions when referenced literature did not include all five countries. Instances when this is the case are noted in the text. A diagram of the literature selection process is presented in Fig. 1. The review process and findings also benefited from comments from 11 international experts on alcohol and drinking cultures. The findings from the literature review and key themes that emerged are summarized henceforth.

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• Fig. 1 

  Flowchart of literature selection process. ^aNote: 36 additional records were obtained from other sources, including policy documents and gray literature searches.

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Results 

Drinking cultures: the importance of sociocultural contexts 

A key theme influencing drinking cultures that was identified was the role of sociocultural contexts. Throughout much of the Western world, alcohol plays an important role as a social lubricant that is associated with various celebrations, business, and social and sport functions, and is consumed in religious and cultural ceremonies as well as festive and transitional rituals.¹, ³ Drinking alcohol also serves as an expression of comradeship and solidarity, and is a drug widely used to facilitate social interaction and bonding.¹ Giving an indication of the degree to which alcohol consumption is embedded in culture, its various functions as a regulator of mood and emotions are often denoted in figures of speech.¹⁴ Indeed, as Mandelbaum points out:

in some languages, as in English, the very term ‘drink’ takes on the connotation of drinking alcoholic liquids¹⁵ (p. 281).

The role that alcohol plays in facilitating social interaction is reflected in places designed for drinking, providing insights into the way alcohol is regulated both formally and informally.¹⁶ Runge (1987), for example, described typical drinking patterns in Germany which resonate across a range of Western cultures. Public houses thus tend to their own social norms with which people identify that are negotiated between customers and staff, enabling the sanctioning of undesirable behaviors of customers.¹⁷ A landlord may thus occupy a key position in determining a pub’s culture. Importantly, a pub atmosphere disengages individuals from their social status and background. Drinking places are thus environments designed to be socially inclusive. They facilitate social interaction independent of individuals’ social standings. For example, the ability to hold one’s drink, quick-wittedness, sense of humor and communication skills are constructs that allow for integration into the social milieu different social groupings within a pub setting.¹⁷ The pub thus functions as a means of fulfilling aims such as bonding, conversations, rest, relaxation and stimulation, in addition to consuming alcohol.¹⁸

Social and cultural norms and influences play a pivotal role in influencing alcohol consumption and drinking-related behaviors. While rules governing drinking behaviors vary and are often informal, socially negotiated and acquired via the socialization process, enforcement of ‘drinking laws’, for example by landlords in public houses, can make a difference to drinking and related behaviors. These informal rules and social norms that govern alcohol consumption are reflected in attitudes toward alcohol.¹⁹ For example, in some countries, such as Germany, it is a highly valued skill to be able to hold one’s drink,²⁰ whilst other countries, such as the UK, appear to value and may indeed ‘celebrate’ relatively high levels of intoxication.²¹ Also, people in binge drinking or ‘dry’ countries like Sweden are more likely to attribute consequences to their drinking than those in ‘wet’ countries.²² These variations in level of drinking and drunkenness can be described as the ‘hedonism’ dimension to drinking cultures. Furthermore, there are also differences in the extent of the ‘function’ dimension of drinking cultures, that is the way in which alcohol is integrated into (everyday and special) rituals and transitions.

Culturally defined norms of alcohol consumption also represent a powerful means of regulating drinking behaviors.²³ These predominantly informal rules appear to be acquired through the socialization process, and govern both socially permissible drinking frequencies and amounts, in addition to specifying the occasions when it is permissible to consume alcohol.¹⁵ Additionally, socially learned expectations about what it means to be drunk in a given society also appear to be culturally prescribed,²⁴ suggesting that drunken behaviors largely reflect alcohol expectancies.²⁵ At the same time, however, data also suggest that while drunken behavior appears to be largely culturally construed, overall consumption rates are also associated with violent behaviors and suicide.²³ Social roles – partnership and marriage, parenthood and holding a job – are all related to drinking rates.^26:d, ^27:e

Gender roles also form an important sociocultural driver of drinker cultures. Generally across the included countries, alcohol consumption is higher among men than women. However, in countries in which gender roles have been re-aligned and women have achieved a more equal place in society alongside men, the differences in drinking rates between men and women are smaller.²⁸ These changes have been noticeable in each of the five countries included in the review, in which gender ratios of drinking are largely homogenous. Other sociocultural factors such as modernization, urbanization, changes in the job market, and marriage and divorce rates have influenced these shifts in gender roles, and associated changes in drinking cultures. This suggests that institutional settings and arrangements impact upon drinking cultures more than religious, moral and spiritual influences.²⁸ Social welfare systems across the five countries also influence drinking cultures in each domain. In Sweden, a country with a strong welfare system, women tend to drink more if in employment, if they live in a non-traditional family setting and if they have a low level of education. In France, by contrast, single females have a lower rate of heavy drinking.^29:f For men across all five countries, a higher level of education is correlated with lower rates of heavy drinking. In Germany, higher educated women are more likely to drink heavily.³⁰ In general, the social welfare system and gender equity in a country influence how education, employment and family roles are associated with drinking patterns.^29:f These culturally defined norms and gender roles influence the ‘control’ dimension of drinking cultures (i.e. the extent to which modes of social control impact upon drinking styles).

Drinking cultures: variations 

Notwithstanding some of the variations in relation to sociocultural influences on drinking cultures already discussed, other sources of variation exist. Naturally, given the cultural diversity of the five Western European countries included in the review, variations in drinking cultures were identified. Despite a suggested homogenization of drinking cultures (discussed later) and noticeable increases in binge drinking, cultural variations still exist. These are particularly noticeable concerning the extent to which excessive alcohol consumption is associated with negative expectancies and outcomes such as antisocial behavior.^31:g In the UK, alcohol and antisocial behavior are synonymous, and alcohol is implicated in half of all crime.³² In other countries, such as Sweden, public health concerns frame attitudes.

There are also marked differences in terms of the frequency with which people consume alcohol above ‘safe’ limits. UK drinkers, for example, tend to consume five or more drinks on many more occasions per annum, than do, for example, Germans in spite of lower overall per-capita consumption. Moreover, in a six-country comparison, the UK displayed the highest annual frequency of heavy drinking.⁵, ³³ These variations are extrapolated when considering data in relation to young people; binge drinking among UK youth is the highest in Europe, while it is among the lowest in Spain.¹⁰

Alcohol policy offers another source of variation across the five countries in the review. Sweden has maintained a comparatively strict and robust alcohol control policy with a state monopoly of alcohol sale and supply. Although Swedish control of alcohol policy was weakened somewhat due to membership of the European Union (EU) (e.g. restrictions on duty imports were decreased³⁴), the alcohol policy agenda remains driven by public health concerns.³⁵ Furthermore, Sweden has taken an active and lead role in driving alcohol policy in the EU arena, making alcohol a key focus during the Swedish Presidency of the EU during 2009, and hosting an expert conference on alcohol in Stockholm during September of that year. Conversely, in the UK, alcohol policy has been strongly influenced by the alcohol industry and, in some respects, has become less strict than in other countries, with increasing availability of alcohol, extension of opening hours, and systems of self-regulation in place.³⁶, ³⁷ Furthermore, alcohol policy in the UK has tended to be framed in terms of law and order, and with a focus on binge drinking and young people.³⁸, ³⁹ In France, legislation on alcohol marketing – the ‘Loi Evin’ – strictly controls activity.⁴⁰ In the UK, alcohol marketing continues to operate under a system of co-regulation despite pressures from the public health community.⁴¹ In Spain, attempts to introduce more robust alcohol control policies have floundered.⁴², ⁴³ In the Alcohol Policy Index Ranking, Sweden is ranked 4th, Spain is 17th, the UK is 20th, France is 26th and Germany is 28th, demonstrating the range and diversity in alcohol policy across these included countries.⁴⁴

Drinking cultures: homogenization 

Despite the diversity of sociocultural influences and the variations evident across the drinking cultures of France, Germany, Spain, Sweden and the UK, a powerful theme emerging from the review was a perceived homogenization of drinking cultures across Western European countries.⁴⁵ Using extant typologies of drinking cultures, broad distinctions in terms of drinking culture can be drawn between countries with ‘wet’ drinking cultures and ‘dry’ cultures.⁴⁶ ‘Wet’ cultures such as France tend to be characterized by relatively high per-capita consumption, and young people and children are socialized into drinking from an early age.⁴⁷, ⁴⁸, ⁴⁹ ‘Dry’ cultures, by contrast, tend to have lower levels of per-capita consumption; when alcohol is consumed, it is more likely to lead to intoxication^50; and alcohol does not feature as prominently in the socialization process.¹ It appears that countries with ‘dry’ drinking cultures such as Sweden or the UK tend to have a history of temperance movements,⁵¹ with ‘wet’ cultures traditionally being more likely to consume wine as opposed to spirits.⁵² Thus wine-producing countries with ‘integrated’ drinking cultures show a greater tendency to embed alcohol consumption in everyday social occasions, such as meal times, and tend to have lower abstinence rates.¹, ⁵³

However, this organizational logic of typologies has been challenged in recent years. Scholars have highlighted that distinctions between cultures based on the types of alcoholic beverages typically consumed have implicitly been based on male drinking patterns, rather than reflecting those of both genders.⁵⁴ It has also been argued that it is readily possible to identify four typical types of drinking cultures – abstinent societies, constrained ritual drinking, banalized drinking and fiesta drunkenness – but that these apply to a limited number of societies.⁴⁵ Room and Mäkelä⁴⁵ argue that the wet–dry dichotomy should be replaced by a typology that is based on the regularity of drinking and the extent of drunkenness. They also suggest additional dimensions, including behavior while drinking/intoxicated, the degree to which drinking is segregrated or integrated with other aspects of social life, and modes of social control of drinking.

The review found support for some of these assertions challenging the traditional wet–dry dichotomy. More recent trends toward the homogenization of drinking cultures with decreasing differentiation across countries have been identified.⁵⁵ Consumption levels, for example, are decreasing in many European wine-producing countries such as Spain,⁵⁶ and consumption rates appear to be increasing in Northern Europe.⁵⁰ In France and Spain, there is less of a focus on family mealtime drinking, and in Sweden there is less of an emphasis on solitary drinking than in the past. Alcohol consumption in these countries has also shifted from a single type of drink (varying by age group, social class and location) to consumers drinking many types of alcohol.⁹

In Germany, traditionally a beer drinking culture with some wine-producing regions,⁵⁴, ⁵⁷ beer consumption has steadily decreased³² and wine has become more popular in sections of German society.²⁰, ⁵⁷ In Sweden and the UK, there has also been an increase in the popularity of wine,⁵⁷, ⁵⁸, ⁵⁹ with wine consumption overtaking beer in Sweden by 2006.⁶⁰, ⁶¹ On the other hand, beer consumption is increasing in France and Spain,⁹, ⁶² and is almost comparable with that of wine in the latter. Throughout much of Western Europe, wine has become the most popular drink among women, with increasing attraction for more affluent families due to lifestyle changes and taxation.^57:h Whilst this may intuitively seem like evidence of diversity in drinking cultures, the actuality is that drink preferences are converging across many countries.

In addition to changes in drink preferences, there have also been profound changes in the manner in which alcoholic drinks are consumed. In Sweden and the UK, for example, drinking at the weekends in binge sessions has become the dominant alcohol consumption trend.⁶³, ⁶⁴ These patterns are becoming more common in Spain, where increasing numbers of people, especially younger populations, drink more heavily on the one occasion and more often at weekends, whereas previously drinking was traditionally spread out over the week and involved smaller quantities per drinking episode.⁶⁵, ⁶⁶

Gender differences in consumption rates, while still noticeable,⁵⁴ are also diminishing both in terms of volume and drinking frequency. Although moderate drinking continues to be the norm, an increase in binge drinking patterns among both young men and women has taken place over the last decade.¹⁰, ⁶⁷ Countries in which heavy episodic drinking, particularly among young people, was uncommon have experienced considerable increases.¹⁰ In line with these developments, gender roles in relation to alcohol have changed dramatically over the last two decades or so, and it has become much more socially acceptable for women to drink heavily.⁶⁸

Among young Spaniards, drinking cultures have become more cosmopolitan as a result of external cultural influences and marketing, and are being influenced less by traditions passed down through the generations.⁴⁸, ⁶⁹ Drinking in public places has also become hugely popular, and the botellón phenomenon, where young people meet in public places such as plazas and often consume alcohol before moving on to pubs and clubs, has stimulated much debate in Spanish society.⁵⁷, ⁶⁹, ⁷⁰ Developments of this nature mirror a tendency toward an increase in social drinking which is evident across much of Western Europe.⁹ These developments are influenced by social, cultural and economic factors, and excessive social drinking has become increasingly popular as a hedonistic pastime pursuit.⁷¹

The trend by which drinking cultures appear to be blending throughout Western Europe may thus reflect factors such as homogenization of lifestyles, urbanization, greater female independence, globalization of alcohol marketing (especially for beer, spirits and new beverages), and moves toward greater homogeneity of legislation and regulation (e.g. EU alcohol policies).⁵⁶, ⁷¹, ⁷²

Furthermore, notwithstanding increasing homogenization of drinking cultures, several and often not mutually exclusive drinking cultures may co-exist.⁵⁴ Room and Mäkelä⁴⁵ thus point out that members of industrial societies frequently combine regular (e.g. a few drinks in the evening) and sporadic (e.g. excessive weekend consumption) drinking patterns. In this way, people cannot be easily identified as belonging to one particular drinking culture, as they may belong to several depending on circumstances.

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Discussion 

Drinking cultures: a new typological order 

Traditionally, drinking cultures have been conceptualized in terms of ‘wet’ and ‘dry’, and been applied to a country rather than individuals as the unit of analysis, although this approach has been criticized for not being sufficiently nuanced. Additionally, the increasing homogenization of drinking patterns with trends toward hedonistic drinking, and associated costs to individuals and society, necessitates that drinking cultures are rethought.

It is proposed that there is a need to move beyond the long-established dichotomy of ‘wet’ and ‘dry’ drinking cultures.⁴⁶ In doing so, it is important to recognize the need for a straightforward and intuitive typology of drinking cultures. Given that intemperate alcohol consumption appears to be increasing throughout much of Western Europe, it appears possible to combine Room and Mäkelä’s⁴⁵ typology based on the regularity of drinking and the extent of drunkenness into a single hedonism dimension. Alcohol consumption can feasibly be conceptualized culturally in terms of hedonism and its psychosocial functions. This could capture the extent to which individuals’ general lifestyles with regards to alcohol can, for example, be described as hedonistic (or ascetic). Additionally, the authors propose a further dimension that is concerned with the function (e.g. inter/intrapersonal, ritual, intoxication) that drinking occasions fulfill. This basic dimension could encapsulate many of Room and Mäkelä’s⁴⁵ additional dimensions, although it may be necessary to add a further control dimension to describe the extent to which modes of social control impinge on drinking styles. Such an approach would produce typologies more reflective of contemporary society and culture. Understanding some of the social and cultural factors that influence how people drink, and how this relates to the dimensions identified, can offer insight into understanding the role and meaning of drinking alcohol in society. Moreover, such an approach would be better able to pay more attention to gender differences in developing typologies of drinking cultures.⁵⁴

Drinking cultures: research needs 

Despite the wealth of information gathered by the review on drinking cultures across the included countries, information on drinking in domestic situations (at-home drinking) was somewhat lacking. This suggests that research in this area, particularly given the trend of increasing alcohol consumption at home,⁵⁹, ⁷³ would be welcomed. Further, the review identified a paucity of literature on issues relating to drinking cultures and children. For instance, there was little research into the nature and impact of drinking settings where children may be initially exposed to consumption styles. Also, while drinking cultures influence what, where and how people drink, it is less well documented how young people are socialized into drinking. Given the importance of youth population segments in shaping drinking cultures, not just now but in the future, further research and understanding of this area is necessary.

Review limitations 

There are some limitations impacting upon the inferences that can be drawn from this review of the literature on drinking cultures. Firstly, the review was limited to five Western European countries due to language and translation issues, resource limitations and the requirements of the funding organization. Supplementing the findings of this research with published literature in other languages and from other countries would enrich the discussion. This is particularly relevant given the expansion of the EU during the past decade. Secondly, it was agreed with the funder that the review should only consider texts focusing on cultures rather than individual level behaviors. However, individual behaviors make an important contribution to cultural zeitgeist, and this is the case in relation to alcohol. Whilst several of the tomes identified in this review examine the contribution of individual behaviors to drinking cultures, a more detailed examination of these associations would further our understanding. Thirdly, given the fast paced nature of cultural development, it is almost impossible to produce reviews of this nature that assess the nature and level of all changes that occur. Updates of literature reviews are a good way to address this issue but are dependent on funding and resources to facilitate the process. Finally, when examining sophisticated cultural phenomenons such as drinking cultures, it is extremely difficult to develop firm assumptions on drivers of cultural change. Indeed, the challenge of understanding what drives culture and cultural change is well recognized within scholarly reseach.⁷⁴ Therefore, whilst reviews such as this are informative, they cannot be regarded as the paramount authority on an extremely complicated topic.

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Conclusions 

What this review has illustrated is that drinking cultures are strongly influenced by the sociocultural and political contexts within which they are located. Furthermore, despite obvious diversity and variations, there is firm evidence that there is a degree of homogenization of drinking cultures across European countries. This suggests that previous typologies are outdated and that a new order recognizing the work of Room and Mäkelä,⁴⁵ but importantly incorporating general lifestyle, function and control dimensions, is better able to explain contemporary drinking cultures. The application of this new dimensional approach toward drinking cultures would naturally depend upon the design and purpose of research studies. Nevertheless, consideration of the dimensions proposed here (hedonism, function and control) may assist researchers investigating variations in drinking cultures in contemporary society.

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Ethical approval 

None sought.

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Funding 

Funding for the original review was provided by NHS Health Scotland.

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Competing interests 

None declared.

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Acknowledgments 

The authors wish to thank the following colleagues who contributed to the original review report: Kathryn Angus, Jennifer Dooley, Romain Merlot and Stephen Thomson.

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• d Note: the Plant et al. (2008) study did not include France.
• e Note: the Kuntsche et al. (2009) study did not include Spain.
• f Note: the Kuntsche et al. (2006) study did not include Spain.
• g Note: the Lindman et al. (1994) study did not include Germany, Sweden or the UK.
• h Note: the Ahlström et al. (2001) study did not include Spain and Sweden.