It has been clearly shown that presumably similar amounts of alcohol tend to have different health effects (both beneficial and adverse) in different cultures. Greater health benefits from moderate alcohol intake have been shown, for example, in southern European countries (where wine with meals is common) than in more northern European countries, where beer and spirits are more likely to be consumed and usually not with food. Some of these differences may relate to the beverage consumed, while others may relate especially to different patterns of consumption. Further, in certain cultures, intoxication after drinking is expected and even tends to not be condemned. In the typical Italian culture, however, it would not be socially acceptable for a guest at a family dinner to become overtly intoxicated, and such would probably be less often reported in an epidemiologic study even if it had occurred. Thus, similar rates of alcohol-use disorders would be ascertained differently in different countries.
We know that the net effect of alcohol consumption relates to the amount of alcohol, the type of beverage, the rapidity of consumption, whether drinking with or without food, and surely a number of genetic factors of the drinker. What we are often unsure about is what the cultural context of drinking is for an individual subject or subjects in a certain population: different cultures seem to help control, or not control, the risk of drinking excessively. As pointed out by the present paper, these factors complicate the comparison of results of epidemiologic studies from different cultures.
In planning and interpreting results of epidemiologic studies, investigators now realize that simply estimating the average alcohol consumption over a period of time, usually a week, is inadequate to quantify alcohol exposure. The pattern of consumption (especially whether with or without food and whether regularly or in binges) is especially important. And, as the present study points out, knowing about the cultural aspects of drinking for a specific population is also key to interpreting the results. How best to do this, so that studies in different countries can be compared, remains difficult.
Reference: Rehm J, Room R. The cultural aspect: How to measure and interpret epidemiological data on alcohol-use disorders across cultures. Nordic Studies on Alcohol and Drugs 2017;34:330–341. DOI: 10.1177/1455072517704795