Book Review: Alcohol Policy and the Public GoodAlcohol Policy and the Public Good, by EdwardsGriffith et al. (Oxford, New York and Tokyo: Oxford University Press, 1994), 226 pp., $26.95 (paper only).

Alcohol Policy and the Public Good, by Griffith Edwards et al. (Oxford, New York and Tokyo: Oxford University Press, 1994), 226 pp., $26.95 (paper only). In a collaborative project underwritten by the World Health Organization and many national research institutes, Griffith Edwards and a number of internationally known alcohol policy researchers have provided the latest word on the extent to which alcohol policy saves lives and prevents disease. The bottom line is Quite a lot. Alcohol Policy and the Public Good is an updating of and sequel to a widely read and politically influential book of 1975, Alcohol Control Policies in Public Health Perspective, edited by Kettil Bruun et al. and published by the Finnish Foundation for Alcohol Studies. In the present volume, Edwards says that the current project undertook a somewhat different approach to the problem of conceptualizing alcohol problems in society, although more space could have been devoted to the differences in assumptions between the two projects. Presumably the present group of authors, some of whom, like Edwards, contributed to the first volume, wanted to strike a note of independence from the earlier project. The book represents something of a testimonial to the past 20 years in alcohol policy research and to the success of a relatively small group of researchers in Europe and North America in securing official patronage to trace the public health consequences of alcohol in commodity or market-based societies (for the most part) and to measure the impact of various policy initiatives to reduce those problems. It has been an interesting history, one in which the research agenda has expanded steadily, with a substantial payoff for policy making. As a result, we now know a great deal about what happens when alcohol is taxed, what happens to rates of drunk driving for the 18-21 age group when the legal age for drinking alcohol is changed, and what forms of information given to the public about the risks of alcohol seem to have the most favorable impact. We still don't know as much as we might wish about long-term trends in alcohol consumption across societies that are quite different in their political and social structure, or even across societies that are quite similar in their major institutions. Nor do we know much about those occasions when alcohol policy moves to the top of the political agenda, and what factors are at play when alcohol policy decisions are taken. The introduction by J.E. Asvall, director of the World Health Organization in Europe (Copenhagen office), argues that Alcohol Policy and the Public Good represents what scientists can tell policy makers about alcohol policy. I think this is only partially true. First of all, the book is written in the ponderous and leaden "official style" of WHO, with its curious English paraded almost as a banner of international political correctness. Sentences like "Across space and historical time and within the context of culturally determined systems, administrative formulae, and belief as to the fundamental nature of the target issue . . ." follow one after another. The various governments are referred to as "responsible administrations," and they are enjoined not to sit passively and watch "the flow of the [alcohol policy] tides." The authors replace vagueness with a numbing complexity. They argue that although the word "alcoholism" is widely used, it still has no precise meaning. Instead, they propose "the biaxial concepts of alcohol problems and alcohol dependence (p. 20, emphasis in original). The editor at Oxford either must have been asleep or simply gave up at the sheer task of translating this document into readable prose. I suspect that Edwards and his colleagues believe that because the alcohol policy research record is now so much more extensive than in 1975, the impact of their labors will be all the greater. I seriously doubt it. The earlier book answered a straightforward question: Does total consumption matter in attempting to reduce the level of alcohol-related problems in society? …