Andrew -- Noone has held to the Ledermann theory in its original form
for years -- since the early 1970s, I would say.
   The more general formulation that there is a regularity in the distribution
of consumption of drinking where alcohol is relatively freely available as
a market commodity (e.g., no rationing) is widely accepted.  In fact, the
lognormality of the distribution of consumer behavior or commodity
consumption is a general phenomenon, not limited to alcohol: you tend to
get a distribution like this whenever the amount an individual's behavior
changes is proportional to their present level of the behavior.
   That rates of alcohol problems tend to go up and down with the overall
level of consumption in a given society is also pretty well accepted.  It's
possible to point to interesting exceptions (e.g., cirrhosis mortality and
alcohol consumption in the US in the 1970s), but there is still the general
rule.
   All of this is anathema to the alcoholic beverage industries, of course,
which resist the idea that selling more alcohol may result in ore troubles.
This may explain why VINEXPO hosted your conference.
   A current source for the "public health approach" is Griffith Edwards et
al., Alcohol Policy and the Public Good, Oxford University Press, 1994.
Robin
 
>>> Andrew Barr <[log in to unmask]> 04/29/98
02:43am >>>
Very little has been published in anything other than statistical journals
about the Ledermann theory, although I did mention it in the British
edition of my social history of drink (pp. 315-6, 320, 323-4). Formulated
by a French statistician called Sully Ledermann, it posits (if that is the
word) that there exists a direct statistical correlation between the
average level of alcohol consumption and the amount of alcohol-related
harm
in any given society. This forms the basis of the "public health model"
(which I think is the US term) or "population" model (the UK term) of
dealing with alcohol problems, according to which alcohol-related
problems
are increased if average consumption increases and decrease if
average
consumption falls, i.e. alcoholism is not a disease that strikes
individuals but a social problem affecting society at large.
 
Obviously this approach has encountered some difficulty in getting
accepted
in the US because it conflicts with the disease theory of alcoholism
propagated by Alcoholics Anonymous and (I believe) pragmatically
adopted by
the medical profession as a means of getting alcoholics into treatment.
Nevertheless, the public health/population model is official WHO policy
and
is supposed to have been adopted by its member countries. It lies behind
the target declared by the WHO some years ago of reducing alcohol
consumption by 25 per cent by the year 2000, which the US government
adopted in its "Healthy People 2000" report published in 1990. So it is
very influential, even if it is wrong (I am no statistician, but I simply
don't understand how it can apply uniformly to different societies with
different drinking patterns, as it is supposed to).
 
But I do believe that its influence must be declining now that all the
evidence about the health benefits of moderate drinking stands in the
way
of the efforts of the WHO and its member states to tell their citizens who
drink moderately to cut down on their alcohol consumption for the sake
of
the national health. That is why I was so surprised to read a report of the
Irish Health Minister advocating precisely this policy - "Less is Better"
being the WHO dictum to get moderate drinkers to cut down.
 
The Alcohol in Moderation Conference at VINEXPO in Bordeaux last June,
in
which I was involved, was basically directed at debunking this approach
-
hence our title, "Is More Better?" Unfortunately, not everyone who made
speeches at the conference wrote them out and no one recorded them,
so we
have only a few transcripts. The speakers were Jancis Robinson,
Thomas
Stuttaford, Diederick Grobbee, Jacques Weill (a statistician who tried his
very best to explain to a lay audience why Ledermann was wrong),
Dwight
Heath and myself. Alcohol in Moderation now has a web site at
http://www.btinternet.com/~aimdigest, and can be contacted by email at
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