Different alcoholic beverages are seen as causing more or less trouble, with spirits historically often seen as the most troublesome. Differences in "trouble per liter" could reflect differences in the beverages themselves (e.g., faster effect of stronger beverages, additives/contaminants in informal beverages), or could reflect characteristics of those drinking each beverage. Using two alternative definitions of beverage choice and measures of personal and social consequences of drinking, the article examines trouble per liter among beer, wine, and spirits drinkers in 19 different societies represented in the GENACIS dataset. There is no general pattern that holds across cultures of more or less trouble being associated with a particular beverage type. Wine seems to be less associated with trouble than beer or spirits in a number of societies, but there are counterinstances in other societies. There is no overall trend across cultures in comparing trouble associated with beer and with spirits. In a number of societies, drinkers with no predominant beverage report more problems than those mainly drinking beer or wine. Controlling for gender and age reduces the tilt towards less trouble from wine drinking, particularly for social consequences of drinking.
KEY WORDS: Alcoholic beverage choice, beer, wine, spirits, alcohol problems, cross-national, GENACIS project.
Distilled spirits drinks, which usually have a higher alcohol content than fermented drinks, are widely regarded as more harmful than the latter, even at equivalent levels of consumption. Reflecting this view, spirits beverages have often been kept more restricted in availability than fermented beverages, e.g., through confining spirits sales to government retail stores or through licensing fewer outlets to sell them. In most countries, higher taxes per unit of ethanol are charged on distilled than on fermented beverages.
The differential restrictions by type of beverage have clear historical roots. England had its "gin epidemic" in the 18th Century (Coffey, 1966), and other European countries - and their colonies in the period of European empires - also had periods of a national binge on distilled spirits at some time in the course of the last three centuries (e.g., Hauge, 1978). Distillation on an industrial scale was a feature of early stages of industrialization, and the resulting social and health problems from ready availability of cheap spirits ("drunk for a penny, dead drunk for twopence") were obvious to all. The great temperance movements of the 19th and early 20th centuries can be seen as societal reactions to the effects of these waves of cheap spirits (Rorabaugh, 1976).
In some places, these temperance movements eventually succeeded in imposing complete prohibition of alcohol sales for a shorter or longer time (Schrad, 2010), and the experience of prohibition also pointed differentially to spirits as a source of problems. With prohibition, very quickly almost all illicit alcohol was in the form of spirits, the least bulky and most concealable way of transporting and supplying a given quantity of ethanol. The already negative reputation of spirits was thereby further heightened. Thus, when prohibition was repealed where it had been enacted, preference in terms of greater physical availability and lower taxation was often given to "lighter" beverages.
Despite the weight of historical experience, present-day studies do not necessarily find big or consistent differences between types of alcohol beverage in the "harm per liter" of ethanol. It is clearly much easier to die of an overdose of alcohol from concentrated spirits than from beer, but there are few other consistent differences between beverages in other physiological or mental risks (Mäkelä, Mustonen, & Österberg, 2007). It is clear that violence and other social problems are often differentially associated with different beverages, but they are not necessarily more common with stronger beverages. …