Alcohol and Moral Regulation

Public Attitudes, Spirited Measures and Victorian Hangovers

Yeomans, Henry

• Publisher: Policy Press
• Year: 2014
• ISBN:
  9781447323471
• Edition: 1
• Topic: Ciencias sociales
• Subtopic: Criminología

Alcohol consumption is frequently described as a contemporary, worsening and peculiarly British social problem that requires radical remedial regulation. Informed by historical research and sociological analysis, this book takes an innovative and refreshing look at how public attitudes and the regulation of alcohol have developed through time. It argues that, rather than a response to trends in consumption or harm, ongoing anxieties about alcohol are best understood as 'hangovers' derived, in particular, from the Victorian period. The product of several years of research, this book aims to help readers re-evaluate their understandings of drinking. As such, it is essential reading for students, academics and anyone with a serious interest in Britain's 'drink problem'.

SEVEN

Health, harm and risk

Introduction

Chapter Six identified efforts to morally regulate drinking within law and public discourse relating to crime and disorder in the late 20th and early 21st centuries, and found that these efforts were/are, to some degree, shaped by Victorian temperance attitudes. Along with crime and disorder, the other major social problem associated with alcohol in contemporary society is ill-health. Alcohol is consistently connected to a variety of health problems, including liver disease, heart disease, pancreatitis, foetal alcohol spectrum disorder (FASD) and certain types of cancer. Such forms of harm are associated with any forms of excessive consumption but especially with alcoholism, whose sufferers are usually defined by their habitual, compulsive or uncontrolled drinking. To deal with some of these problems, there has been: a promotion of abstinence from alcohol for young people under the age of 15;¹ experiments with bans on super-strength beer and cider;² demands for forceful clampdowns on the number of licensed premises entirely in so-called ‘binge towns’;³ calls for a total ban on all alcohol advertising and sponsorship;⁴ enhanced monitoring of patients’ drinking by GPs;⁵ and most prominently, persistent campaigns for the imposition of a minimum unit price to reduce the affordability of alcoholic drinks.

The significance and prevalence of alcohol-related health problems has been a magnetic topic for public debate and regulatory projects in recent years. Interestingly, public discourse on alcohol and health has been increasingly shaped by a variety of campaign groups, including public health organisations and professional medical bodies. Minimum unit pricing (MUP), in particular, has been tirelessly promoted by such groups.⁶ The prominence of doctors, surgeons and epidemiologists within this health-focused discourse might imply that a more evidence-based approach to the social problem of alcohol, disconnected from the moralistic attitudes of the past, is emerging. Such a transformation would be consistent with the apparent triumph of the harm-based libertarianism of Hart over the legal moralism of Devlin in the 1960s, described in Chapter Five. It would also resonate with the macro picture of social change painted by sociologists Ulrich Beck and Anthony Giddens, in which the rise of a social order dominated by rational, secular assessments of catastrophic risk serves to sideline more traditional moral considerations.⁷ In regards to alcohol, to what extent is this accurate? Does this new public health coalition espouse a historically novel, scientific approach to alcohol? Have projects to morally regulate drinking been altered by these issues of health, harm and risk?

This chapter examines the development of drinking as a health problem from the 18th century onwards. It includes sections on health broadly as well as alcoholism specifically. Although sometimes characterised as a moral, social or psychological condition, it is usual in current parlance to frame alcoholism as ostensibly a health problem of some form. Its discursive development also tends to run parallel to the construction of wider alcohol-related health problems in the sense that two significant shifts have been identified in their recent histories. These are, first, the replacement of traditional and explicitly moral understandings of drink problems with medical ideas in the mid-20th century and, second, the emergence of a public health-oriented approach to governing drink in the late 20th century, which concentrated on total per capita consumption.⁸ With an intensive concern for developments in the 1960s and 2000s, this chapter examines the changing construction of alcohol as a health problem through time.⁹

Drink, health and moral health until the 1960s

Historians and social scientists studying health discourse related to alcohol tend to identify a new approach that has developed since the mid-20th century. The ‘value-based morality’ of the temperance movement is seen to have been replaced by medical or scientific understandings of alcohol-related health problems.¹⁰ Thom examines how the medically inspired ‘disease model’ of alcoholism attained dominance over the older ‘moral model’ during this period.¹¹ Nicholls further describes how ‘the moral argumentation’ of temperance activists was replaced by the apparently ‘morally neutral language of science’ in which the consequences of drinking are awarded primary importance.¹² Sulkunen argues that consensus on what constitutes the moral ‘good life’, as well as the legitimacy to promote this through public regulation, has been overridden by a process of ‘normative neutralization’.¹³ He claims that the saturation of contemporary Western societies with the principle of universal individuality has fatally weakened efforts to impose morals, including healthier lifestyles, on others. Do these developments indicate that, by the 1960s, the projects to morally regulate drinking had weakened?

The emergence of public health

The ‘ulcer in the social body’

For much of history, alcoholic drinks were regarded as healthy. In part, this was because beer provided a safer alternative to water. The reasons water was often unsafe only began to be understood when Dr John Snow linked the outbreak of cholera in London in 1848–49 to the contaminated water supplied by the Broad Street Pump. But, as Barr describes, people all over the world had been aware that drinking water was potentially hazardous long before Snow’s research.¹⁴ Alcoholic drinks were not just safer beverages, they were also widely regarded as possessing certain health too. Whisky, for example, was believed by many to ward off influenza until at least the early 20th century¹⁵ and beer was seen as an ‘article of diet’,¹⁶ a normal foodstuff, for much of the 19th century. Burnett provides some support for the latter idea by calculating that, in the 17th century at least, beer provided 20 to 25% of an average person’s required calorie intake.¹⁷ Alcohol, beer particularly, was healthy and nutritious; the brewers were not, therefore, discordant with many people’s opinions when they claimed that beer is a ‘food beverage’ and ‘part of the strength of Britain’¹⁸ during the First World War. Chapter Four noted that it became common to refer to teetotallers as ‘pussyfoots’ after the visit to Britain of US prohibitionist William ‘Pussyfoot’ Johnson in 1919. While the term might literally mean cautious or stealthy, it was commonly used pejoratively to imply indecision, timidity or fear.¹⁹ Drinkers, by implication, were strong, brave and decisive.

Nevertheless, alcohol has also been connected to a variety of health problems since at least the 18th century. In 1729, the London Journal discussed how excessive consumption of meat or drink was‘pernicious to the Health and Vigour of any Person, in the Discharge of the Offices of Life’.²⁰ Later in the century, a letter from ‘Setaymot’ in the Public Advertiser reiterated these beliefs, stating that health of the body and mind could be improved with ‘sobriety, gentleness, and temperance in meats, drinks, and exercises’.²¹ These habits of cleanliness and sobriety, Setaymot continued, bestow virtue upon the observer; it is through this ‘inward principle’ that such persons ‘are not subject to indispositions, nor molested with fevers; their heads are not dulled with fumes, nor their stomachs oppressed with fainting fits, or windy gripping humours; they rise fresh as the morning sun’.²² It was common for excessive drinking to be connected to such broad, ill-defined health complaints, although some commentators were more specific about the ailments they associated with alcohol. On the subject of drink in 1710, the Athenian News asked:‘How many Diseases flow from that vitious [sic] fountain? How many are fed and nourished by it?’, before specifically identifying gout, which can ‘bring Pain enough with it, so as to make a few Years seem an Age’, as one such disease.²³ The Athenian News, however, pointed out that gout was a ‘Danger of Drunkenness’ and a product of intemperance. The good and bad properties of alcohol were thus mediated by the concept of ‘temperance’, defined as restraint or balance in personal diet and lifestyle.

In 1754, the Public Advertiser noted that ‘health is, more than is commonly thought, in a Man’s own Power’ and the reward of temperance is that ‘one immediately feels its good Effects’.²⁴ If general personal restraint improves wellbeing, then health (and ill-health) is in the hands of the individual. Writing in World, ‘Academicus’ elaborated further:

The thinking part of man being allowed to be a modification of matter, it must be supposed to be a part of the body…. Hence it will indisputably follow, that all powers of the mind, even the moral faculties, are inseparably connected with the temperament and habit of that body, of which she is part. Insomuch that prudence (the foundation of all morality) as well as justice, fortitude and temperance (the other cardinal virtues) and their opposites entirely depend upon the constitution. It will therefore become the province of the physician to extirpate the vicious habits of mankind, and introduce the contrary; to suppress luxury, and create chastity; to make the foolish prudent; the proud humble…. And all this is easy to be done, by the assistance of alternative medicines, and by a properly adapted regimen, that shall be perfective of each virtue, and repugnant to each vice.²⁵

The body and mind were inseparable and morality of the body, expressed through the ‘properly adapted regimen’, was believed to improve the virtuosity of the mind. Individuals were responsible for their own physical and mental wellbeing; a virtuous life led to good health and, by inference, an intemperate life led to ill-health. Either way, health was fused to moral health.

The virtuous practice of temperance mediated between the purported good and bad effects of alcohol in the 18th century. To an extent, this approach continued to be evident in the 19th century. In 1830, the Derby Mercury recognised alcohol’s two faces by attacking the Beer Act on the grounds that it would discourage working men from taking beverages home to their families where they would be consumed as a ‘bodily nutrient, and not a moral poison’.²⁶ But the rise of the temperance movement and the turn to teetotalism in the 1830s signified a hardening in attitudes as alcohol became associated with a larger number of often serious conditions. Some of these aetiological connections, such as the Morning Chronicle’s statement that a man’s consumption of spirits would ‘ruin his health by destroying his liver’,²⁷ are now clinically established. Others have been discredited, as Barr highlights by describing how in t...