Testing Consensus About Situational Norms on Drinking: A Cross-National Comparison

Abstract

Objective:

Drinking norms vary with the situation and the person’s role in it. They may be located at a societal level or may be specific to subgroups in the society. This article compares norms about drinking at the societal level as reported in surveys in 12 countries, testing the degree of consensus on the norms by comparing answers of abstainers and heavy episodic drinkers in each society.

Method:

In national or regional general population samples of respondents ages 18–65 in Argentina, Australia, Costa Rica, India, Nicaragua, Nigeria, Peru, Sri Lanka, Sweden, Uganda, Uruguay, and the United States, endorsements of drinking norms across 10 situations are compared, across the 12 societies, and within each society by drinking pattern.

Results:

Substantial societal variation was found regarding the acceptance of drinking at all, and of heavier drinking in specific situations, although the societies shared a rough ordering of situations in terms of acceptability of drinking. In each society, abstainers and heavy episodic drinkers differed on norms, although the differences were smaller for “no drinking” in relatively “dry” situations than on accepting drinking at least “enough to feel the effects” in “wet” situations.

Conclusions:

Although societies vary in their acceptance of drinking and the drinking amount, there seems to be an approximately shared ordering of situations in terms of relative acceptability of drinking and heavier drinking. At the societal level, there is more consensus on where there should be no drinking than on where drinking enough to feel the effects is acceptable.

Sociological discussions of drinking in post-industrial societies have long recognized that substantial differentiations are made in everyday life about what is appropriate and expected in terms of drinking at all or, if drinking, how much to drink. These differentiations are made not only in terms of the status of the person, but also in relation to the social situation and the person’s role in that situation. Indeed, drinking can be described as a highly enclaved activity (Room, 1975) in the stream of life.

Whether and how much drinking is acceptable for a person in a particular situation and role is subject to social norms—what psychologists call injunctive norms (Cialdini et al., 1991). In the social psychological literature, these are contrasted with descriptive norms—respondents’ opinions about the actual distribution of drinking behavior in a specific population (Borsari & Carey, 2003). However, the aim of the present study is to focus on injunctive norms about whether and how much drinking is acceptable for a given situation in different populations. These are collectively held expectations, subject to some degree of enforcement (Bicchieri, 2000). The collectivity that holds the expectations may be the whole society or may be subcultures or social worlds within the society (Savic et al., 2016). For large, complex societies, we cannot expect unanimity concerning most norms on alcohol use. There will be some variation between subgroups, and the norms applicable in a specific circumstance may include expectations both from a societal level and from subgroups.

A substantial ethnographic literature on drinking norms (Room & Mäkelä, 2000), particularly concerning tribal and village societies, has found wide variation. Comparing accounts of drunken comportment in different societies, MacAndrew and Edgerton (1969) noted variation not only in the acceptability of intoxication but also in what they called the “within-limits clause”: in what ways and how far behavior while drunk was expected and allowed to diverge from sober behavior. Besides the ethnographic literature, there have also been some qualitative studies in complex societies (e.g., Trocki et al., 2013). Quantitative studies have been less common, except among college students (e.g., Borsari & Carey, 2003). In both traditions, primary studies have been mostly within one society, although a few comparative studies, beyond MacAndrew and Edgerton’s pioneer work, have been published (e.g., Fjaer et al., 2016; Lemert, 1964; Pyörälä, 1995).

Situational drinking norms like the ones considered in the present study were studied previously in the United States (Room & Roizen, 1973). Respondents were asked whether and how much drinking would be acceptable in eight particular situations and roles, ranging from “a father playing with his small kids” to “a man out at a bar with some of his male friends.” Daily drinkers and infrequent drinkers differed considerably on the acceptability of drinking in some situations, but tended to agree on the ordering of situations in terms of the acceptability of drinking in them. Later studies depicted wide variations in American drinking norms between different situations, with considerable stability over time (Greenfield & Room, 1997).

This article analyzes such drinking norms among adults in 12 countries taking part in the GENACIS (Gender, Alcohol, and Culture: An International Study) collaboration (Wilsnack et al., 2009). The article explores consensus on the situational drinking norms in two directions: the extent of agreement between different societies on drinking norms in diverse situations and the extent of consensus about the norms between abstainers and heavier drinkers within each society. A further dimension of variation, the extent to which drinking norms differ by gender in particular situations, is the subject of a separate article (Kuntsche & Room, 2018).

In examining the extent of normative agreement on drinking norms within the society, we focus on sets of three situations at the opposite ends of a rough continuum on acceptance of the fact and amount of drinking. The item choice for both sets was based on evidence in former studies (Greenfield & Room, 1997; Room & Roizen, 1973), with when about to drive a car, when in charge of small children as a parent, and for a couple of co-workers out to lunch being classified as “dry” situations. Most countries have blood alcohol concentration (BAC) legal limits for driving a motor vehicle, so that the norm that this is an inappropriate circumstance to be feeling the effects of alcohol can be expected to be widely diffused. The idea that a parent in charge of small children should be sober enough to protect them from harm may also be expected to be widely held (Room, 2011). Responses concerning the couple of co-workers out to lunch are likely to be influenced by norms concerning drinking and work life, with the expectation of sobriety at the workplace established at least where the classic temperance movements were strong (Gusfield, 1991).

Situations classified as “wet” are circumstances in which drinking might be expected, if drinking and indeed drinking enough to feel the effects of alcohol is normative in any situation at all: attending a party at someone else’s home; when with friends at home; and for a man out at a bar with friends. Responses concerning the wet and dry situations were also compared with four “in-between” situations: for a wife having dinner out with her partner; for a husband having dinner out with his partner; when getting together with friends after work before going home; and for a woman out at a bar with friends. We note that, for one of these situations, the difference between classification as wet or in between depends on the drinker’s gender, reflecting what was found in former studies.

In the analysis of consensus within a society on situational norms, we are probing a problematic issue in the contention that “injunctive norms account for much of human behaviour” (Cialdini et al., 1991, p. 204). Cialdini et al. note that various writers “have despaired at the ability of this concept to predict or explain a significant amount of the variance of social behaviour” because “frequently within the same societal group mutually incompatible norms exist simultaneously” (p. 204). In our examination of normative agreement, we compare the responses of two sets of respondents in each society differentiated in terms of their personal drinking behavior: those who are abstaining from alcohol use in the past year and those who are heavy episodic drinkers (HEDs; consuming an equivalent of 5 or more drinks, i.e., ≥60 g pure ethanol, on an occasion more than six times in the past year).

Method

Data

The study used data from 12 regional or national surveys in the GENACIS study conducted with face-to-face or telephone interviews between 2001 and 2007 on a total of 20,596 adults. Ethical approval for each survey was obtained from the responsible body at the national level. Detailed descriptions of the project, questionnaire, and study procedures are available (GENACIS, 2001; Wilsnack et al., 2009; www.kettilbruun.org/projects/genacis/overviews/overview_sampling_design.pdf). For convenience, the surveys are referred to by their country’s name, although only the American, Swedish, and Uruguayan samples are national. The Sri Lankan sample is near-national (17 of the 25 districts), and the other samples are regional: of states (5 in Nigeria; 4 in Uganda; 1 in Argentina, Australia, and India) and of cities and their environs (5 in Nicaragua; 2 in Peru; 1 in Costa Rica) (Wilsnack et al., 2009). For comparability, analyses in this article are limited to respondents ages 18–65 (18–64 in Peru).

As seen in Table 1, abstinence rates varied between 11.5% in Sweden and 79.3% in India and Nicaragua, whereas heavy episodic drinkers ranged from 4.2% in Sri Lanka to 50.0% in Sweden.

Table 1.

Sample size and gender distribution (unweighted) and drinking patterns (weighted), age 18–65 subsample,^a by country

Country	Sample size	Survey year	Percentage women	Percentage abstainers	Percentage HED
Argentina	1,000	2003	55.4	15.6	14.8
Uruguay	1,000	2004	62.4	31.9	9.9
Peru	1,531	2005	66.4	32.8	15.4
Costa Rica	1,162	2003	50.2	43.4	10.7
Nicaragua	1,984	2005	70.1	79.3	12.1
Nigeria	2,040	2003	46.5	67.3	17.1
Uganda	1,451	2003	50.7	54.7	15.0
Sri Lanka	1,106	2003	50.5	68.4	4.2
India	2,558	2003	48.1	79.3	12.0
Sweden	1,461	2002	50.3	11.5	50.0
Australia	1,036	2007	50.7	15.5	14.2
USA	4,267	2001	51.0	31.9	16.6

Notes: HED = heavy episodic drinker.

^aPeru only surveyed 18- to 64-year-olds.

Measures

Situational drinking norms were introduced as follows: “Now I’ll describe situations that people sometimes find themselves in. For each one, please tell me how much a person in that situation should feel free to drink.” The wording of each situation is spelled out in Table 2. For each situation, the respondent was asked, “How much drinking is all right? Would you say no drinking; one or two drinks; enough to feel the effects, but not drunk; or getting drunk is sometimes all right?” The answers were dichotomized in two ways: (A) “no drinking” versus all responses accepting drinking (abstinence); and (B) “drinking enough to feel the effects” or “getting drunk is sometimes all right” (drinking to intoxication) versus responses of “no drinking” or “one or two drinks.” The combination in (B) reflected that generally there were few responses that “getting drunk is sometimes all right”; only in Uganda, Sweden, and Australia did 10% or more of respondents give this answer on any item (Room, in press).

Table 2.

Percentage answering “no drinking” to “How much drinking is all right [in each situation]?”

How much drinking is all right? – No drinking	Dry situations			In-between situations				Wet situations
Country (% missing cases)	j. When going to drive a car	b. As a parent, spending time with small children	g. For a couple of co-workers out for lunch	d. For a wife having dinner out with her husband	c. For a husband having dinner out with his wife	i. When getting together with friends after work before going home	f. For a woman out at a bar with friends	a. At a party, at someone else’s home	e. For a man out at a bar with friends	h. When with friends at home
Argentina (0.2%–1.6%)	96.1	75.2	52.8	18.8	10.5	52.6	31.5	6.4	11.0	8.1
Uruguay (0.1%–0.2%)	95.7	80.8	57.3	25.8	20.9	55.5	36.2	10.1	19.8	17.9
Peru (0.1%–0.3%)	96.5	76.5	47.3	32.9	26.6	47.5	41.2	9.7	12.3	18.7
Costa Rica (0.4%–0.5%)	94.1	93.6	84.5	45.2	41.0	53.1	49.4	32.4	33.8	47.1
Nicaragua (0%–0.1%)	94.9	92.7	69.4	71.4	64.3	72.4	71.6	49.3	49.8	68.2
Nigeria (1.2%–1.7%)	91.5	83.4	69.2	69.1	67.9	72.4	66.2	54.1	54.2	63.7
Uganda (3.5%–5.6%)	86.0	62.8	58.9	41.9	34.5	42.5	42.5	21.6	18.8	27.9
Sri Lanka (0%)	99.3	98.4	97.1	96.1	89.0	93.0	98.0	56.4	81.7	81.7
India (0.9%–1.4%)	99.3	98.9	92.3	97.3	95.9	87.2	96.6	74.8	76.7	88.2
Sweden (1.4%–5.7%)	98.6	31.5	83.9	4.1	3.5	44.8	2.4	2.4	1.8	2.4
Australia (0.4%–2.5%)	64.2	49.1	35.8	4.1	4.3	15.9	4.8	3.7	3.5	5.1
USA (0.1%–0.6%)	82.7	84.3	76.1	n.a.	14.9	35.8	18.3	13.1	13.2	15.4

Notes: _n._a. = not asked. The letter (a to j) above each item indicates the order in which the items were asked. The percentage range for each country shows the lowest and highest proportions excluded from analysis because of missing data on a situational norm question.

Normative consensus was measured by examining the extent of consensus on situational drinking norms between those with differing choices and patterns concerning their own drinking. Thus, responses on the wet and dry situations were compared between abstainers and HEDs.

Drinking status of the respondent.

Based on the responses to the annual frequency of alcohol consumption and the frequency of HED, respondents were divided between being an abstainer in the past 12 months; being a drinker but not an HED in the past 12 months; and being an HED drinker, defined as noted previously.

Presentation of results.

The included surveys are arranged in groups by continent in presenting the results, except that three high-income countries are at the bottom of the tables. According to the United National Conference on Trade and Statistics data for 2004, the nominal gross national product per capita for Argentina, Uruguay, Peru, and Costa Rica was in the range of USD $2,439–$4,325; for Nicaragua, Nigeria, Uganda, Sri Lanka, and India in the range of USD $280–$820; and for Sweden, Australia, and the United States in the range of USD $31,598–$39,650 (UNCTAD, 2005, pp. 316–323).

Analyses.

Percentages giving the specified response in the country sample are shown in Tables 2 and 3, and in the drinking category for the country in Tables 4 and 5 (for legibility, the figures here are rounded to whole percentages). In Tables 4 and 5, the mean percentage (m) for the three situation items is shown. A t test is used as a measure of how different the abstainers’ and the HEDs’ responses are, with p ≤ .05 indicating little difference in average responses between abstainers and HEDs. Analyses are based on those answering the situational norms and alcohol consumption questions; percentages of missing cases on the norm questions are given in Table 2.

Table 3.

Percentage answering either “enough to feel the effects” or “getting drunk is sometimes all right” to “How much drinking is all right [in each situation]?”

How much drinking is all right? — Enough to feel the effects or — Getting drunk is sometimes all right	Dry situations			In-between situations				Wet situations
Country (% missing cases)	j. When going to drive a car	b. As a parent, spending time with small children	g. For a couple of co-workers out for lunch	d. For a wife having dinner out with her husband	c. For a husband having dinner out with his wife	i. Getting together with friends after work before going home	f. For a woman out at a bar with friends	a. At a party, at someone else’s home	e. For a man out at a bar with friends	h. With friends at home
Argentina	0.7	1.1	1.7	5.5	7.0	7.2	14.2	29.7	35.2	23.4
Uruguay	0.1	0.4	1.5	3.4	3.6	3.6	12.2	19.0	23.0	14.7
Peru	0.1	1.9	3.4	6.5	9.5	14.9	18.2	42.4	54.4	37.8
Costa Rica	0.1	0.4	0.3	2.2	2.3	9.8	17.1	14.1	29.8	16.4
Nicaragua	0.8	0.9	7.3	2.5	3.8	8.1	7.2	12.9	24.6	11.0
Nigeria	1.9	1.5	7.6	3.8	5.2	7.7	9.7	14.8	19.9	8.4
Uganda	3.0	10.4	12.7	17.8	22.8	24.5	19.7	38.0	48.3	32.9
Sri Lanka	0.5	0.4	0.5	1.0	1.9	2.4	1.2	20.7	8.2	7.8
India	0.2	0.1	2.4	0.4	0.4	6.2	0.9	6.4	10.4	3.0
Sweden	0.0	8.9	1.0	29.0	30.0	10.4	58.0	70.2	62.8	61.2
Australia	0.9	4.8	7.5	24.6	24.8	21.6	57.1	57.4	66.5	61.0
USA	1.0	0.8	1.8	n.a.	6.7	9.6	29.0	31.6	38.3	29.3

Notes: _n._a. = not asked. The letter (a to j) before each item indicates the order in which the items were asked.

Table 4.

Percentages of abstainers and HEDs responding “no drinking” and responding it’s all right to drink “enough to feel the effects” or to be drunk, for three dry situations

	% of abstainers saying “no drinking”				% of HEDs saying “no drinking”					% of abstainers saying ≥ “OK to feel effects”				% of HEDs saying ≥ “OK to feel effects”
Country	j. Before driving	b. Parent of kids	g. Work lunch	M	j. Before driving	b. Parent of kids	g. Work lunch	M	t	j. Before driving	b. Parent of kids	g. Work lunch	M	j. Before driving	Parent of kids	Work lunch	M	t
Argentina	100	77	62	80	96	74	38	69	-3.8	0	1	0	0	0	1	8	3	3.4
Uruguay	99	90	70	86	86	65	48	66	-6.1	0	0	1	0	0	4	8	4	3.0
Peru	98	83	58	79	92	68	39	66	-6.4	0	1	3	1	0	3	6	3	2.2
Costa Rica	99	99	92	97	83	75	62	73	-7.6	0	0	0	0	0	2	1	1	1.6
Nicaragua	96	95	76	89	88	84	42	71	-9.4	0	0	5	2	4	5	22	10	6.0
Nigeria	95	90	79	88	81	70	46	65	-12.0	1	2	5	3	4	2	16	7	4.6
Uganda	92	76	71	80	70	44	45	53	-10.1	1	6	9	5	6	17	19	14	4.9
Sri Lanka	100	100	99	100	100	94	90	95	-2.4	0	0	0	0	0	0	0	0	1.7
India	100	99	97	99	98	98	70	87	-9.6	0	0	0	0	1	1	15	6	7.2
Sweden	100	63	85	83	98	24	81	68	-7.2	0	1	1	1	0	14	1	5	6.4
Australia	90	68	54	71	44	34	20	33	-10.5	0	3	3	2	1	11	16	9	4.5
USA	96	93	82	90	62	68	62	64	-20.7	0	1	1	1	4	3	5	4	7.1

Notes: HED = heavy episodic drinker (drinking 5+ drinks more than six times in the past year). Responses on how much it’s OK to drink when: j: going to drive a car; b: as a parent, spending time with small children; g: for a couple of co-workers, out to lunch. M = mean score for j, b, g; t = significance testing of mean score, abstainer vs. HED. Significant differences (p ≤.05) in bold (borderline for Peru on “OK to feel the effects”).

Table 5.

Percentages of abstainers and HEDs responding “no drinking” and responding it’s all right to drink “enough to feel the effects” or to be drunk, for three “wetter” situations

	% of abstainers saying “no drinking”				% of HEDs saying “no drinking”					% of abstainers saying ≥ “OK to feel effects”				% of HEDs saying ≥ “OK to feel effects”
Country	a. At party	e. Man at bar	h. At home, friends	M	a. At party	e. Man at bar	h. At home, friends	M	t	a. At party	e. Man at bar	h. At home, friends	M	a. At party	e. Man at bar	h. At home, friends	M	t
Argentina	21	28	24	24	4	7	6	6	-6.1	16	21	12	16	51	56	42	50	-8.2
Uruguay	24	35	37	32	2	7	8	6	-9.6	7	13	4	8	56	53	45	51	-10.1
Peru	20	26	30	25	3	3	8	5	-11.2	25	38	24	29	69	76	63	69	-14.6
Costa Rica	59	63	76	66	5	2	10	6	-27.3	5	10	5	7	31	79	45	52	-13.6
Nicaragua	57	59	76	64	14	9	34	20	-22.2	7	17	6	10	47	62	37	49	-15.3
Nigeria	70	70	78	73	18	19	37	25	-22.4	8	12	5	8	36	42	19	32	-11.6
Uganda	35	30	43	36	4	5	10	6	-15.0	25	34	20	26	65	75	55	65	-14.5
Sri Lanka	74	92	89	85	11	55	43	36	-9.9	6	2	3	4	66	30	34	43	-7.7
India	83	85	93	87	42	42	68	51	-21.2	2	4	1	2	30	43	11	28	-13.9
Sweden	16	14	13	14	1	3	0	1	-5.5	32	24	24	27	85	82	79	82	-16.9
Australia	18	16	28	20	0	1	0	0	-7.3	19	32	26	26	86	86	85	86	-15.9
USA	36	34	38	36	1	2	2	2	-20.7	14	17	13	15	60	74	59	64	-31.7

Notes: HED = heavy episodic drinker. Responses on how much it’s OK to drink when: a: at a party, at someone’s house; e: for a man out at a bar with friends; h: with friends at home. M = mean score for a, e, h; t = significance testing of mean score abstainer vs. HED. All t values that show a significant difference (p ≤ .05) are in bold.

Results

Responses on situational norms in 12 societies: An overview

Table 2 shows the percentage answering that no drinking was acceptable for each situation in each country. There was wide consensus on no drinking when about to drive a car, although less so in two countries where attention to measures to prevent drink-driving has been most stringent. In both Australia (with a .05% BAC limit) and the United States (with a .08% limit), substantial minorities thought one or two drinks were acceptable when intending to drive. This was not true in Sweden, reflecting the country’s lower BAC limit (.02%), discouraging any drinking before driving.

There was considerable variation on the acceptability of drinking by a parent spending time with small children. Although no drinking was specified by 75% or more of respondents in 9 of the 12 countries, at least one or two drinks was accepted by two thirds of Swedish and half of Australian respondents. The substantial cultural acceptance in Sweden of moderate drinking in family life finds support in other studies: In a Swedish study of 12- to 18-year-olds, 63% reported that they consumed alcohol together with a parent (Lundborg, 2007), and retrospective studies of childhood experiences found that, for informants born in the 1990s, “moderation often means that the parents drink beer or wine with dinner and sometimes several times a week” (Bernhardsson, 2014, p. 234) and that “moderate routine drinking . . . emerges to the child as a safe contact with drinking, signifying a neutral, predictable habit of an adult” (Törrönen & Rolando, 2018, p. 233). Although a majority of respondents in 10 of the 12 societies specified no drinking for co-workers, consensus on this was generally lower—and lowest in Australia and Peru.

Variation between societies in response distributions on no drinking were much greater for the wet situation items. Fewer than 20% specified no drinking as the expectation in these circumstances in six of the societies, including not only Argentina, Uruguay, and Peru but also three societies with an active temperance history: Sweden, Australia, and the United States (Room, 1990; Savic & Room, 2014). In contrast, majorities in India, Sri Lanka, and Nigeria specified no drinking for each of the situations, and Nicaragua came close to this. In Sri Lanka, India, and Nigeria, for each of the 10 situations asked about, a majority of respondents took the view that no drinking was the expectation.

In general, proportions calling for no drinking in the wet situations were considerably less than the proportions for the dry situations. In all of the 108 pairwise comparisons of proportions within each country, the percentage for the abstinence norm was lower for a wet than for a dry situation. In general but not always, responses for the four in-between situations in the middle of Table 2 were between those on the left and the right.

Table 3 shows for each situation in each country the percentages of those reporting drinking to intoxication being acceptable. There was substantial unanimity in most countries against this for each of the dry situations; only in Uganda did more than 10% say drinking more than one or two drinks was acceptable in any of these situations. But even for the wet situations, only a minority approved drinking enough to feel the effects in most countries. Sweden and Australia were the only countries in which a majority agreed that drinking to intoxication was all right for all wet situations, with a majority in Peru for one of the circumstances. In other countries, approval was below 50%, often well below. Approval rates were lowest in Sri Lanka and India.

Proportions approving drinking to intoxication were uniformly higher for the three wet situations than for the three dry situations, although for one pair of situations the rates in Nigeria were nearly equal. Approval rates for the four in-between items in the middle of Table 3 were generally between those in the dry and wet situations, with only two exceptions for comparisons with the wet and eight for comparisons with the dry situations.

Normative consensus or dissensus by personal drinking status

Gauging the extent of normative consensus by comparing responses of abstainers with the responses of HEDs, we averaged the percentages across the three items in the dry and wet set for both drinking status groups (Table 4). Mean values are shown for each set of three items, and a t test on the difference between the two means. As expected, in all countries significantly more abstainers than HEDs approved no drinking (left half of table). Sri Lanka shows the lowest difference between abstainers and HEDs, whereas Australia shows the largest difference, with less than half as many HEDs as abstainers saying “no drinking.” Other countries in which the difference is at least 20 percentage points are Costa Rica, Nigeria, Uganda, and the United States.

Abstainers everywhere were nearly unanimously against drinking enough “to feel the effects” in all three dry situations (right-hand side of table). But only minorities of HEDs, too, specified that drinking enough “to feel the effects” would be normative. Only in Uganda, Australia, and Sweden did more than 10% of HEDs agree it was acceptable for a parent spending time with small children to drink enough to feel the effects; for a couple of co-workers out to lunch, there were five societies where at least 10% of the HEDs thought it was acceptable: Nicaragua, Nigeria, Uganda, India, and Australia. There is thus substantially more consensus between abstainers and HEDs that it is not acceptable to drink enough to feel the effects in these dry situations, with the greatest consensus on “when going to drive a car” and the least on “a couple of co-workers out to lunch.” However, the difference in mean scores across the three items is enough to be significant in each country.

Table 5 compares responses of abstainers and HEDs on the three wet norm questions. Across all countries, the mean score between abstainers and HEDs differed significantly in no-drinking responses (left-hand side of table). Clearly, in India and Sri Lanka, abstainers have sufficient confidence in their own choice for a strong majority to say drinking is unacceptable, and there are lesser majorities also in Costa Rica, Nicaragua, and Nigeria. In nearly all these cases, drinking “with friends at home” was the least acceptable situation.

In India, for all three situations, and in Sri Lanka, except for the party at someone else’s house, substantial proportions of HEDs agreed with the situational norm of abstaining. Elsewhere, however, less than one quarter of HEDs agreed with “no drinking,” except for 37% agreeing in Nigeria and 34% in Nicaragua with not drinking with friends at home. Within-society agreement on the norms concerning whether abstaining was acceptable in these situations was low, comparing averaged responses of abstainers and HEDs. The lowest differences were 13–20 percentage points, in Argentina, Peru, Sweden, and Australia; the highest (48–60 percentage points) were in Nigeria, Sri Lanka, and Costa Rica.

Disagreement between abstainers and HEDs was stronger on whether it is acceptable to drink to intoxication in wet situations (right-hand side of table), with the mean score differences significant for all countries. There was substantial variation in how many abstainers agreed it was acceptable to drink enough to feel the effects in these situations. Rates were more than 30% for “a man out at a bar with friends” in Peru, Uganda, and Australia, and for “at a party, at someone else’s house” in Sweden. Across the items, these countries had proportions of acceptance among abstainers that stood out above others, whereas proportions were especially low in India and Sri Lanka.

Among HEDs, there was acceptance above 75% of drinking to intoxication in all three situations in Sweden and Australia, and at or above 70% acceptance for a man out at a bar with friends also in Peru, Costa Rica, Uganda, and the United States. The average rate of acceptance among HEDs of drinking enough to feel the effects in the situations was 43% or above everywhere except in India (28%) and Nigeria (32%).

Abstainers and HEDs differed substantially on the acceptability of feeling the effects in wet situations. The lowest difference was 24 percentage points (Nigeria) and the highest 60 (Australia), with differences elsewhere except for India of 35 percentage points or more. The average difference was greater for drinking to intoxication than for abstention in the higher- and middle-income countries, except for Costa Rica, but this was reversed in the five lower-income countries (Nicaragua, Nigeria, Uganda, Sri Lanka, and India).

Looking at Tables 4 and 5 together and comparing responses of abstainers and HEDs in each of the societies, there was generally more consensus on drinking norms in dry situations than in wet. Comparing the two pairs of average percentage differences—in Table 4 versus Table 5—the difference in responses is greater for the dry situations than for the wet only for Australia, and marginally for Sweden, at the no-drinking level. Generally, the differences are least for drinking enough to feel the effects in dry situations, and most for wet situations—with a split, as noted above, roughly between lower-income and other countries on whether the percentage difference is higher for abstinence (in lower-income countries) or for drinking to intoxication. If the percentage point differences between abstainers and HEDs were averaged across countries, there was only a 4 percentage–points difference on drinking to intoxication in dry situations, and 19 percentage points on abstaining in these situations (calculated from Table 4). For drinking enough to feel the effects in wet situations (calculated from Table 5), the average difference on abstaining between abstainers and HEDs was 34 percentage points, and for drinking to intoxication was 41 percentage points.

Discussion

In general, the present study revealed most consensus in a given country between abstainers and HEDs on not drinking to intoxication in dry situations. So there seems to be fair cultural unanimity at least on a within-limits clause (MacAndrew & Edgerton, 1969) concerning level of drinking in drier situations in all 12 countries. In contrast, the least consensus was on drinking to intoxication in wet situations. The extent of consensus in views between abstainers and HEDs on abstaining generally falls between these contrasting levels of consensus on drinking to intoxication.

The study’s methods impose several limitations. The situational norm items provide a reasonable sampling of situations, but closed-ended responses to survey items asked in diverse languages inherently involve limitations in comparability; there are nuanced differences in meaning and in conceptual boundaries between response categories. The items may have missed specific situations and roles in a country in which drinking to intoxication is more widely accepted. Conversely, we have presumed that respondents answered concerning collective norms, but personal attitudes and rules may also influence answers to questions on “how much drinking is all right.” Some respondents may also have felt constrained in acknowledging the acceptability of such behavior, although such prevarication would itself indicate that the acceptability is questionable.

The results suggest that the place of alcohol in everyday life varies substantially between the 12 countries included in this analysis; this diversity is reflected in the quite different distributions of responses to questions on situational drinking norms. Although at least 80% of respondents in six countries (including all three of the high-income countries) accepted at least some drinking in the wet situations, only a minority saw drinking as acceptable in these situations in India, Sri Lanka, and Nigeria; there was also substantial opposition in Nicaragua. But despite the differences between countries in the degree of normative acceptance of drinking at all and drinking to intoxication, there was a substantial common ordering in terms of the relative acceptability of drinking in the different situations.

Overall, a general rule at the societal level seems to be that there is more agreement on norms against drinking at all in dry circumstances than on norms allowing heavier drinking in wet circumstances. For normative agreement concerning it being acceptable to drink to intoxication, one must look below the level of the society as a whole and instead look at subgroups of a given society, such as subcultures and social worlds (Savic et al., 2016).

Concerning drinking norms as injunctions on behavior, the study’s implications are that norms on drinking applying generally in a country are those about abstaining in dry situations. Only three countries (Australia, Peru, and Sweden) had less than a majority specifying abstaining for any of the three dry situations. For the three wet situations, there were only slim majorities for a norm accepting drinking to intoxication, and only in the same three countries.

To find injunctive norms in favor of drinking, particularly in favor of drinking more than a little, if we define such norms in terms of opinions of a strong majority, then we must find their location below the level of the whole country in subcultures or social worlds revolving around or at least involving heavy drinking. Even in a fairly wet country, such social worlds may involve a minority of adults. For instance, an analysis of the Australian data used in this analysis found that only 7% of adults were themselves risky drinkers and also were relatively frequent participants in the social worlds of drinking (Room et al., 2016). Of these respondents, 36% reported having been pressured by a friend to drink more within the last year, whereas 44% of them reported pressure from family members to drink less. To find norms favoring relatively heavy drinking, one must zero in on such minorities. This is an approach that is now being taken in Australia, initially with studies of prescriptive norms in heavy drinking social worlds (Wilkinson et al., 2017) and now with initiatives in public health interventions in such worlds (VicHealth, 2018).

Acknowledgments

An earlier version of this article was presented at the 44th Annual Alcohol Epidemiology Symposium of the Kettil Bruun Society, Chiang Mai, Thailand, May 28–June 1, 2018. Robin Room and Sandra Kuntsche receive support from the Foundation for Alcohol Research and Education, an independent, nonprofit organization working to stop the harm caused by alcohol. Robin Room, Sandra Kuntsche, and Thomas K. Greenfield received support from a grant from the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA; Grant AA023870) through the Public Health Institute of California. Paul Dietze received support from Senior Research Fellowship 1136908 from the Australian National Health and Medical Research Council. The data are analyzed as part of the Gender, Alcohol and Harm to Others (GENAHTO) project, which has been supported by the aforementioned NIAAA grant and by a grant from the Australian National Health and Medical Research Council (NHMRC; Grant 1065610). The data used in this article are from the Gender, Alcohol, and Culture: An International Study (GENACIS) project. GENACIS is a collaborative international project affiliated with the Kettil Bruun Society for Social and Epidemiological Research on Alcohol and coordinated by GENACIS partners from the University of North Dakota, Aarhus University, the Alcohol Research Group/Public Health Institute, the Centre for Alcohol Policy Research, La Trobe University, and the Addiction Switzerland Research Institute. Support for aspects of the project has come from the World Health Organization, the Pan American Health Organization, the Quality of Life and Management of Living Resources Programme of the European Commission (Concerted Action QLG4-CT-2001-0196), and NIAAA grants (AA012941, AA015775, AA022791, and Center Grant P50 AA005595). Support for individual country surveys was provided by government agencies and other national sources. The study leaders and funding sources for data sets used in this report are (and we thank them):

Argentina: Myriam Munné, Ph.D., World Health Organization

Australia: Paul Dietze, Ph.D., NHMRC (Grant 398500)

Costa Rica: Julio Bejarano, M.Sc., World Health Organization

India: Vivek Benegal, M.D., World Health Organization

Nicaragua: José Trinidad Caldera Aburto, M.D., Ph.D., Pan American Health Organization (PAHO)

Nigeria: Akanidomo Ibanga, Ph.D., World Health Organization

Peru: Dr. Maria Piazza, Pan American Health Organization (PAHO)

Sri Lanka: Siri Hettige, Ph.D., World Health Organization

Sweden: Karin Helmersson Bergmark, Ph.D., Ministry for Social Affairs and Health, Sweden

Uganda: M. Nazarius Tumwesigye, Ph.D., World Health Organization

United States: Thomas K. Greenfield, Ph.D., NIAAA (Grant P50 AA005595)

Uruguay: Raquel Magri, M.D., Pan American Health Organization (PAHO).