ABSTRACT
The initial hypothesis and evidence that moderate alcohol consumption reduces the overall mortality rate through its protective effect against cardiovascular disease are now broadly known and accepted (see Chapters 12 and 13). This evidence continues to accumulate, most recently in a study of nearly a half a million middle-aged and elderly people in the United States (Thun et al., 1997). Yet notwithstanding these findings—along with many long-held cultural beliefs that drinking improves health—most people consume alcohol for experiential rather than health reasons (Hall, 1996; Lowe, 1994b; see Chapters 18 and 20 and the Introduction). The critical role of pleasure not only as a motivation for drinking but also as a potential cause or indicator of positive health outcomes is attracting medical attention. As an editorial in the British Medical Journal noted, “Public health campaigns have often ignored people's requirement for pleasure” (Cleare & Wessely, 1997, p. 1637). However, clinical medicine has begun to identify global quality of life and level of general functioning as essential dimensions of health outcomes (Wilson & Cleary, 1995; see Chapter 23). Taking into account the psychosocial as well as medical benefits of moderate drinking balances the heretofore exclusively negative public health emphasis on problematic psychosocial consequences of drinking (accidents, violence, addiction), which considers health consequences of drinking exclusively in terms of risk reduction (Edwards et al., 1994).
