Extreme drinking in a culture of moderation: The Chinese situation

In China per capita consumption of alcohol is increasing rapidly and alcohol use is widespread. In general alcohol use is not recognized as a public health problem. Until recently no laws regulated purchase and use of alcohol. There is a widespread Confucius-based belief in moderation and respect for others that strongly influences alcohol use; nevertheless, extreme drinking is not uncommon and is expected in some situations.

Detailed focus group discussions with young adults in four cities provided extensive narrative data to describe extreme drinking and explore its rationalization in the face of a culture of moderation. Narrative descriptions were compared with widely held and often conflicting maxims, for example “1000 cups is not enough for a bosom friend,” but “alcohol in the stomach, grief in the heart.” Extreme drinking is perhaps most routinized in the business sector, which in China had a long tradition prior to the establishment of the “People's Republic” and which is now redeveloping. In the business sector practices like proxy drinking allow drinking with all its symbolism to be carried out with the illusion of moderation in the interest of deal making. Extreme drinking is discussed in the context of a rapidly changing society that faces the need to develop policies to reduce alcohol-related risks. A model is proposed to show how traditions of moderation can be used to guide policy development and advocacy to encourage risk reduction, harm reduction, and prevention.