Short Communication European Addiction Research
Eur Addict Res 2014;20:319–323 DOI: 10.1159/000363230
Received: November 4, 2013 Accepted: April 27, 2014 Published online: October 10, 2014
Differences in Alcohol-Related Research Publication Output between Countries: A Manifestation of Societal Concern? Michael Savic a, b Robin Room c–e a
Turning Point Alcohol and Drug Centre, Eastern Health, b Eastern Health Clinical School, Monash University, Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, and d Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia; e Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden c
Key Words Alcohol research · Social history of alcohol · Alcohol policy
Abstract In a recent bibliometric analysis of alcohol- and other drugrelated research publications in 11 countries, differences were found in research output across countries. In this paper we use additional secondary data to explore possible sociohistorical factors that may contribute to differences in alcohol-related peer-reviewed publications across countries. Aside from general scientific productivity, we propose a possible link between the degree to which societies are concerned with alcohol and alcohol-related research outputs. © 2014 S. Karger AG, Basel
In a recent article published in European Addiction Research, Bramness et al. [1] conducted an international comparison of alcohol- and other drug-related research publications as indexed on the Thompson ISI database. The authors found that the USA had the highest absolute number of peer-reviewed publications but noted differences in publication outputs relative to population size © 2014 S. Karger AG, Basel 1022–6877/14/0206–0319$39.50/0 E-Mail [email protected] www.karger.com/ear
across countries. In their analysis of outputs relative to population size, the small Northern European countries were more prolific. Bramness et al. [1] postulate that this difference might be due to historical, moral and religious differences but suggest that ‘this is difficult to decide’ (p. 21). In this paper, we take a socio-historical angle to explore the differences noted by Bramness et al. in alcohol-related research publications between countries. We consider what alcohol research output says about societies and their relationship to alcohol. We contend that societies that have historically ‘worried’ about alcohol consumption and its harms have higher relative research outputs, and that high research outputs are perhaps a manifestation of continuing concern about alcohol use and its consequences in these countries. Our starting point was to examine whether alcohol research output could be partly explained by overall research output. We searched the Scopus database to collect indicative data on the total number of research publications (in any field and in any language) in each of the countries studied by Bramness et al. [1] over the 2001– 2011 period. We then calculated the overall number of research publications per million inhabitants in each Michael Savic Turning Point Alcohol and Drug Centre 54–62 Gertrude Street, Fitzroy Melbourne, VIC 3065 (Australia) E-Mail MichaelS @ turningpoint.org.au
Mean relative number of alcohol research publications 2001–2011
100 Finland 80 Sweden USA
60
Denmark Netherlands 40
UK
20
Spain
Italy
10,000
country and plotted this against the data on alcoholrelated research relative to population size from the figure supplied by Bramness et al. [1]. As is illustrated in figure 1, countries with a higher alcohol research output relative to population size appeared to also have a greater overall research output in general. This suggests that a high alcohol research output might partially be a function of general scientific productivity. The Scandinavian countries as well as the Englishspeaking countries all have histories of Protestantism, which has been shown to have a relationship to national scientific productivity, even after national wealth is controlled for [2]. This is reflected in the overall research output, and indeed in the alcohol research output relative to population size, but there are anomalies. For instance, the Netherlands and Denmark both produce more scientific papers relative to population size than the USA or Norway but produce less alcohol-related research papers by comparison. This suggests that the overall research output alone cannot totally explain the alcohol-related research output. Other socio-historical factors are likely to illuminate this further. 320
Eur Addict Res 2014;20:319–323 DOI: 10.1159/000363230
Germany France
0
Fig. 1. Mean relative number of alcohol research publications by all scientific papers in the Scopus database 2001–2011 (per million inhabitants).
Norway
15,000 20,000 25,000 All scientific papers 2001–2011
30,000
For instance, we observed that high alcohol research output nations were all countries in which the temperance movement had a foothold in the 19th and early 20th centuries. Levine [3] identified two features of temperance cultures, as follows: (1) distilled liquor was prominent and (2) they were strongly influenced by Protestant notions of self-control, to which alcohol was viewed as posing a significant threat. In essence, temperance cultures were galvanised by concern about alcohol and its consequences and the desire to curtail these. Temperance cultures predominate in Nordic and English-speaking countries, although there are some exceptions. While Levine [3] categorised countries as either temperance cultures or not, he did acknowledge that countries such as Denmark, Germany and the Netherlands had smaller-scale temperance movements. This is a point that is corroborated by Barrows and Room [4], who noted that by the end of the 19th century there were temperance movements in the Netherlands and Germany. Eriksen [5], too, described the presence of a temperance movement in Denmark but argued that this was undermined by brewers who appealed to patriotic symbolism Savic /Room
as a way of ensuring the viability of their products [6]. Drastic taxing of spirits during and after World War I is also likely to have taken a lot of impetus out of the temperance argument in Denmark, since rates of drinking fell as a result [7]. We compared the rate of alcohol-related research publications relative to population size from Bramness et al. [1] of countries with temperance and non-temperance cultures based upon a modified version of the classification of Levine [3] (table 1). Countries with temperance cultures appear to have, on average, a greater number of alcohol-related peer-reviewed publications compared to countries with no temperance culture. Levine [3] hypothesised that: ‘in recent years popular and scientific concern with alcohol problems has been strongest among the English-speaking and Nordic countries. For example, it is those nations that send most of the scientists and researchers to international collaborative studies on alcohol problems and policy. However, it is difficult to statistically test the idea that societies which had large temperance movements in the past have retained the strongest concern with alcohol problems and misuse’ (p. 29). Publication in peer-reviewed journals is not the only indicator of ‘scientific concern’ about alcohol. Indeed, non-peer-reviewed reports (and other means of research dissemination) have historically been important in countries where English is not the official language and where the emphasis is on local dissemination [7]. Even though this might be the case, figure 1 illustrates that countries such as Germany, Spain, France and Italy had fewer overall peer-reviewed publications relative to population size when publications in languages other than English were included [8, 9]. Given the apparent relationship between overall research output and alcoholrelated research output, we would expect that even if alcohol-related publications in languages other than English were counted by Bramness et al. [1], this would not make a large difference in terms of the general patterns observed. Our observation of research publication output based upon data from Bramness et al. would seem to support the hypothesis that scientific concern about alcohol is strongest in countries which had temperance movements. Levine [3] cites the initial growth of Alcoholics Anonymous in temperance cultures (although by 1986 it had spread well beyond these countries [10]) and the existence of neo-temperance organisations that stress the dangers of alcohol as further illustrations of broader continuing concern with alcohol in these countries. Differences in Alcohol-Related Research Output between Countries
Table 1. Presence of a temperance culture in the countries includ-
ed in the study by Bramness et al. [1] Major temperance movement
Smaller temperance No popular tempermovement1 ance movement2
UK Finland Norway Sweden USA
Denmark Germany Netherlands
France Italy Spain
1 Levine
[3] acknowledged that there were smaller temperance movements in these countries, although not of the scale of other temperance cultures. 2 Temperance activity has been noted in France [8] and Italy [9], but this did not generate significant popular support.
As well as scientific and popular concern, countries with historical temperance movements also tend to retain stricter alcohol control policies. For instance, we used the Alcohol Policy Index [11] as an indicator of the strength of alcohol control policies in the countries sampled in the study by Bramness et al. [1] (fig. 2). The Alcohol Policy Index provides a score out of 100 and measures five policy areas, including the physical availability of alcohol (maximum 32 points) drinking context (maximum 8 points), alcohol prices (maximum 24 points), alcohol advertising (maximum 3 points) and the operation of motor vehicles (maximum 34 points). Higher scores indicate stricter alcohol policies. While there are limitations to the quantitative measurement of alcohol control policies [12], the Alcohol Policy Index does provide an indicator to enable international comparisons. As illustrated in figure 2, temperance countries on average appear to have stronger alcohol control policies than non-temperance countries, as well as higher alcohol research outputs relative to population size. There are a couple of notable exceptions. The UK, which had a relatively strong temperance movement, has a lower alcohol research output than the Netherlands and Denmark, which had smaller temperance movements. Similarly, Germany, which had some temperance activity, has very weak alcohol control policies, yet has a marginally higher alcohol-related research output than the non-temperance countries. This suggests that researchers and policy makers in temperance cultures appear to have advertently or inadvertently inherited a temperance culture concern about alcohol. Finland, Norway and Sweden are particularly good examples of this. All three had strong state alcohol Eur Addict Res 2014;20:319–323 DOI: 10.1159/000363230
321
Fig. 2. Mean relative number of alcohol re-
search publications (per million inhabitants) of countries which had major, small and no temperance movements by mean Alcohol Policy Index score.
Major temperance Small temperance
Eur Addict Res 2014;20:319–323 DOI: 10.1159/000363230
Finland
No popular temperance 80
Sweden USA
60
Norway Denmark 40
Netherlands UK
20
Germany
Spain
France
Italy
0 20
monopolies as part of the legacy of the temperance era, while countries such as Denmark did not [7]. The state’s involvement in the alcohol market (notably in retailing) meant that there was a ‘test bed’ for social research on alcohol, which was in keeping with the strong tradition of social engineering and experimentation in Nordic countries [13]. One might argue that these monopolies ensured that the state could never escape its responsibility for alcohol problems. State monopolies also meant that the private industry interests were always weaker and unable to promulgate the argument that alcohol problems were always about this small and special category of people labelled ‘alcoholics’. In this environment, funding for alcohol research was prioritised – and sometimes provided through the alcohol monopoly itself, as was the case in Finland until the mid-1990s [7] – enabling a strong Nordic tradition of alcohol research to develop and thrive [7]. This begs the question of whether a high alcohol-related research output is related to the need to generate evidence for an alcohol control policy or to evaluate an existing control policy (given the salience of the evidencebased policy paradigm). Olsson et al. [7] observed that in 322
Color version available online
Mean relative number of alcohol research publications 2001–2011
100
30
40 50 Mean Alcohol Policy Index score
60
70
Sweden and Finland (both temperance cultures) control policies have been weakened since the 1950s and that alcohol policy impact studies have been concerned with the effects of weakening control measures. As temperance cultures generally have more control policies to begin with, there are more policies available to weaken and subsequently evaluate. However, alcohol policy impact studies form a small part of the alcohol-related research literature. Obviously, there are likely to be other factors that influence the degree to which societies are concerned with alcohol and its harms and, by extension, alcohol-related research output. The epidemiology of drinking is likely to be one. Room and Mäkelä [14] argue that the regularity of drinking and the extent of intoxication are two dimensions that influence the way in which cultures view and respond to alcohol. Likewise, expectations and values around use and intoxication, and the degree to which they form a part of social life, may also be important. The way in which research is funded and organised may also be important. Why is it that in the UK – a temperance culture – the alcohol-related research output relSavic /Room
ative to population size is lower than in the Netherlands or in Denmark, which did not have temperance movements of the same scale? In some countries dedicated funds for ‘social problems’, or alcohol research in particular, may be limited. This means that alcohol research may lose out, since it is not central to any academic department or profession but crosses many. Bramness et al. [1] offer useful bibliometric insights into the state of addiction research, which we have expanded upon using additional secondary data in order to situate these within a historical and social context. While limited by sample size, our observations point to the role of general scientific productivity and the enduring legacy of 19th- and early 20th-century temperance cultures in alcohol-related research outputs. Not only do countries with higher alcohol-related research outputs relative to population size have higher scientific productivity and temperance histories, but they also tend to exhibit stricter controls on alcohol. While there are other contributing factors, and while our analysis is limited to a small number of countries, the alcohol-related research output appears to be influenced by both historical and contemporary ‘worry’ about alcohol and its consequences. If this is true, then alcohol-related research output might indicate or be indicative of the cultural position of alcohol in societies. Scientific productivity aside, nations with high rates of alcohol-related research publications relative to population size might be seen as being worried about alcohol, while countries with low rates of alcohol-
related research output might be less so. Increases or decreases in the national alcohol research output over time may mirror changes in the cultural position of alcohol or vice versa. Future research might extend this work to other English-speaking countries (e.g. Australia, Canada, Ireland, New Zealand) as well as other countries (e.g. in Eastern Europe, Asia, South America, Africa) to further investigate the applicability of our observations in other contexts. Exploring the type of research conducted in different countries in the analysis (e.g. qualitative, quantitative, policy, sociological, historical, treatment/intervention) would be useful in terms of empirically identifying research traditions and what can be learnt from these. By coding the source countries of citations drawn upon in reference lists, such research might also ascertain the degree to which alcohol-related research cultures are inward or outward looking. Future research might also investigate spending on alcohol research and the number of dedicated alcohol research institutes in each country and their influence on research output. Research funding, one might assume, would be another feature of societies concerned with alcohol. Acknowledgement We would like to thank Jørgen Bramness, who kindly provided us with a version of figure 2 for use in this paper, which we modified slightly.
References 1 Bramness JG, Henriksen B, Person O, Mann K: A bibliometric analysis of European versus USA research in the field of addiction: research on alcohol, narcotics, prescription drug abuse, tobacco and steroids, 2001–2011. Eur Addict Res 2014;20:16–22. 2 Cole S, Phelan TJ: The scientific productivity of nations. Minerva 1999;37:1–23. 3 Levine H: Temperance cultures: alcohol as a problem in Nordic and English-speaking cultures; in Lader M, Edwards G, Drummond C (eds): The Nature of Alcohol and Drug-Related Problems. New York, Oxford University Press, 1992, pp 16–36. 4 Barrows S, Room R: Introduction; in Barrows S, Room R (eds): Drinking: Behavior and Belief in Modern History. Berkeley, University of California Press, 1991, pp 1–25.
Differences in Alcohol-Related Research Output between Countries
5 Eriksen S: Drunken Danes and sober Swedes? Religious revivalism and the temperance movements as keys to Danish and Swedish folk cultures; in Stråth B (ed): Language and the Construction of Class Identities. The Struggle for Discursive Power in Social Organisation: Scandinavia and Germany after 1800. Gothenburg, University of Gothenburg Press, 1990, pp 55–94. 6 Eriksen S: The making of the Danish liberal drinking style: the construction of a wet alcohol discourse in Denmark. Contemp Drug Probl 1993;20:1–33. 7 Olsson B, Ólafsdóttir H, Room R: Nordic traditions of studying the impact of alcohol policies; in Room R (ed): The Effects of Nordic Alcohol Policies: What Happens to Drinking and Harm When Alcohol Controls Change? Helsinki, Nordic Council for Alcohol and Drug Research, NAD Publication No 42, 2002, pp 5–16. 8 Mitchell A: Unsung villain: alcoholism and the emergence of public welfare in France, 1870– 1914. Contemp Drug Probl 1986;13:447–471.
9 Morgan P: Industrialization, urbanization, and the attack on Italian drinking culture. Contemp Drug Probl 1988;15:607–626. 10 Mäkelä K: Social and cultural preconditions of Alcoholics Anonymous (AA) and factors associated with the strength of AA. Br J Addict 1991;11:1405–1413. 11 Brand DA, Saisana M, Rynn LA, Pennoni F, Lowenfels AB: Comparative analysis of alcohol control policies in 30 countries. PLoS Med 2007;4:e151. 12 Karlsson T, Österberg E: Scaling alcohol control policies across Europe. Drugs Educ Prev Pol 2007;14:499–511. 13 Bruun K: Conversation with Kettil Bruun. Br J Addict 1985;80:339–343. 14 Room R, Mäkelä K: Typologies of the cultural position of drinking. J Stud Alcohol 2000; 61: 475–483.
Eur Addict Res 2014;20:319–323 DOI: 10.1159/000363230
323
Copyright: S. Karger AG, Basel 2014. Reproduced with the permission of S. Karger AG, Basel. Further reproduction or distribution (electronic or otherwise) is prohibited without permission from the copyright holder.
Eur Addict Res 2014;20:319–323 DOI: 10.1159/000363230
Received: November 4, 2013 Accepted: April 27, 2014 Published online: October 10, 2014
Differences in Alcohol-Related Research Publication Output between Countries: A Manifestation of Societal Concern? Michael Savic a, b Robin Room c–e a
Turning Point Alcohol and Drug Centre, Eastern Health, b Eastern Health Clinical School, Monash University, Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, and d Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia; e Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden c
Key Words Alcohol research · Social history of alcohol · Alcohol policy
Abstract In a recent bibliometric analysis of alcohol- and other drugrelated research publications in 11 countries, differences were found in research output across countries. In this paper we use additional secondary data to explore possible sociohistorical factors that may contribute to differences in alcohol-related peer-reviewed publications across countries. Aside from general scientific productivity, we propose a possible link between the degree to which societies are concerned with alcohol and alcohol-related research outputs. © 2014 S. Karger AG, Basel
In a recent article published in European Addiction Research, Bramness et al. [1] conducted an international comparison of alcohol- and other drug-related research publications as indexed on the Thompson ISI database. The authors found that the USA had the highest absolute number of peer-reviewed publications but noted differences in publication outputs relative to population size © 2014 S. Karger AG, Basel 1022–6877/14/0206–0319$39.50/0 E-Mail [email protected] www.karger.com/ear
across countries. In their analysis of outputs relative to population size, the small Northern European countries were more prolific. Bramness et al. [1] postulate that this difference might be due to historical, moral and religious differences but suggest that ‘this is difficult to decide’ (p. 21). In this paper, we take a socio-historical angle to explore the differences noted by Bramness et al. in alcohol-related research publications between countries. We consider what alcohol research output says about societies and their relationship to alcohol. We contend that societies that have historically ‘worried’ about alcohol consumption and its harms have higher relative research outputs, and that high research outputs are perhaps a manifestation of continuing concern about alcohol use and its consequences in these countries. Our starting point was to examine whether alcohol research output could be partly explained by overall research output. We searched the Scopus database to collect indicative data on the total number of research publications (in any field and in any language) in each of the countries studied by Bramness et al. [1] over the 2001– 2011 period. We then calculated the overall number of research publications per million inhabitants in each Michael Savic Turning Point Alcohol and Drug Centre 54–62 Gertrude Street, Fitzroy Melbourne, VIC 3065 (Australia) E-Mail MichaelS @ turningpoint.org.au
Mean relative number of alcohol research publications 2001–2011
100 Finland 80 Sweden USA
60
Denmark Netherlands 40
UK
20
Spain
Italy
10,000
country and plotted this against the data on alcoholrelated research relative to population size from the figure supplied by Bramness et al. [1]. As is illustrated in figure 1, countries with a higher alcohol research output relative to population size appeared to also have a greater overall research output in general. This suggests that a high alcohol research output might partially be a function of general scientific productivity. The Scandinavian countries as well as the Englishspeaking countries all have histories of Protestantism, which has been shown to have a relationship to national scientific productivity, even after national wealth is controlled for [2]. This is reflected in the overall research output, and indeed in the alcohol research output relative to population size, but there are anomalies. For instance, the Netherlands and Denmark both produce more scientific papers relative to population size than the USA or Norway but produce less alcohol-related research papers by comparison. This suggests that the overall research output alone cannot totally explain the alcohol-related research output. Other socio-historical factors are likely to illuminate this further. 320
Eur Addict Res 2014;20:319–323 DOI: 10.1159/000363230
Germany France
0
Fig. 1. Mean relative number of alcohol research publications by all scientific papers in the Scopus database 2001–2011 (per million inhabitants).
Norway
15,000 20,000 25,000 All scientific papers 2001–2011
30,000
For instance, we observed that high alcohol research output nations were all countries in which the temperance movement had a foothold in the 19th and early 20th centuries. Levine [3] identified two features of temperance cultures, as follows: (1) distilled liquor was prominent and (2) they were strongly influenced by Protestant notions of self-control, to which alcohol was viewed as posing a significant threat. In essence, temperance cultures were galvanised by concern about alcohol and its consequences and the desire to curtail these. Temperance cultures predominate in Nordic and English-speaking countries, although there are some exceptions. While Levine [3] categorised countries as either temperance cultures or not, he did acknowledge that countries such as Denmark, Germany and the Netherlands had smaller-scale temperance movements. This is a point that is corroborated by Barrows and Room [4], who noted that by the end of the 19th century there were temperance movements in the Netherlands and Germany. Eriksen [5], too, described the presence of a temperance movement in Denmark but argued that this was undermined by brewers who appealed to patriotic symbolism Savic /Room
as a way of ensuring the viability of their products [6]. Drastic taxing of spirits during and after World War I is also likely to have taken a lot of impetus out of the temperance argument in Denmark, since rates of drinking fell as a result [7]. We compared the rate of alcohol-related research publications relative to population size from Bramness et al. [1] of countries with temperance and non-temperance cultures based upon a modified version of the classification of Levine [3] (table 1). Countries with temperance cultures appear to have, on average, a greater number of alcohol-related peer-reviewed publications compared to countries with no temperance culture. Levine [3] hypothesised that: ‘in recent years popular and scientific concern with alcohol problems has been strongest among the English-speaking and Nordic countries. For example, it is those nations that send most of the scientists and researchers to international collaborative studies on alcohol problems and policy. However, it is difficult to statistically test the idea that societies which had large temperance movements in the past have retained the strongest concern with alcohol problems and misuse’ (p. 29). Publication in peer-reviewed journals is not the only indicator of ‘scientific concern’ about alcohol. Indeed, non-peer-reviewed reports (and other means of research dissemination) have historically been important in countries where English is not the official language and where the emphasis is on local dissemination [7]. Even though this might be the case, figure 1 illustrates that countries such as Germany, Spain, France and Italy had fewer overall peer-reviewed publications relative to population size when publications in languages other than English were included [8, 9]. Given the apparent relationship between overall research output and alcoholrelated research output, we would expect that even if alcohol-related publications in languages other than English were counted by Bramness et al. [1], this would not make a large difference in terms of the general patterns observed. Our observation of research publication output based upon data from Bramness et al. would seem to support the hypothesis that scientific concern about alcohol is strongest in countries which had temperance movements. Levine [3] cites the initial growth of Alcoholics Anonymous in temperance cultures (although by 1986 it had spread well beyond these countries [10]) and the existence of neo-temperance organisations that stress the dangers of alcohol as further illustrations of broader continuing concern with alcohol in these countries. Differences in Alcohol-Related Research Output between Countries
Table 1. Presence of a temperance culture in the countries includ-
ed in the study by Bramness et al. [1] Major temperance movement
Smaller temperance No popular tempermovement1 ance movement2
UK Finland Norway Sweden USA
Denmark Germany Netherlands
France Italy Spain
1 Levine
[3] acknowledged that there were smaller temperance movements in these countries, although not of the scale of other temperance cultures. 2 Temperance activity has been noted in France [8] and Italy [9], but this did not generate significant popular support.
As well as scientific and popular concern, countries with historical temperance movements also tend to retain stricter alcohol control policies. For instance, we used the Alcohol Policy Index [11] as an indicator of the strength of alcohol control policies in the countries sampled in the study by Bramness et al. [1] (fig. 2). The Alcohol Policy Index provides a score out of 100 and measures five policy areas, including the physical availability of alcohol (maximum 32 points) drinking context (maximum 8 points), alcohol prices (maximum 24 points), alcohol advertising (maximum 3 points) and the operation of motor vehicles (maximum 34 points). Higher scores indicate stricter alcohol policies. While there are limitations to the quantitative measurement of alcohol control policies [12], the Alcohol Policy Index does provide an indicator to enable international comparisons. As illustrated in figure 2, temperance countries on average appear to have stronger alcohol control policies than non-temperance countries, as well as higher alcohol research outputs relative to population size. There are a couple of notable exceptions. The UK, which had a relatively strong temperance movement, has a lower alcohol research output than the Netherlands and Denmark, which had smaller temperance movements. Similarly, Germany, which had some temperance activity, has very weak alcohol control policies, yet has a marginally higher alcohol-related research output than the non-temperance countries. This suggests that researchers and policy makers in temperance cultures appear to have advertently or inadvertently inherited a temperance culture concern about alcohol. Finland, Norway and Sweden are particularly good examples of this. All three had strong state alcohol Eur Addict Res 2014;20:319–323 DOI: 10.1159/000363230
321
Fig. 2. Mean relative number of alcohol re-
search publications (per million inhabitants) of countries which had major, small and no temperance movements by mean Alcohol Policy Index score.
Major temperance Small temperance
Eur Addict Res 2014;20:319–323 DOI: 10.1159/000363230
Finland
No popular temperance 80
Sweden USA
60
Norway Denmark 40
Netherlands UK
20
Germany
Spain
France
Italy
0 20
monopolies as part of the legacy of the temperance era, while countries such as Denmark did not [7]. The state’s involvement in the alcohol market (notably in retailing) meant that there was a ‘test bed’ for social research on alcohol, which was in keeping with the strong tradition of social engineering and experimentation in Nordic countries [13]. One might argue that these monopolies ensured that the state could never escape its responsibility for alcohol problems. State monopolies also meant that the private industry interests were always weaker and unable to promulgate the argument that alcohol problems were always about this small and special category of people labelled ‘alcoholics’. In this environment, funding for alcohol research was prioritised – and sometimes provided through the alcohol monopoly itself, as was the case in Finland until the mid-1990s [7] – enabling a strong Nordic tradition of alcohol research to develop and thrive [7]. This begs the question of whether a high alcohol-related research output is related to the need to generate evidence for an alcohol control policy or to evaluate an existing control policy (given the salience of the evidencebased policy paradigm). Olsson et al. [7] observed that in 322
Color version available online
Mean relative number of alcohol research publications 2001–2011
100
30
40 50 Mean Alcohol Policy Index score
60
70
Sweden and Finland (both temperance cultures) control policies have been weakened since the 1950s and that alcohol policy impact studies have been concerned with the effects of weakening control measures. As temperance cultures generally have more control policies to begin with, there are more policies available to weaken and subsequently evaluate. However, alcohol policy impact studies form a small part of the alcohol-related research literature. Obviously, there are likely to be other factors that influence the degree to which societies are concerned with alcohol and its harms and, by extension, alcohol-related research output. The epidemiology of drinking is likely to be one. Room and Mäkelä [14] argue that the regularity of drinking and the extent of intoxication are two dimensions that influence the way in which cultures view and respond to alcohol. Likewise, expectations and values around use and intoxication, and the degree to which they form a part of social life, may also be important. The way in which research is funded and organised may also be important. Why is it that in the UK – a temperance culture – the alcohol-related research output relSavic /Room
ative to population size is lower than in the Netherlands or in Denmark, which did not have temperance movements of the same scale? In some countries dedicated funds for ‘social problems’, or alcohol research in particular, may be limited. This means that alcohol research may lose out, since it is not central to any academic department or profession but crosses many. Bramness et al. [1] offer useful bibliometric insights into the state of addiction research, which we have expanded upon using additional secondary data in order to situate these within a historical and social context. While limited by sample size, our observations point to the role of general scientific productivity and the enduring legacy of 19th- and early 20th-century temperance cultures in alcohol-related research outputs. Not only do countries with higher alcohol-related research outputs relative to population size have higher scientific productivity and temperance histories, but they also tend to exhibit stricter controls on alcohol. While there are other contributing factors, and while our analysis is limited to a small number of countries, the alcohol-related research output appears to be influenced by both historical and contemporary ‘worry’ about alcohol and its consequences. If this is true, then alcohol-related research output might indicate or be indicative of the cultural position of alcohol in societies. Scientific productivity aside, nations with high rates of alcohol-related research publications relative to population size might be seen as being worried about alcohol, while countries with low rates of alcohol-
related research output might be less so. Increases or decreases in the national alcohol research output over time may mirror changes in the cultural position of alcohol or vice versa. Future research might extend this work to other English-speaking countries (e.g. Australia, Canada, Ireland, New Zealand) as well as other countries (e.g. in Eastern Europe, Asia, South America, Africa) to further investigate the applicability of our observations in other contexts. Exploring the type of research conducted in different countries in the analysis (e.g. qualitative, quantitative, policy, sociological, historical, treatment/intervention) would be useful in terms of empirically identifying research traditions and what can be learnt from these. By coding the source countries of citations drawn upon in reference lists, such research might also ascertain the degree to which alcohol-related research cultures are inward or outward looking. Future research might also investigate spending on alcohol research and the number of dedicated alcohol research institutes in each country and their influence on research output. Research funding, one might assume, would be another feature of societies concerned with alcohol. Acknowledgement We would like to thank Jørgen Bramness, who kindly provided us with a version of figure 2 for use in this paper, which we modified slightly.
References 1 Bramness JG, Henriksen B, Person O, Mann K: A bibliometric analysis of European versus USA research in the field of addiction: research on alcohol, narcotics, prescription drug abuse, tobacco and steroids, 2001–2011. Eur Addict Res 2014;20:16–22. 2 Cole S, Phelan TJ: The scientific productivity of nations. Minerva 1999;37:1–23. 3 Levine H: Temperance cultures: alcohol as a problem in Nordic and English-speaking cultures; in Lader M, Edwards G, Drummond C (eds): The Nature of Alcohol and Drug-Related Problems. New York, Oxford University Press, 1992, pp 16–36. 4 Barrows S, Room R: Introduction; in Barrows S, Room R (eds): Drinking: Behavior and Belief in Modern History. Berkeley, University of California Press, 1991, pp 1–25.
Differences in Alcohol-Related Research Output between Countries
5 Eriksen S: Drunken Danes and sober Swedes? Religious revivalism and the temperance movements as keys to Danish and Swedish folk cultures; in Stråth B (ed): Language and the Construction of Class Identities. The Struggle for Discursive Power in Social Organisation: Scandinavia and Germany after 1800. Gothenburg, University of Gothenburg Press, 1990, pp 55–94. 6 Eriksen S: The making of the Danish liberal drinking style: the construction of a wet alcohol discourse in Denmark. Contemp Drug Probl 1993;20:1–33. 7 Olsson B, Ólafsdóttir H, Room R: Nordic traditions of studying the impact of alcohol policies; in Room R (ed): The Effects of Nordic Alcohol Policies: What Happens to Drinking and Harm When Alcohol Controls Change? Helsinki, Nordic Council for Alcohol and Drug Research, NAD Publication No 42, 2002, pp 5–16. 8 Mitchell A: Unsung villain: alcoholism and the emergence of public welfare in France, 1870– 1914. Contemp Drug Probl 1986;13:447–471.
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