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The Paradox of Alcohol Policy: The Case of the 1969 Alcohol Act in Finland DAN E. BEAUCHAMP INTRODUCTION The case of alcohol policy in the Nordic countries of Finland, Sweden, and Norway during the 1960s, which was intended to liberalize their alcohol control systems, is already an important and well-researched episode In the alcohol policy literature. This is especially true for Fin- land. Data are readily available on the relationship between altering the regulation of alcohol availability and changes in total consumption, in drinking for purposes of intoxication, in heavy consumption, and the like. An examination of the Nordic experience is important for the ways in which it can help frame our ways of thinking about alcohol policy and how alcohol policy is affected by larger forces for social and cultural change in advanced industrialized societies generally, not just for these small nations. It is arguable that the results of these changes are of minor relevance to American policy. There are important structural differences between the Nordic countries and the United States: most commonly mentioned (Castles 197S, Hancock 1972, Eckstein 1966, Pesonen 1974) are their Dan Beauchamp, a member of the panel, is at the Department of Health Administration, School of Public Health, University of North Carolina. The author is grateful to Kettil Bruun of the Finnish Foundation for Alcohol Studies, and to members of the Social Research Institute of Alcohol Studies in Helsinki, whose invaluable assistance made this study possible. 225

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226 B EA(JCHAMP parliamentary forms, elite autonomy, multiparty traditions, a long his- tory of dominance by the Social Democrats in most countries, and a unique mode of government by consensus and consultation. The small size of the Nordic countries, especially Finland, makes them questionable candidates for comparative research. Finland's population is very small compared with that of the United States roughly 4.5 million inhabitants as opposed to over 200 million in the United States. On the other hand, Sweden, Norway, and Finland bear important sim- ilarities to the United States. All have had a strong temperance tradition; Finland and Norway experienced prohibition; and the state monopoly system of alcohol control is similar to many state systems in the United States. While there are always dangers in generalization from comparative research, Finnish alcohol policy seems important for the United States in two ways. First, the changes have been studied closely by interna- tionally respected researchers. Their findings (which are summarized in this paper) constitute an important body of alcohol policy knowledge regarding alcohol availability and its control by governmental measures. The Finnish literature regarding the 1969 Alcohol Act is an invaluable stock of knowledge regarding the effectiveness of a small number of conventional policy instruments commonly found in advanced indus- trialized countries such measures as tax policy, availability restrictions, and age limits. Thus, one goal in examining the situation in Finland is to develop a wider base of knowledge about substantive elements of alcohol policy as well as some general relationships between available policy instruments that any number of similar societies might consider, recognizing that this knowledge will not be free of specific contextual, historical, or cultural contingencies. As a second aim, we seek to situate this Finnish policy change in the context of cultural changes occurring in mature industrial societies within the past several decades. We refer to the struggle between cultural modernization and cultural fundamentalism (Gusfield 1963) that typi- cally arose as these societies rapidly completed processes of industrial- ization and moved toward postindustrial or advanced industrial patterns of dominant service sectors, advancing levels of affluence, consumption, urbanization, and so forth. This maturation is apparently occurring throughout industrial socie- ties, irrespective of differences in political systems and cultures. If this ' This dominance of the Social Democrats is less true for Finland than for Sweden and Norway. Also, the Social Democrats in all three Nordic countries suffered setbacks in the mid-1970s.

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The 1969 Alcohol Act in Finland 227 view is valid, then alcohol policy changes in Finland provide important insights not only into the impact of specific policy instruments such as taxation or availability, but also into the context of alcohol policy for- mation in societies, such as Finland and the United States, which contain both fundamentalist and modernist views toward alcohol, perhaps as well as an emergent postmodern view. THE FINNISH ALCOHOL POLICY DEBATE Norway, Finland, and Sweden have all had relatively restrictive systems for controlling the sale of alcoholic beverages during this century. Both Finland and Norway experienced an era of prohibitionin Finland it lasted from 1920 to 1933. Sweden only narrowly missed prohibition in a nationwide referendum. All three societies have similar systems for control of alcohol. In each country there is a state monopoly for the manufacture and sale of most alcoholic beverages, except for beer of very limited alcohol content (in Finland, beer with less than 2.25 percent alcohol by weight). Generally speaking, until the liberalization legislation each country only permitted this very light beer to be distributed in shops and restaurants. Wine and spirits are sold through the state monopolies The state monopolies vary only in detail from country to country. In Finland, it is generally agreed, the monopoly (ALKO) is more inde- pendent from the Ministry of Social Affairs and Health. In both Finland and Sweden, the monopoly has in recent years been headed up by rather prominent political figures the director in Finland served as a minister of social affairs and health in the early 1970s. The director of Vinmon- opolet in Norway has been more a nonpolitical manager. ALKO casts a formidable shadow across the Finnish economy. The revenues derived from ALKO constitute almost 8 percent of all state revenues. (The comparable figure for the United States is 2.2 percent of general federal revenues and roughly 1 percent of state and local revenues.) Furthermore, ALKO also has substantial restaurant and ho- tel holdings: as much as 10 percent of all hotel rooms in Finland are reportedly owned by the monopoly. ALKO is not just a retailing or- ganization like the American state monopoly systems; it is also a sub- stantial manufacturer of alcohol beverages. ALKO's size and prominence in Finland seem to intensify real con- tradictions among the three statutory purposes of ALKO: to manufac- ture and sell alcoholic beverages, to raise revenues and to hold down consumption. An important new factor for ALKO has also entered into alcohol policy within the last decade. This is the emergence of an "in-

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228 j' BEAUCHAMP comes policy" in Finland, a process of negotiation in which the govern- ment, the unions, and business attempt to adjust prices, wages, and salaries. The upshot is a rather direct pressure on ALKO from the trade unions to restrain price increases in order to moderate the impact of inflation. The current director of ALKO, Pekka Kuusi, is a social scientist who Dined ALKO shortly after World War II. One of his earliest research activities was the completion of one of the first national sample surveys in Finland, a survey of Finnish drinking habits (Kuusi 1948~. His most ambitious alcohol policy research project was an experiment to measure the impact of making beer and wine more available in rural market towns. At that time all alcoholic beverages were prohibited in the rural communes as part of the original legislation establishing the postpro- hibition alcohol control system. In fact, this rural prohibition extends back to 1902. The Alcohol Legislation Committee was formed by the Parliament in 1948, and its report in l9S1 prompted wide public discussion. The anticipation of this policy debate was a key factor in the establishment by ALKO of the Finnish Foundation of Alcohol Studies in 1950 as well as in ALKO's support for Kuusi's study of rural prohibition. It was during this period that ALKO independently liberalized wine sales by no longer requiring identity cards for purchasing lighter wines (Kuusi 1957~. The changes recommended by the Alcohol Legislation Committee- the end of rural prohibition and the liberalization of beer- would over- turn established traditions. Rural prohibition predated national prohi- bition and continued after its repeal. State monopoly stores were per- mitted only in urban areas or market towns; since 1902 no sale of alcohol had taken place in rural areas in Finland, which as late as 1960 encom- passed 60 percent of the Finnish population. Thus, when the Alcohol Legislation Committee recommended in 1951 that beer (with no more than 3.5 percent alcohol by weight) be sold in retail shops and licensed restaurants, this modest recommendation stood to overturn an unbroken 50-year-old policy. (This change did not actually occur until 18 years later. The Alcohol Act was passed in 1968 and went into effect on January 1, 1969. In fact the act went beyond the 1951 recommendation, as we shall see below.) THE FINNISH DRINKING STYLE The way in which Finns define their alcohol problem - the Finnish drink- ing styleis intimately connected to the policy debate over making

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The 1969 Alcohol Act in Finland 229 lighter beverages more available. An excerpt from a 1958 study by the eminent Finnish sociologist, Erik Allardt, might help clarify the Finnish view of their alcohol problems (Allardt 1958, p. 15~: The consumption of alcohol in Finland is smaller that in most European coun- tries.... More than half the adult population uses alcoholic beverages less often than once a month and the most common pattern is to use alcohol a few times in a year. In spite of this low rate of consumption drunkenness is a comparatively common phenomenon. In 1950 the rate of arrest for drunkenness was about ten times higher in Finland than in Sweden and three times higher than in Norway. There is evidence showing that Finnish immigrants in the United States in the early nineteen-twenties had rates of arrest for drunkenness higher than any other immigrant group.... Studies of Finnish drinking habits reveal that the Finns drink at irregular intervals' mainly on Saturdays and Sundays, and they are apt to drink great quantities at a time. The consumption of distilled spirits is heaviest, while the consumption of wines and brewed beverages is much smaller. The drinking of alcohol is to a great extent regarded as a means of getting drunk. The Finnish drinking style is seen as the inclination to engage in drinking bouts for the explicit purpose of serious intoxication, inter- spersed with rather long periods of relatively little or no use of alcohol. Survey researchers in Finland have been mainly interested in how much an individual drinks on a particular occasion with relatively little in- terest in constructing detailed topologies of drinkers. Consequently, in Finland there has until recently been very little interest in estimating the number of "alcoholics." By contrast, in the United States, the par- adigmatic definition of alcohol problems has been the long-term and chronic ingestion of alcohol, particularly manifesting itself in deterio- rating health, career, and family life among middle-aged men. Intoxi- cation and public drunkenness are clearly alcohol problems, but the central problem of alcoholism is "loss of control" over alcohol, which for all practical purposes means heavy, chronic use of alcohol for very long periods of time. This is regarded as the problem of a distinct minority of individuals, although that minority is quite large in number due to the large size of the United States. Until the late 1960s, Finnish aggregate or total consumption was among the lowest in the world. It still remains in the middle range despite the notable increases during the 1960s and the 1970s. Despite this modest overall consumption, researchers in Finland and elsewhere have commented on Finland's relatively high per-capita arrests for drun- kenness. Southern European countries drank much more per capita than Finland yet had much lower arrest rates for drunkenness (Ahlstrom- .. Laakso and Osterberg 1976~. Thus, a point of view emerged that an

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230 BEAUCHAMP increase in consumption, specifically of wine and beer, might lead to learning more moderate drinking styles and a decline in arrests for drunkenness. THE FIRST TEST FOR THE DEBATE The debate over the existing alcohol control system and the peculiarities of the Finnish drinking style provide the introduction to the first test of the effectiveness of liberalizing alcohol measures the rural prohibition experiment of the early l950s (Kuusi l9S7~. The introduction to Kuusi's report ore this field experiment addresses alcohol policy in the postwar period from the perspective of those in- dividuals and groups who sought to modernize and develop Finnish society. Kuusi argued that the increase of state power to pursue collec- tive security in many areas is a necessary attribute of modern social democracies. But Kuusi warns of the need to remove excessive restric- tions in the social sphere, to reevaluate the necessity of burdensome traditional and moralistic restraints that may be counterproductive. Kuusi is clearly taking the cultural modernist view, referring to these restraints as categorical restrictions.2 Regarding the controversy over making alcohol available in rural areas and making certain forms of beer more available in retail shops, he lists six different hypotheses set forward regarding the results of such change: (~) the number of temperate persons will decline; (2) the frequency of drinking will increase; (3) a shift in the consumption patterns will occur to the advantage of the light beverages; (4) the use of illicit liquors will decline; (S) the quantities consumed at one sitting will decline; (6) drunkenness and breach of public peace will become more common. Kuusi notes that those in favor of temperance tended to stress the first and second hypothesestemperance will decline and drinking fre- quency will increase. The state alcohol monopoly favored the third and fourth hypotheses, predicting a shift to light beverages and a decline in the use of illicit beverages. Kuusi noted that the division of opinion on 2 Kuusi (1957. pp 2-3) argues that. while on balance the trend of modern social policy has been to stress social organization and collective approaches. it is often the case that the boundary line between the demonstrated needs of individuals for security from risk and their need for freedom must be carefully assessed. He goes on to suggest in rather veiled terms that sometimes this line can be drawn too heavily on the side of security and indeed may be done so to safeguard the interests of "certain groups."

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The 1969 Alcohol Act in Finland 231 the expectation of a decline in temperate persons and an increase in frequency of drinking was not so large as it might seem, since both sides agreed that this might happen, with those favoring change arguing that more drinking and more frequent drinking were actually occurring than the temperance groups seem to believe. The sharpest point of disa- greement centered around the shift in consumption to light beverages. The experiment took place in four dry market towns located in rural areas. Two were control towns: beer and wine only were made available through new state-owned stores. A survey was made in 1951 of the experimental and control towns before the opening of the stores and followed up with the measurements taken in the period 1952-1953 to determine the effects of the change (Kuusi 1957~. In general, Kuusi found that those who used alcohol very little were little affected by the opening of the experimental stores; the use of beer increased sharply in some areas (particularly in those communities in which drinking frequency was already higher); and the use of illicit liquor declined. Kuusi also found only slight indications of an increase in the amount of alcohol consumed at a given occasion. There was no appre- ciable increase in public drunkenness, and, indeed, Kuusi questioned the relation of the control system to the frequency of excessive drinking. The results of the experiment were somewhat frustrated by changes in alcohol policy put in place by ALKO at the beginning of the exper- imental period. However, the results were interpreted by Kuusi as broadly supportive of the liberalization position, although he states this position very carefully and tentatively. THE 1969 ALCOHOL ACT: THE SECOND TEST It is not possible to reconstruct here the complex forces that led to the 1968 policy changes followed by the 1969 Alcohol Act. but for our purposes the broad outlines are of interest. The central point is that there were substantial forces for liberalization within Finnish society, and some of those in a strong position to influence policy were in favor of these changes. It is clear that sentiment strongly favoring a less re- strictive alcohol policy grew during the 1960s among the leaders of ALKO, among the experts at the Finnish Foundation for Alcohol Stud- ies, and among the general public. In the opinion of these experts, the key was the sharp social and demographic changes occurring in postwar Finland, accelerating during the early 1960s and culminating in the election of 1966. The left generally did well in this election, and the new government was a coalition of the Center Party, the Social Democrats. and the party of the Finnish Communists.

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232 BEAUCHAMP This election was seen as a pivotal one, especially among young people in Finland, as it represented something of a break with the past, a strong commitment to growth, and a promise to liberalize Finnish society. A very popular book of this period was Pekka Kuusi's A Social Policy for the Sixties: A Plan for Finland (1964), which called for a comprehensive plan of social provision for the nonproducing sector (the aged, the poor, and the handicapped) in order to maintain expanding, aggregate eco- nomic demand. These ideas of development and deliberate stimulation of growth, coupled with a growing climate of permissiveness and a much younger population, seemed to collide with what was perceived as a very restrictive state alcohol policy. Temperance organizations within Finland were opposed to these changes. The Nordic countries have had a rather strong temperance history. While membership has declined in the post-World War II pe- riod, this decline has been somewhat offset by the tendency of temper- ance members to be active in politics. Also, the temperance organiza- tions have in a sense become part of the bureaucracy, in that they are subsidized by the State Ministry for Social Affairs and Health directly and through the operation of local temperance boards, which serve mainly as alcohol education agencies at the communal level. The forces for liberalization easily carried the day, and the statutory changes that are of interest here are these: restrictions were abolished on the number of rural areas in which alcohol was permitted (in 1968 nearly 50 percent of Finland lived in areas in which no state store was permitted), the state alcohol monopoly's policy toward the licensing of restaurants was changed so as to permit alcohol (especially beer) to be sold in more restaurants, and the legal drinking age was reduced from 21 to 20 years for distilled beverages, 18 for light beer, and medium beer was allowed to be sold in retail shops. THE AFTERMATH OF LIFTING RESTRICTIONS What were the results of this much-debated, long anticipated change? As a parliamentary commission was later to report, the effects of these changes took virtually everyone by surprise. First of all, and perhaps most spectacularly, total per-capita consumption of alcohol in beverages increased by 46 percent (1.33 liters) during the first year. Most of this initial increase (1.17 liters) was accounted for by the 124-percent rise in beer drinking. The consumption of spirits also rose in 1969 by 0.15 liters of alcohol, then continued to rise at a steady 0.20 (approximately) liters per year through 1975; the rise in beer consumption continued at a much lower rate of 0.05 liters per year after 1969. By 1975 the use of

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The 1969 Alcohol Act in Finland TABLE ~ Per-Capita Consumption of Alcoholic Beverages in Finland, 1951-1975, in Liters of Absolute Alcohol 233 Alcoholic Distilled Beverages, Year Spirits Wines Beer Total Retail Catering - 1951 1957 1962 1968 1969 1972 1975 1.36 1.15 1.42 1.43 1.58 2.19 2.81 0.10 0.24 0.26 0.51 0.52 0.63 0.97 0.32 0.33 0.43 0.94 2.11 2.28 2.41 1.79 1.79 2.11 2.88 4.21 5.10 6.19 1.33 1.29 1.63 2.19 3.09 3.69 4.73 0.46 0.43 0.48 0.69 1.12 1.41 1.46 Source: Ahlstrom-Laakso and Osterberg (1976, p. 9~. Reprinted by permission. beer had increased a cumulative 156 percent (0.147 liters) since 1968; spirits 96 percent (1.38 liters), wine 87 percent (0.46 liters) (see Table 1~. Total consumption reached 6.19 liters in 1975. In recent years alcohol consumption has apparently stabilized. The sustained increase in strong alcoholic beverage use in the intervening years is given an interesting interpretation by the Finnish researchers, as we shall see below. The changes in availability of medium beer with the new law were radical and sudden. The number of applicants for licenses to retail me- dium beer was considerable, and ALKO granted a license to almost every applicant.-The total number of monopoly stores, medium beer shops, and full-licensed restaurants also increased sharply during the first 3 years of the change in the system. These changes are summarized in Table 2. According to a survey by Makela (1971), the estimated number of drinking occasions during which blood alcohol of drinkers reached at least the 0.10 level increased by about 25 percent. Another researcher TABLE 2 Finnish Distribution Network for Medium Beer, 1969-1975 Number of Outlets Retail Rural Retail Service Rural Service Year Outlets Outlets Outlets Outlets 1969 17,431 9,878 2,716 1,195 1971 15,560 9,034 3,406 1,647 1973 13,550 7,374 3,319 1,524 1975 11,965 6,965 3,086 1,393 Source: Ahlstrom-Laakso and Osterberg (1976, p. 6). Reprinted by permission.

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234 B EAUCH A M P TABLE 3 Per-Capita Alcohol Consumption, Finland and Sweden Per-Capita Alcohol Consumption Finland Liters Percentage Sweden Liters Percentage Total 1951 2.58 3.49 1962 3.01 4.03 1973 7.41 6.73 increase 1951-1962 0.43 16.7 0.54 15.5 1962-1973 4.40 146.2 2.70 67.0 Source: Makela and Osterberg (1976, p. 6~. estimated an increase in heavy consumers of alcohol from 61,000 in 1961 to 91,000 in 1969, whereas the increase would be likely to have stopped at 71,000 had the law remained unchanged (Purontaus 1970, cited in Bruun et al. 1975, p. 81~. The sharp increase in consumption during this period in Finland was put in a larger historical perspective by Ahlstrom-Laakso (1975, p. 1~: In Finland and also obviously in other countries the concern over the increased consumption among young people is connected with the general growth of alcohol consumption. After abolishing the Prohibition Act in 1933, less than a litre of pure alcohol was consumed a year in Finland. The two-litre limit was broken after three decades in the first half of the 1960's. From the year 1968 to the year 1973, the consumption of alcohol again doubled. This took five years; in other words, one-sixth the time that it took for the previous con- sumption to double. Finns consumed 5.6 litres of pure alcohol per capita in 1973. This dramatic rise in consumption during the 1960s and early 1970s was not restricted to Finland; it happened in most industrial countries, especially those with a relatively low aggregate consumption (Sulkunen 1976~. But the percentage rise in Finland exceeds that of any comparable country (Keller and Gurioli 1976~. Makela and Osterberg (1976) have compared Finland with Sweden during the period 1951-1973. Their re- search reveals that Finland's growth in per-capita consumption paral- leled Sweden until the Finnish liberalization in 1969; after this change the Finnish level rose to a point higher than that of Sweden during the early 1970s (see Table 3~. MORE RECENT SURVEY REPORTS Jussi Simpura of the Social Research Institute of Alcohol Studies pro- vides us with a very complete picture of changes that occurred in 1969

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The 1969 Alcohol Act in Finland TABLE 4 Data on Previous Week's Use of Alcohol by 15- to 69- Year-Old Finns in 196S, 1969, and 1976 235 Year Women Men Alcohol consumer (% of total) 1968 57 87 1969 65 91 1976 80 91 Weekly drinking instances per alcohol 1968 0.5 0.9 consumed 1969 0.8 1.5 1976 0.7 1.4 Average consumption of alcohol in a single 1968 3.0 7.3 instance of drinking (centiliters 100-percent 1969 3.2 6.2 alcoholic 1976 4.4 8.4 Average weekly consumption of alcohol 1968 0.88 5.96 (centiliters 100-percent alcohol, all 1969 1.66 8.37 respondents 1976 2.52 10.32 a The results are based on drinking instances within the week preceding the interview and represent a typical autumn week of the year. Source: S'mpura (1978~. Reprinted by permission. and subsequently. Simpura in 1976 essentially replicated the two earlier national surveys conducted by Makela in 1968 and 1969. The few key findings for the alcohol policy debate in Finland were (Simpura 1978~: from 1968 to 1975, abstinence rates among women fell sharply and, while there was some slight decline for men abstainers in the first year of the new legislation, the number of male abstainers remained constant thereafter (see Table 4~. The mean or average drinking instance changed in a rather surprising way. Not unexpectedly, the average number of drinking instances in- creased rather sharply in the first year; this number then declined (very slightly) over the next 6-year period. Recall that from the standpoint of the ongoing alcohol policy debate in Finland, an increase in drinking frequency was regarded by many as a sign that drinking was becoming more moderate and that lighter drinks (such as beer) were being consumed. Simpura (1978) speculates that there actually was an increase in drink- ing instances in 1976, but this was not revealed in the survey because medium beer had in the intervening period become defined as a non- alcoholic drink (much like the light beer that was available in Finland in retail shops prior to the change). Thus, he believes respondents were less likely to report the drinking of medium beer in their responses. We will discuss this change further below' but the researchers at the Finnish Foundation are persuaded that medium beer instances are not accurately reflected in the 1976 survey. There is a decline from 1968 to 1969 in the average amount of alcohol

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244 BEAUCHAMP TABLE 9 Last Drinking Occasion of the Finnish Population over 19 Years, in 1946, 196S, 1969, and 1976 Percent of the Population Month Ago More Never or More Recently N Total Population 1946 19 30 51 2~891 1968 19 1,663 1969 15 1,570 1976 9 20 70 2,601 Women 1946 31 33 36 1968 32 420 1969 25 399 1976 15 25 60 1.326 Men 1946 5 26 69 1968 4 1,243 1969 3 1,171 1976 4 16 80 1,275 Source: Sulkunen (1979a, p. 11~. Reprinted by permission. after World War II present a sharp rate of change in contrast with the generations that preceded in terms both of abstinence rates and age of initial alcohol use. An extended quotation by Sulkunen (1979a, pp. 36-37) helps clarify this point: Drinking by adolescents seems, in the light of the preceding observations, to be a phenomenon that began to emerge among those who were born in 1916- 1925 and who reached their adolescence after the war (approximately 1930- 1946~. Kuusi (1948, 111) estimates that probably more than 25~o of the males in this age group had their first drink in the army or in the war. Commenting on these data, Kuusi wondered in worry: "Is it too early now to assess whether this practice of boozing at a premature age will be found as a transitional aftermath of the war, or will it develop into a permanent custom? In any case, this is a phenomenon that deserves continuous attention" (Kuusi, 1948~. After thirty years, the answer is somewhat distressing. Boozing at a premature age did not only develop into a permanent custom. It developed into a practice of boozing in childhood. In fact, in 1976 drinking at the age of 15-19 was no less common that at the age of 20-29, if measured by the proportion of those who had ever taken a drink.

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The 1969 Alcohol Act in Finland TABLE 10 Last Drinking Occasion of Finnish Population over 19 Years by Occupational Position, in 1946 and 1976 245 Occupational Position Never Month Ago More or More Recently Unclassified or unknown 1946 1976 (N = 117) 9 24 67 Farmers 1946 22 33 45 1976 (N = 415) 21 26 53 Farm workers, etc. 1946 23 32 45 1976 (N = 57) 14 16 70 Industrial workers 1946 17 28 55 1976 (N = 1,033) 9 20 71 Lower white-collar 1946 16 30 54 1976 (N = 670) 5 19 76 Upper white-collar 1946 10 24 66 1976 (N = 309) 3 16 81 Source: Sulkunen (1979a, p. 14). Reprinted by permission. Sulkunen does not so much argue that this "wet" generation drank more on average than did the earlier generation but rather that it tended to be more likely to drink and to begin drinking at an earlier period. Sulkunen pays particular attention to the decline of abstinence among older women in Finland (1979a). He argues that there is tentative evi- dence that the younger group in turn encouraged the older persons to drink, especially older women. Sulkunen regards these differences in drinking styles as truly generational rather than age differences. Sulkunen's assessment of the meaning of declining abstinence rates and a sharp increase in the numbers who use alcohol at an early age can be summarized as follows: Any evaluation of the 1969 Alcohol Act and its consequences must take into account a post-World War II sea change in the general cultural and political climate regarding alcohol. The 1969 Alcohol Act is the culmination of postwar values. Abstinence began to decline sharply from the start of this period especially during the 1960s, among young women and teenagers of both sexes. Sulkunen does not deny that the 1969 act had an independent impact on this trend toward earlier drinking and lower rates of abstinence. In fact, if one carefully

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246 BEAUCHAMP TABLE 11 Changes in Age of First Drink for Finns in 1946 and 1976 by Rural-Urban Residence 1946 1976 Age at First Drink Rural Urban Rural Urban -15 8 8 24 26 1~17 19 22 42 46 1~20 42 47 68 74 21- 68 79 89 92 Never 20 14 11 8 Don't know 12 7 TOTAL 100 100 100 100 N 1,056 1,545 Source: Sulkunen (1979a, p. 32~. Reprinted by permission. scrutinizes the data that Sulkunen relies on, one can note that the de- clines in these abstinence rates became more marked and noticeable in the period following the 1969 act. One might quarrel with some details of Sulkunen's interpretation. Clearly the impulse toward liberalization found widespread support among the postwar generation. Yet it is unlikely that this group had a decisive political voice in the mid-1960s, even if one acknowledges the great increase in participation of the young in that election. We must remember that this period was one during which many factors contrib- uted to a more liberal climate, and that many key figures in the alcohol policy debate favored these changes. There is room for disagreement as to what weight to assign to cultural changes in drinking habits, the rise in consumer expenditure for alcohol, and the increased availability brought by the 1969 act, in evaluating the subsequent rise in consumption and associated problems. But the prin- cipals in the alcohol policy debate see all three as factors, differing only in which they would emphasize. SUMMARY AND CONCLUSIONS The most striking fact to an outsider speaking with various participants in alcohol policy in Finland is the consensus they present on the debate's central issues. Officials of ALKO and the Department of Social Affairs and Health, Finnish Foundation researchers, and leaders of the tem- perance organizations appear to agree about several key issues. First, there is widespread consensus that the impact of the 1969 act was on balance not favorable and that, while many factors beyond the

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The 1969 A Icohol A ct in Finland 247 act must be taken into account in explaining the rise in consumption in Finland after 1969, the act itself was directly responsible for a significant fraction of the increase in problems. Paradoxically, there is at least tacit acceptance by almost everyone that, while the legislative changes were probably introduced too abruptly and with too much optimism, there was little likelihood that these changes were avoidable by any government during this period. There is the possibility, however, that despite support for liberalization during the post-World War II period, these changes might have been introduced more gradually. There were similar changes in the other Nordic coun- tries, and the move toward liberalization and the left in Finland was very popular with a young and very vocal generation whose values were taken up by the major parties in Finland. Reforms of the existing alcohol system were one of those changes that enjoyed wide popularity among the general public. It is important to note that there is also something of a consensus on just why these adverse consequences occurred. A collective process of social learning (Heclo 1974) seems to have occurred among those re- sponsible for or attentive to alcohol policy. Perhaps the most widely shared area of interpretation is the addition hypothesis. Nearly everyone on the Finnish alcohol policy scene now agrees that it is not so easy to simply replace existing drinking patterns or structures with new ones, particularly by the process of enlarging the availability of lighter beverages. Thus the earlier optimism of the Finnish Alcohol Legislation Committee, which in 1951 recommended making lighter beverages more available to stimulate the substitutions of beer and wine for spirits, seems to have been the central casualty of the aftermath of the 1969 act. Further, there is endorsement by all of the principals that per-capita consumption must itself be a central feature of Finnish alcohol policy. The parliamentary committee formed to ana- lyze the impact of the liberalization episode took the central goal to be not only controlling consumption but also lowering it (Report of the Alcohol Committee 1978~. The main instruments for this goal are to be pricing policy and restrictions on availability (mainly Saturday closings for ALKO and stricter licensing of beer establishments). In a larger sense, the Finnish case represents something of a shift in the conflict between Gusfield's cultural modernism and cultural fun- damentalism, and perhaps the emergence of a new perspective in this longstanding conflict. The postwar period in Finland had speakers for both viewpoints. The research community at the Finnish Foundation and the policy makers at ALKO generally endorsed a cultural modernist viewpoint. They not

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248 BEAUCHAMP only argued for liberalization of alcohol control policy, but they also voiced this support in terms of the changing cultural values and climate of the times (see Kuusi 1957, pp. 1-3~. The cultural fundamentalists resisted these moves, sometimes in terms of the traditional values of abstinence, at other times in terms of the researchers who wrote darkly of the Finnish hereditary type types who were given over to compul- sive, explosive drinking that all too often resulted in violent outbursts. The disputants have moved somewhat closer to one another in this debate. It is misleading to depict this episode as one involving contending interest groups of roughly equal size, especially today. By and large the groups who are concerned with alcohol policy are quite small in Finland, and alcohol policy issueswhile enjoying wide coverage in the press- have become defined as a secondary problem in Finnish society. The terms of the debate narrowed considerably under the new consensus; the issues became much more matters of technique and detail rather than broad policy. It seems that all sides have recognized (with different degrees of regret) that times have fundamentally changed in Finland. Most parties seem to sense the permanence of postindustrial society and its rejection of temperance and abstinence. At the same time, all sides now realize that modernity is not a process of replacing old values and structures with new and improved ones. Rather modern and traditional values regarding alcohol tend to coexist cheek-by-jowl with one another; traditional patterns of drinking are not replaced, but endure and are even magnified. One is reminded of Joseph Schumpeter on the process of economic modernization (cited in Bendix 1964, p. 10~: Social structures, types and attitudes are coins that do not readily melt. Once they are formed they persist, possibly for centuries, and since different structures and types display different degrees of ability to survive, we almost always find that actual group and national behavior more or less departs from what we should expect it to be if we tried to infer it from the dominant forms of the productive process. The dominant form of the productive process to which Schumpeter refers can be for our case that the shift is a predominance of rural to industrial occupational structures undergirded and overlaid by the values of localism, religious fundamentalism, and an ethic of work productivity, thrift, and abstemiousness. This shift, which has been occurring for quite a number of decades in many Western societies (and for a very much shorter period in Finland), is defined as a marked decline in agricultural labor, then stabilization of the industrial sector, and finally rapid growth

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The 1969 Alcohol Act in Finland 249 in the service sector (happening in Finland almost simultaneously). The traditional values are ultimately displaced by the values of consumption, leisure, and emancipation from restrictions on such matters as drinking, sexual conduct, and other areas of private life. The current period in Finland represents something of a retreat from the heady optimism of the 1960s and not just for alcohol policy. In fact, the rate of growth has slowed considerably, and the general debate concerning the wisdom of rapid, continuous growth espoused by nearly all parties during the 1960s is heard in Finland as elsewhere. Further, there is assimilation by the younger generation (and likely not just because they are becoming older and the normal age-related decline in rates of alcohol consumption has begun to set in). These changes have brought something of a cultural reassessment and social retrenchment. A central tenet of cultural modernism is that mod- ern men and women should be free from the burden of tradition. Though there are clear differences between societies, the triumph of the indi- vidual from moral restraints has been a broad cultural theme of the West. This triumph occurred at the same time as general social security provisions for the entire society were being strengthened, and society's share of consumption in the form of taxes and control of economic activity increased dramatically. Nevertheless, for the modernist the in- dividual was to be free of restrictive social norms aimed at closely shaping his or her personal life-style. It would be a serious mistake to see the shift in Finland regarding alcohol policy as a return to earlier traditional positions. Those who supported the liberalization measures have on balance prevailed. The principle of individual freedom from onerous and restrictive alcohol policy measures anchored in conflicts over societal status has been firmly established. The old traditional-modern split seems to be in a process of replace- ment by one that represents different issues in postindustrial culture. In that culture, the fundamental value of individual autonomy in per- sonal life-style choices remains solidly established, and the goal of closely determining by legal mechanisms styles of drinking has been firmly rejected. The central goals for alcohol policy are to shift from proscribing drinking that is seen as harmful to relying on macro policy and regulatory mechanisms to prevent harmful aspects from worsening. One of the surprising implicit areas of agreement that can be faintly discerned in Finland is the gradual recognition of the benefits of the Finnish style of drinking. One of the virtues of episodic drinking is that it minimizes adverse impact on productivity and also minimizes the effects of more sustained or chronic ingestion on the liver and other

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250 BEAUCHAMP physical structures. This view was expressed both by the temperance movement representatives and alcohol policy researchers. This is an interesting development. It represents a modified accept- ance of the goal of freedom for the individual regarding matters of alcohol use and abandonment of the attempt to directly shape the modal pattern of drinking in Finland. The traditional and predominantly rural values that stress abstemious if not abstinent conduct have begun to disappear. (The parliamentary committee did, however, suggest that as an educational goal the government should attempt to reduce "admi- ration for alcohol, and especially drunkenness.") At the same time, the belief that simply liberalizing measures (and the disappearance of the earlier stern attitude) would result in an improved situation for alcohol problems has gone by the board. What remains is the commitment to liberating individuals from an excessively restrictive alcohol policy (e.g., rural prohibition) as a basic principle and, paradoxically, the reappearance of the necessity for broad aggregate control mechanisms. There is now a growing emphasis on health and safety issues, which apparently is enlarging the previous preoccupation with the Finnish drinking style. The attempt to find a better marriage between alcohol and larger economic policy, especially income policy, is also a new central part of the alcohol policy debate. The question of medium beer represents something of a problem for alcohol policy makers, with the temperance groups anxious to find some way to retreat from the current widespread availability. But one senses that medium beer has become a symbolic issue; other than a general tightening of controls over licensing, the removal of medium beer from the retail shops will probably not occur. This debate in the Parliament continues at this writing, with the trend seeming to be one in which the government is seeking to gain more control over the policy-making apparatus of ALKO, primarily by strengthening the functions of the administrative board. The future of alcohol policy in Finland seems to be an attempt to sort out the new boundaries between personal freedom and interest in Finnish society so that problems with alcohol can be held to as low a level as the recognition of this freedom (and other values) permits. IMPLICATIONS FOR THE UNITED STATES At the first glance, the debate in Finland over alcohol policy seems remote and over issues that do not concern the United States. The federal government's power over alcohol policy is a great deal more limited here than in Finland, and the debate here is conducted in dif-

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The 1969 Alcohol Act in Finland 251 ferent terms. The evidence that liberalization did have a discernible impact on alcohol problems is important for the growing discussion of alcohol policy in the United States, but it does not in itself constitute decisive evidence. Even in monopoly states there is little onnortunitv to avail ourselves of these same policy measures. The principal value of the Finnish experience, beyond the light it sheds on general issues regarding alcohol availability and other control measures, may well lie in providing a new conceptual context for the ongoing debate regarding alcohol and alcohol policy in the United States. In the United States, policy measures to restrict the availability of alcohol or to influence per-capita consumption are seen by some as a retreat from the values of cultural modernism and a return to rural, traditional viewpoints viewpoints currently characterized as "neopro- hibitionism." This characterization might well have applied if these is- sues had been raised in the period following repeal. Then a call by the "drys" for a return to, if not prohibition, at least a much more restrictive control system for alcohol could fairly be interpreted as a victory for cultural fundamentalism and the "drys." But almost a generation has passed since repeal, and the post-World War II generation in the United States grew to maturity protesting United States involvement in Vietnam, advocating civil rights, and urg- ing less restrictive measures for drugs such as marijuana. Alcohol policy per se was off the public agenda in this period of our postindustrial society. What we have now, however, is the entry of several new factors in the debate that may well fuel reconsideration of the postrepeal alco- hol policy model. What has arisen in postindustrial society is a funda- mental concern with the quality of the environment, the social costs of unrestricted growth, inflation, and unchecked consumption. A very broad and diverse body of support has grown up around the ecology movement, and there seems to be little diminution of support for this issue even as its economic impact becomes more manifest. Likewise, the impact of inflation and expensive and depleting energy sources have called into question assumptions about the modal personality of postin- dustrialism, about consumption as a central and relatively unrestricted right. In the area of health policy specifically, there is increased aware- ness of the limits of clinical health care and increasing attention to life- style and environmental hazards. This means that in postindustrial culture the privacy and anonymity of the individual has undergone some pressures for alteration. It is true that this debate still contains many lines of the older traditional-mod- ~ ~ ,

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252 BEAUCHAMP ernist conflict. The life-style debate in health policy (Kass 1975, Knowles 1976), for example, is often challenged by some as one more example of attempts by public health reformers to conduct campaigns of moral reform. The dominant view appears to be that there is an appropriate place for reasonable limits over life-style threats to health. These limits are likely to be established along the lines of the struggle for consumer or environmental protection: strong advocacy against certain features of industrial organization, especially pollution, manufacturing of hazardous products, and advertising practices. This emerging concern with the quality of life in postindustrial society involves a struggle to find a new language for appropriate limits to consumption behavior, while preserving the gains of postindustrial so- ciety in abandoning harmful or counterproductive moralistic restraints. In the preliminary skirmishes between those who advocate a reexami- nation of alcohol policy and those opposed, the first group attempts to persuade the second that they are not party to a general programmatic return to traditional systems restraint, but instead are part of a general trend within the larger society for heightened concern for environmental protection, safety in transportation, and consumer protection. There is no evidence currently available that this particular devel- opment has occurred in Finland, nor is it necessary for this argument. The shifts in alcohol policy in Finland can be seen as preliminary skir- mishes in a larger cultural struggle to define the postindustrial values, particularly for alcohol. In the earlier period in Finland, the struggle between traditional and modern values predominated. In the most re- cent period, this tension has begun to fade (but not to disappear). There seems to be a readiness at least for a discussion of limits to alcohol consumption. This indicates the reliance on tax measures and broad regulatory policy (licensing, limiting ALKO's marketing pressures, ed- ucation, etc.), but rejection of measures like personal identity cards or a system of sharply restricted availability. At the same time there is heightened appreciation of the health benefits of the traditional Finnish style of drinking and a deepened respect for the inability of available and acceptable social policy measures to influence this radically. To Americans this suggests that there is significant value in retaining our own present structure of alcohol consumption. Ours is an enor- mously pluralistic structure that shows great variation from region to region and ethnic group to ethnic group. Nevertheless, a fundamental attribute of the structure is a modal drinker who either drinks not at all or very little indeed. To retain this overall pattern it cannot, however, be treated as an attempt to closely shape the life-styles for drinkers. That approach,

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The 1969 Alcohol Act in Finland which is the heritage of the cultural fundamentalism, must be rejected, and the modernist emphasis on freedom from close restraint and indi- vidual choice must be firmly upheld. Nevertheless, the government and others involved in policy should respect the value of this pattern of alcohol consumption and try to discourage modes of drinking that are markedly divergent. The policy implication of this for the United States is that a corner- stone of alcohol policy might well take the form of attempting not only to minimize adverse consequences from alcohol consumption, but also to discourage drinking models that attempt to undermine the dominant or modal pattern of limited drinking. This should always be undertaken as an explicit attempt to work out in a new way an appropriate model for alcohol use that is congruent with the values and dominant images of postindustrial culture. 253 REFERENCES Ahlstrom-Laakso, S. (1975) Changing Drinking Habits Among Finnish Youth. Report No. 81 from the Social Research Institute of Alcohol Studies. The State Alcohol Mo- nopoly, Helsinki, Finland. Ahlstrom-Laakso, S., and Osterberg, E. (1976) Alcohol policy and the consumption of alcohol beverages in Finland in 1951-1975. Bank of Finland Monthly Bulletin No. 7. Helsinki: Bank of Finland. Allardt, E. (1958) Drinking norms and drinking habits. Pp. 7-109. in E. Allardt, T. Markkanen, and M. Takala, eds., Drinking and Drinkers: Three Papers in Behavioral Sciences. Stockholm: Almquist and Wiksell. Bendix, R. (1964) Natzon-Building and Citizenship. New York: Anchor. Bruun, K., Edwards, G., Lumio, M., Makela, K., Pan, L., Popham, R. E., Room, R., Schmidt, W., Skog, O-J., Sulkunen, P., and Osterberg, E. (1975) Alcohol Control Policies in Public Health Perspective. Helsinki: Finnish Foundation for Alcohol Studies. Castles, F. G. (1978) The Social Democratic Image of Society. London: Routledge and Kegan Paul. Eckstein, H. (1966) Division and Cohesion in Democracy. Princeton, N.J.: Princeton University Press. Gusfield, J. (1963) Symbolic Crusade: Status Politics and the American Temperance Move- ment. Urbana, Ill.: University of Illinois Press. Gusfield, J. (1967) Moral passage: The symbolic process in public designations of deviance. Social Problems 15:175-188. Gusfield, J. (1968) Prohibition: The impact of political utopianism. Pp. 257-308 in J. Braeman, R. Bremner, and D. Brody, eds., Change and Continuity in Twentieth Century America: The 1920's. Athens, Ohio: Ohio State University Press. Hancock, M. D. (1972) Sweden: The Politics of Postindustrial Change. Hinsdale, Ill.: Druden Press. Helco, H. (1974) Modern Social Politics in Britain and Sweden. New Haven. Conn.: Yale University Press. Kass, L. (1975) Regarding the end of medicine and the pursuit of health. Public Interest 40:1 1-42.

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254 B EAU CH A MP Keller, M., and Gurioli, C. (1976) Statistics on Consumption of Alcohol and Alcoholism. New Brunswick, N.J.: Journal of Studies on Alcohol. Knowles, J. (1976) Individual reponsibility. In John Knowles, ea., Doing Better and Feeling Worse. New York: Norton. Kuusi, P. (1948) Suomen Viinapulma Gallup-Tutkimaksen Valossa. Helsinki: Otava. Kuusi, P. (1957) Alcohol Sales Experiment in Rural Finland. Publication No. 3 of the Finnish Foundation for Alcohol Studies. Helsinki. Kussi, P. (1964) Social Policy for the Sixties: A Plan for Finland. Helsinki: Finnish Social Policy Association. Makela, K. (1971) Measuring the Consumption of Alcohol in the 1968-1969 Alcohol Consumption Study. Social Research Institute of Alcohol Studies, Helsinki. Makela, K., and Osterberg, E. (1976) Alcohol consumption and policy in Finland and Sweden, 1951-1973. Drinking and Drug Practices Surveyor 12:4-45. Osterberg, E. (1979) Indicators of Damage and the Development of Alcohol Conditions . . . 1950-1975. January, 1979 mimeo for the International Study of Alcohol Control Experience, Finnish Foundation for Alcohol Studies. Helsinki. Pesonen, P. (1974) Finland: Party support in a fragmented system. Pp. 271-314 in R. Rose, ea., Electoral Behavior: A Comparative Handbook. New York: The Free Press. Poikolainen, K. (1979) Increase in Alcohol-Related Hospitalizations in Finland 1969-1975. Mimeo, Department of Public Health Science, University of Helsinki. Purontaus, J. (1970) Cost-Benefit Analysis and the Finnish Alcohol Policy. Unpublished Master's Thesis, University of Helsinki. Report of the Alcohol Committee. (1978) English Summary of Committee Report. Pre- pared by Oy ALKO Ab Information Service. Simpura' J. (1978) The Rise in Aggregate Alcohol Consumption and Changes in Drinking Habits. The Finnish Case in 1969 and 1976. Manuscript. The Social Research Institute of Alcohol Studies, Helsinki. Simpura, J. (1979) Who Are the Heavy Consumers of Alcohol? International Study of Alcohol Control Experiences. Mimeo, March 1979. the Finnish Foundation for Alcohol Studies, Helsinki, Finland. Sulkunen, P. (1976) Drinking patterns and the level of alcohol consumption: An inter- national overview. Pp. 223-281 in K. J. Gibbons, et al., eds., Research Advances in Alcohol and Drug Problems, Vol. 3. New York: John Wiley. Sulkunen, P. (1979a) Abstainers in Finland 1946-1976. A Study in Social and Cultural Transition. Report No. 126, August 1979~ the Social Research Institute of Alcohol Studies, Helsinki, State Alcohol Monopoly. Helsinki. Finland. Sulkunen. P. (1979b) Drinking Populations. Institutions and Patterns. Part II: Individual - Drinking Patterns. Draft mimeo~ July 31. 1979. the Social Research Institute of Alcohol Studies, State Alcohol Monopoly, Helsinki, Finland. Vidich, A. J., and Bensman J. (1968) Small Town and Mass Society. Princeton. hI.J.: Princeton University Press.