Prevention of Alcoholism The Ledermann Model of Consumption

Ledermann model of alcohol consumption is an important concept for anyone who wishes to understand the underpinnings of modern policy efforts to prevent heavy drinking and alcoholism. The point of departure for this concept is a set of observations about how alcohol consumption is distributed in human societies.

Many have thought of this distribution as occurring in two parts. First, there is the great mass of "normal" drinkers; their drinking might be plotted as a bell-shaped curve, with a few people drinking no more than a sip in a year, an increasing number drinking greater amounts than a sip but less than the average amount, and then a declining number drinking more than the average amount, until the graph reaches the normal drinkers who drink much more than the average—and these are relatively few in number. Second, there is a much smaller number of "abnormal" drinkers; their drinking distribution also might be plotted as a bell-shaped curve, but this curve is shifted to the right of the distribution for normal drinkers. Figure 1 shows this two-distribution concept of normal and abnormal drinking, with the number of drinkers on the y axis and the amount consumed on the x axis.

Sully Ledermann, a French demographer, thought of this problem in relation to a single distribution that was not bell shaped or normal in its distribution. He imagined that drinking ought to be plotted in relation to a single curve, with a shape that is known as "lognormal" and without a categorical distinction between normal and abnormal drinkers. The shape is known as lognormal because the natural logarithms of individual consumption, rather than actual consumption values, are normally distributed. Assuming Ledermann is correct, the majority of individuals within a society will drink relatively modest amount of alcohol, and a small proportion will drink large quantities, but this will appear in an asymmetric or "skewed" distribution curve with a longer tail to the right of the average alcohol-consumption level (see Figure 2). To the right of the curve there should be no bump, which would be caused by the presence of an abnormal-drinkers category, distinct from the category of normal drinkers.

Perhaps the most important implication of Ledermann's thinking about alcohol consumption has to do with the prevention and the reduction of heavy drinking. Categorical distinctions between normal and abnormal drinkers make it possible to focus prevention and intervention efforts on the abnormal drinkers. In contrast, the Ledermann model suggests that efforts can be focused on the great mass of people who drink modestly as well as on the heavier drinkers: In so doing, reductions in the average amount of alcohol consumed should also result in significant reductions in the proportion of people who are very heavy drinkers. This difference in approach is part of an important ongoing debate about how societies can best organize to reduce the hazards of alcohol use.

Alcohol No More

Alcohol No More

Do you love a drink from time to time? A lot of us do, often when socializing with acquaintances and loved ones. Drinking may be beneficial or harmful, depending upon your age and health status, and, naturally, how much you drink.

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