Long waves of alcohol consumption and the sustainable development goals.

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Though the United Nations deals with its Sustainable Development Goals (SDGs) in blocs of 15 years at a time, "sustainable" indicates a longer-term focus, aiming at steady human progress, including in public health and welfare. But the alcohol history in many countries shows "long waves" of consumption, repetitively rising, then falling, then rising again. Underlying this dynamic are competing interests pushing in opposite directions. One set of interests, both private and governmental, seeks profits from an attractive and habit-forming product, with relative costs that have fallen with industrialisation and commercialisation. Opposed are the interests of those harmed by the effects of alcohol, and the interests of public health and welfare. With alcohol, there is also a less obvious set of interests favouring drinking: alcohol is an instrument of conviviality and collectivity, as expressed in rituals like reciprocal drink-buying and toast-offering. The long waves result from the competition of these interests. Alcohol becomes more available by industrialisation or other factors, and alcohol consumption and harms from drinking rise. Reaction to this from public health and welfare interests results in measures driving consumption levels back down. Then to a new generation the restrictions seem unnecessary; they are removed; and consumption rises again. Long waves with different periodicity are exemplified in 3 different patterns of national history: in countries with strong temperance movement histories, in Russia, and in France. The long waves raise an issue which challenges the steady-progress assumption of the SDGs: are moves to lower alcohol consumption sustainable? More complex thinking and policymaking may be required to deal with alcohol policies in the frame of the Sustainable Development Goals.