The summer before I went to university in Dublin, I was in a state of high anxiety – not about the prospect of leaving home or the coming course work so much as my ability to drink alcohol in any quantity. To my young mind, being able to drink a lot was as important a part of college life as being able to write a good paper. So I put in a lot of effort – to drinking – until I was able to knock back pints with the best of my new classmates.

This kind of blind obligation to binge drink is exactly the kind of potentially dangerous boozing that's led to a surge of new warnings from health experts. According to a report released this week by the World Health Organization (WHO), fully 16% of drinkers worldwide engage in heavy episodic (or binge) drinking – the most harmful form.

WHO is urging governments to take aggressive steps to address the problem by raising taxes on alcohol sales, raising minimum drinking ages, regulating sales and so on. But if regulations alone were enough to reduce binge drinking, then countries with stricter rules would have better drinking habits. Except that isn't always the case.

As Western countries go, the United States is relatively puritanical about boozing – the legal drinking age is 21, liquor taxes are high, sales are regulated and public drinking is a no-no in most places. Yet binge drinking is a popular sport in the US, even among teenagers. The WHO report says 24.5% of American drinkers engage in bouts of heavy episodic drinking.

Despite early pub closing times and high taxes on alcohol sales, Britain's binge drinking rate is even worse, at 33.4%. In Ireland, where the laws are even stricter than in the UK, I'm embarrassed to say that a whopping 48.2% of drinkers binge.

Then we have the virtuous Italians, who love their vino, their apertivos and their digestivos but report a heavy episodic drinking rate of just 6.2%. Compared to the US, Britain and Ireland, alcohol is super-cheap in Italy and, until last year, the legal drinking age was just 16. Clearly the Italian model is the one to emulate – but it's the country's drinking culture and not its drinking laws that make the model work.

Malcolm Gladwell examined the influence of culture on the way people drink in a 2010 New Yorker piece. In it, he referenced the work of Yale researchers from the 1950s who looked into drinking habits of first- and second-generation Irish and Italian immigrants in New Haven, Connecticut, where the university is based. Both communities liked to drink, but it isn't hard to guess which group suffered the more negative consequences from doing so. The Yale clinic admitted 1,200 alcoholics from the community into its clinic – the majority of whom were Irish. Only a fraction were Italian. As Gladwell wrote:

Here were two groups who practiced the same religion, who were subject to the same laws and constraints, and who, it seemed reasonable to suppose, should have the same assortment within their community of those genetically predisposed to alcoholism. Yet the heavy drinking Italians had nothing of the problems of their Irish counterparts.

Clearly the drinking laws of their adopted land had less influence on these immigrants than the cultural influences they brought with them from their home countries. The Italians had absorbed the strong cultural message that drinking was something you did in moderation, with food, while the Irish immigrants had absorbed the same mistaken cultural message I heard at the age of 17: you drink to get drunk.



I'm not suggesting that laws play no part in regulating behavior; it's just that, by themselves, they don't do nearly enough. The situation with American college students is a case in point. Studies have shown that a higher minimum-age drinking law has helped to prevent alcohol-related deaths in this demographic – and that is not nothing. But drinking (and binge drinking) is still so common among underage students that universities might as well hand out fake-ID cards along with their prospectuses to save the kids time. The strong cultural message that drinking to excess is a normal rite of passage, I think, has more bearing on student behavior than any regulations imposed by the government. So, if we really want to see a reduction in binge drinking, the message needs to change along with the law and its enforcement.

It is possible to do better on both fronts – and Ireland may actually be leading the way. Despite those embarrassingly high binge drinking statistics, alcohol consumption in my home country has actually decreased by nearly 20% over the last decade. Some of this decline can be attributed to the 2007 Intoxicating Liquor Act, which introduced random breathalyzer tests for drivers and restricted hours for liquor sales, but cultural factors may have played an even bigger role.

Education campaigns like DrinkAware.ie have been credited with changing perceptions about alcohol use and promoting responsible drinking – and, more importantly, most pubs in Ireland now serve food as well as drink. This might not seem like a big deal to outsiders, but it has been a huge shift in Irish life. The local pub has always been an important social center, except now, instead of knocking back drinks at the bar, Irish people can enjoy drinking and eating – just like the Italians.

Indeed, the sooner we all start drinking like Italians, the better. I often think that if I had not grown up in a country where heavy drinking was so culturally acceptable and even glamorized, I would not have felt such intense pressure as an underage teen to start knocking back booze that I didn’t even like the taste. Fortunately for me, I apparently don't possess the alcoholic gene and eventually learned to enjoy my wine and drink like a normal person. But with 3.3m alcohol related deaths in 2012 alone, clearly many people are not so lucky.

We owe it to those millions to take into account the enormous cultural pressures that can lead people to drink to excess– instead of simply moralizing about their behavior and imposing tighter sanctions and laws. Those measures certainly have their place, but unless the everyday life forces that influence people's drinking habits are confronted, this problem is never going away.