“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.
America tried to rid itself of alcohol once before and found that Prohibition was a disastrous failure that spawned an industry of illicit manufacturing, transporting, and selling — and of course drinking. Speakeasies sprouted like mushrooms, memorialized in many books and movies like The Great Gatsby. The U.S. Congress passed alcohol prohibition laws in 1917, adopted as the 18th Amendment to the Constitution in 1919. Religious consumption of wine was exempted, as was home production of limited amounts. The 21st Amendment 13 years later reversed this course due to public outcry, growth of illegal activity, and decline of governmental tax revenues after the 1929 Depression. The “wets” defeated the “drys” and have held the upper hand ever since.
But today there is a burgeoning temperance movement, not from a legal standpoint, but instead inspired by health considerations.
It reminds me of the current smoking status. When I trained as a physician at Duke Hospital in the late 1960s, one could smell tobacco in the air during an evening stroll through downtown Durham. Smoking and smokers were everywhere: planes, restaurants, homes, hospital rooms — even catheterization labs. In the 1960s, a well-known cardiologist who performed early coronary angiographies is said to have used a hemostat to pick up a cigarette (to avoid contaminating his gloves) to smoke during heart catheterizations.
Today, smoking is banned literally all over — not by constitutional amendments but because medical science proved its adverse health effects, which led to the social movement making it taboo. Of course there will always be smokers, just as there will always be drinkers. Individual freedoms will prevail and permit smokers and drinkers to do as they please, regardless of the health consequences.
But could the same fall from grace that occurred to smoking befall alcohol as we begin to appreciate its harmful effects? Recent data support the conclusion that no amount of alcohol is beneficial, and any amount is harmful to your heart and other organs in proportion to the frequency and quantity consumed.
As I noted previously, an episode of atrial fibrillation several years ago caused me to “cold-turkey sharing a bottle of wine with my wife at dinner and drinking an occasional vodka before bedtime” because I knew that alcohol was an established precipitator of that arrhythmia. Substituting tonic water, nonalcoholic beer, or even coffee has so far abolished recurrent AF episodes (knock on wood!).
Abstinence might be particularly relevant as we enter a new year and consider resolutions to improve our lives. And contemplating the burgeoning number of establishments that serve nonalcoholic drinks, the drys are gaining ground on the wets. Mocktails — nonalcoholic cousins to the usual cocktail — appear with increasing frequency on menus in restaurants and bars across the country and have taken the boring out of alcohol-free drinks.
More than 3 out of 5 adults who have ever smoked have quit. Hopefully, in the years to come, the same statistic might apply to drinking alcohol.
However, at least two major differences distinguish smoking cessation from alcohol abstinence and may prevent this from happening. One is that smoke often bothered nonsmokers in the vicinity of the smoker, which helped lead to its ban. The second is that nondrinkers often feel socially compelled to drink, such as at parties and celebrations.
Whether alcohol abstinence is approaching the end of its beginning, or the beginning of its end, is too early to judge. At the very least, however, we can hope for moderation to comport with the U.S. guidelines of one drink per day for women and two for men.
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