A Response to Two Papers Critiquing the Total Consumption Model by Kari Poikolainen
John Holmes, Colin Angus
Dear Editor,
In two recent articles in Alcohol and Alcoholism, Kari Poikolainen critiques the total consumption model, an influential theory within alcohol control policy, particularly in Northern Europe. We argue that Poikolainen’s critiques are likely to mislead rather than inform readers given the low-quality research designs, flawed statistical analyses and implausible results.
In simple terms, the total consumption model posits a consistent relationship between a population’s average level of alcohol consumption and its level of problem drinking. This suggests an important conclusion for policy-makers—policies that reduce average consumption will necessarily reduce alcohol-related harm. Poikolainen challenges this position in his first paper which concludes that the strictness of alcohol control policies is not statistically associated with the levels of alcohol consumption and that neither is associated with the levels of alcohol-related harm (Poikolainen, 2015). His second paper further concludes that the levels of alcohol dependence in the population determine average consumption rather than vice versa as, in Poikolainen’s …”