Originally published on The News Lens International

While Taiwan isn’t particularly known for having a strong drinking culture, a growing number of voices has been expressing concerns regarding the rise of alcoholism in recent years.

Ask foreigners about Taiwan’s drinking culture, and many of them will probably echo the lamentations of a South Korean professor in SOSReader in 2015 : “台灣人都不喝酒!” (“The Taiwanese just don’t drink !”) Indeed, while Taiwan beer and baijiu are very popular, alcohol doesn’t really play an important cultural role in the everyday lives of the Taiwanese. In recent years though, there has been a definite rise in alcohol use, enough to warrant concerns from observers : blogger Aliav wrote a rather worrying piece in 2015, stating that heavy drinking had become more prevalent and that the situation “had to change now” for the “well-being of future generations”. However, lack of data regarding alcoholism in Taiwan suggests that the real issue lies with a negative perception of drinking – one that would make it difficult for people to ask for help.

Drinking isn’t an essential feature of Taiwanese culture. Meeting with friends for drinks isn’t a very common thing to do, as 27 year-old Guo Junyi (郭峻毅) explains : “When we go out with friends, we hang out at the tea house. Or we go to the nightmarket, eat together, drink more tea or bubble tea. It’s because of our parents, I think. They never drank alcohol, so it’s not a natural thing for us to do. And they always told us to take care of our health.” The lack of bars reflects this situation. Aside from the infamous Revolver, mainly populated by (and overpacked with) foreigners, and a few other hang-outs such as Beer and cheese, Taiwan is quite bar-less : there is no real concept of drinking places. The locals usually drink during meals. At the rechao, bottles of Taiwan beer usually align between bowls of beef noodles and veggies ; at the nightmarket, small groups of elderly Taiwanese people are often seen chatting loudly while sipping on beers, cigarettes lying on the table amidst clouds of smoke. But in this case social bonding is primarily established around food : alcohol is more an accessory than a crucial part of the experience.

Contrast this with the importance of the French apéritif, a ritual in its own right – discussing life, politics, love and the idiocy of the world outside the café with a glass of wine in hand, as the sun sets and the streets start lighting up. Sure, the occasional nuts and cheese will be there – but they are an add-on, an afterthought. What matters is what’s in the glass.

Image source : mingletrend
Image source : mingletrend

Outside of meals, drinking is reserved for celebrations like weddings where Ganbei (乾杯) is de rigueur. The nightclub scene, of course, is another matter. It is common to behold groups of young Taiwanese people hanging out at the tables with expensive bottles of liquor or champagne : but that is to be expected in a setting specifically designed for the purpose of drinking, dancing, and otherwise shutting down your brain. According to Guo Junyi, they don’t represent the majority : “I’d say people who drink like that account for 30% of the young adult population, at least that’s my feeling. And well, usually they have money.” Around 2am a lot of them tend to be passed out at the tables.

Genetics certainly play a key role here. The Taiwanese are indeed well-known for having an extremely low tolerance to alcohol, the lowest in the world : a study conducted by the Medical School of Stanford University found that 47% of the general population are unable to properly metabolize alcohol due to ALDH2 deficiency (the enzyme that assimilates ethanol). This exceeds the ratio in mainland China (35%), Japan (30%), and South Korea (20%). The National Health Department puts this situation forward on its official website : (“Nearly half the population is ALDH2-deficient”) and issues the following warning towards the public :

“People who drink two glasses of red wine everyday are 50% more likely to develop esophageal cancer than those who do not”.

While red wine consumed in moderate quantities is generally beneficial to the cardiovascular health of most people, there’s a good chance it will have the opposite effect on the average Taiwanese.

There is of course an exception to every rule. Following Taiwan’s economic development in the nineties, a strong drinking culture appeared within the business world, wherein people have a tendency to get thoroughly thrashed during business meetings. It shouldn’t come as a surprise that drinking is seen as an efficient response to the levels of daily stress experienced by seasoned businessmen. A good way to celebrate newly-formed partnerships, it also allows for a sense of camaraderie and shared identity away from the wife and kids, separate from other professional sectors. Due to the low tolerance of the Taiwanese, a couple of drinks will usually be enough to get people passing out on the couch – or cheerfully singing pop songs, ties undone and glasses out of place.

Image source : bridebox
Image source : bridebox

And if we are to believe some, this behavior has gone beyond your average business meeting. In recent years voices in the press have expressed concerns regarding alcohol consumption in Taiwan : in may 2015, Taiwanese blogger Aliav notoriously released a piece titled “Taiwan’s drinking culture really needs to change now !”, wherein he denounces the drinking culture in the business world and warns the general public of impending doom, citing recent statistics linking alcohol and traffic accidents – over 110,000 people convicted for drunk-driving in 2014, along with 169 dead and 79 injured as the result of car accidents. There were not only young people among them but also white-collars such as professors, policemen and civil servants.

The numbers, however, should be put into perspective. Alcohol-related traffic casualties in 2014 are actually at a record low. According to governement data, 376 died and 118 were injured in 2012, while in 2011 there were 439 deaths and 137 injured. The most lethal year was 2006 (727 dead, 310 injured). It appears the late 2000s indeed saw an increase in alcohol consumption linked to reckless behavior, but stricter laws regarding drunk driving have reversed the trend. It should also be noted that according to the World Health Organization, the Asia Pacific region has one of the lowest rates of alcohol traffic deaths in the world : it sits at 7.3%, below the global average of 10.9%. Compared to Western countries like France (over 700 deaths recorded in 2015), Taiwan seems to be faring pretty well.

Nevertheless, while the situation isn’t as grim as Aliav paints it, it doesn’t change the fact that alcohol use has risen in recent years. In 2014, it was estimated that the Taiwanese’ alcohol consumption exceeded 700 million liters – ”the equivalent of 282 swimming pools”, according to ET Today. The incriminated beverages were local Taiwan beer as well as imported Holland beer and English whisky. The higher purchasing power of the Taiwanese along with the omnipresence of advertisements lauding Taiwan beer probably factor into this. In social contexts, peer pressure is also a bit of an issue : friends and relatives will urge you to finish your glass by uttering the eloquent expression ‘杯底不可飼金”, ”A goldfish should not be able to survive at the bottom of your glass”. Refusing to kill the goldfish can be seen as a great social offense, which puts alcohol-indifferent people in a delicate position. Of course, this isn’t specific to Taiwan…

But what of alcoholism ? Is it a serious problem in Taiwanese society ? In 2014, Taipei City Psychiatric Center partnered with National Taiwan University’s Intel-NTU Connected Context Computing Center to launch a smartphone App that would help its users fight alcoholism through daily Breathalyzer tests, allowing them to track their progress through graphs and study their own drinking patterns. The head of the Department of Addiction Cure and Prevention, Huang Minqi (黃名琪), stated that the media does not attach enough importance to the issue of alcohol dependence, only mentioning extreme circumstances (traffic accidents or violent behavior caused by drinking) without telling the public of the negative effects alcohol can have on the body.

Image source : Technews
Image source : Technews

Huang Minqi is right to say that the subject gets little attention… as it turns out – and that’s where it gets interesting – it’s very difficult to grasp the prevalence of alcohol dependence in Taiwan, and for a very simple reason : there is almost no data regarding this matter. The fact that such an app was designed shows the problem is real, but to what extent ? In the early 2000s, the governement conducted a National Health Survey meant to investigate health risk factors in the Taiwanese population : but no estimates were given for the number of alcoholics. The most recent survey was carried out in a medical center in 2004 and found that 12.6% of inpatients suffered from alcoholism : it is estimated that 3% of the general population may be affected. An epidemiologic study published in the Journal of Experimental and Clinical Medicine in 2012 (and co-authored by Huang Mingqi) mentions that three nationwide surveys were conducted from the 1940s to the 1990s, but the methodology has been criticized. The one sure thing that came out of it was that the highest rates of alcoholism could be found within aboriginal tribes : (“the prevalence of alcohol dependence among aboriginal people is 10 folds higher than that of Han people”). Economic and cultural factors are probably involved : despite significant public rehabilitation since the nineties, aboriginal people are still facing marginalization in various ways.

Why is there so little data for the Han people ? It may be due to the fact that alcohol addiction (and any addiction in general) has a negative image in Taiwanese society – that it’s perceived as something shameful, something that mustn’t be discussed. The media only mentioning extreme behaviors certainly doesn’t help. Guo Junyi seems to confirm the idea : “If you drink a lot, you’re kind of like a bad guy. A rebel.”

This negative image could be the real problem here. Social and cultural aspects of drinking, a global-scale study presented to the European Commission in 1998, found that “in global statistical terms, physical, psychological and social problems associated with alcohol affect only a small minority of consumers, even in the more ‘problematic’ drinking-cultures.” The issue lies with attitudes in regards to alcohol use :

“Societies with generally positive beliefs and expectancies about alcohol (…) experience significantly fewer alcohol-related problems; negative or inconsistent beliefs and expectancies (…) are associated with higher levels of alcohol-related problems.”

As such, while alcoholism isn’t necessarily a serious societal issue for the moment, what needs to be changed is how it is perceived : otherwise, it may be harder for people to ask for the treatment they need.

Just for fun

Drunkard : 酒鬼 (jiu3gui3)

Heavy drinking : 酗酒 (xu4jiu3)

Pressure someone into drinking : 勸酒 (quan4jiu3)

Your nickname if you have a low tolerance : 一杯醉 (yi1bei1zui4, “One cup and you’re wasted”)

References

  • Yang Zhiqiang (楊 智 強) “Taiwanren bu tai he jiu ? Tanbei de hanguoren yu shang bu shi jiu de taiwan yang zhi qiang 台灣人不太會喝?貪杯的韓國人遇上不嗜酒的台灣”, (The Taiwanese don’t really drink ? When the heavy-drinking Koreans clash with Taiwan’s indifference to alcohol), Sosreader, 27/11/2015, URL : https://sosreader.com/ 台灣人不太會喝?貪杯的韓國人遇上不嗜酒的台灣
  • Aliav “Taiwan he jiu wenhua zhende gai gai yi gai le 台灣的喝酒文化真的該改一改了” (Taiwan’s drinking culture must really change now !), EYE SEE News, 2/05/2015, URL : https://eyeseenews.com/special-column/480- 台灣的喝酒文化真的該改一改了
  • “Yi nian he diao 282 zuo youyongchi ! Taiwaren 2014 yinjiu yu 7 yi gongsheng 1年喝掉282座游泳池! 台灣人2014飲酒逾7億公升” ( They drank the equivalent of 282 swimming pools : the Taiwanese’ alcohol consumption exceeds 700 million liters in 2014), ET Today, 28/01/2015, URL : http://www.ettoday.net/news/20150128/459935.htm
  • “Keji jiejiu jiuyin nan chu ? Jiejiu xiao bangshou bang ni qianghua juexin yuanli jiujing 科技戒 酒酒癮難除?戒酒小幫手幫你強化決心 遠離酒精” (Technology to give up drinking : is alcohol addiction hard to fight ? A little helper assists you in strengthening your resolve to keep away from alcohol), Technews, 19/05/2014, URL : http://technews.tw/2014/05/19/alcoholism-and-alcohol-abstinence-with-the-help-of-app/
  • “He jiu qunuan ? Xiaoxin huang tang xia du, zhi’ai you shangxin, he jiu hui lianghong de ren, youqi yao zhuyi 喝酒取暖?小心黃湯下肚,致癌又傷心,喝酒會臉紅的人,尤其要注意” (Drinking to keep warm ? Be careful of the yellow water in your belly, it is carcinogenic and hurtful, people whose faces turn red when they drink should be particularly cautious) Health promotion Administration, Ministry of Health and Welfare, URL : http://www.hpa.gov.tw/BHPNet/Web/News/News.aspx?No=201602050003
  • Ming-Chy Huang, Chiao-Chicy Chen, “Alcohol dependence in Taiwan : From Epidemiology to Biomedicine”, Journal of Experimental and Clinical medicine 4(2):108-112, 2012.
  • “Jiankang zhi weixian yinsu tantao健康之危險因素探討” (Investigating health risk factors), Report mandated by the Executive Yuan, 30/05/2006.
  • “Social and cultural aspects of drinking : a report to the European Commission”, Social Issues Research Centre, March 1998, URL : http://www.sirc.org/publik/drinking3.html