National Prohibition in the United States: A Cognitive-Behavioral Perspective: Part 2: 20th Century National Prohibition - Abstract
Aim: This is the second of a two part paper that illustrates the importance of cognitive-behavioral factors in the failure of National Prohibition in the United States.
Methods: This second paper discusses the late 19th century forces that initiated National Prohibition, its difficultly with enforcement, and the multiple factors that brought about its repeal in 1933. Part two also details the good, the bad, and the ugly of the 18th Amendment from both cognitive-behavioral and epidemiological points of view.
Findings: Although alcohol consumption decreased and some public health benefits were achieved at the onset of Prohibition, alcohol consumption gradually rose during its tenure, and National Prohibition incurred much opposition and failed as a preventive intervention. Psychological reactance theory predicted the opposition of the population to the loss of an important freedom, and decision theory predicted its demise. In addition, Prohibition was conceived without regard to the ineffectiveness of state prohibition, and it was instituted at a time when 19th century, social mores were being rejected.
Conclusion: National Prohibition violated the Institute of Medicine's guidelines of a universal preventive intervention: being acceptable to the population, having a low cost, and having a low risk. Cognitively, attribution bias contributed to the overlooking of many factors underlying the etiology of problem drinking; psychological reactance contributed to the rejection of National Prohibition; and decision theory accounted for its repeal. National Prohibition also violated the modern framework for an effective intervention, which includes an epidemiological research base and appropriate, cultural timing.