Aim: This is the first of a two part paper that illustrates how cognitive-behavioral factors, the disregard of prior epidemiological data, and misfortunate timing contributed to the failure of National Prohibition in the United States.

Methods: This first paper gives a detailed historical and cultural review of the early colonial, the post-revolutionary war, pre-civil war, and post-Civil-War, drinking patterns in the United States. It addresses the origins of the temperance movement, its evolution into a prohibition movement, and the post–civil war, prohibition in Kansas.

Findings: Attribution theory shows a cognitive bias in the early 19th century temperance and late 19th century prohibition thinking. Scapegoat theory pointed out that the 19th century reformers targeted alcohol itself as the main source of social suffering and, by and large, neglected the context in which it was consumed.

Conclusion: Nineteenth century attribution bias, cognitive errors, and failure to evaluate prior experience set the stage for 20th century, National Prohibition, a disastrous, preventive intervention.

Lewis C (2013) National Prohibition in the United States: A Cognitive-Behavioral Perspective: Part 1: 19th Century Temperance and Prohibition. J Addict Med Ther 1(1): 1004.

•    Temperance movement
•    Prohibitionist movement
•    Attribution bias

In the American colonial period of the 17th and 18th centuries, there was no public conceptualization of an alcohol problem. Alcoholic beverages were highly esteemed, highly valued, and not stigmatized or tainted. Liquor was regarded as healthy: a tonic, a medicine, a stimulant, and a relaxant. It was readily consumed by men and women and routinely given to children. During the 18th century, the per capita consumption was the highest and drunkenness was common. Puritan ministers praised alcohol but denounced drunkenness [1].

However, between 1785 and 1835, the conceptions about alcohol changed. At the beginning almost no one believed that alcohol was a dangerous or destructive substance; however, by the end of this 50 year period, a temperance movement, which had advocated the restraint of the consumption of distilled liquor, was evolving into a prohibitionist movement, which advocated total abstinence from alcohol altogether. Indeed, the prohibitionists’ viewpoint, which attributed the nation’s social problems to alcohol consumption, lead to 19th century state laws and a 20th century constitutional amendment, which regulated its sales, manufacture, and transportation.

When the pilgrims landed, it was at a time in Europe when alcohol was safer to drink than water. In early colonial days, drinking was part of the social fabric, and the wisdom of the day held that alcohol was essential for good health. “Abstinence invited trouble, and some people considered nondrinkers ‘crankbrained ’” [2].

In the very early settlements, the drinking preferences were similar to those in Northern Europe, and local brewing began almost immediately in households and taverns. Distilled liquor was also valued; it had high alcohol content; it kept longer than beer; and it was more easily transported. A preference for hard liquor developed, and the grain liquors formed a central role in shaping 1700s New World drinking patterns. Thus, from the beginning, distilled liquors often raised concerns about misuse and abuse.

The early colonial drinking culture

“Drinking constituted a central facet of colonial life” and “… most settlers drank often and abundantly” [2]. “Beer and cider were the usual beverages at mealtime… [and] …even children shared the dinner beer”[2]. Communal projects and private labor in the fields seldom took place without alcohol, and employers regularly supplied employees with libations. Although, supplying alcohol to farm and city laborers might seem inappropriate by modern standards, the pre-industrialized labor in colonial times was much more physical, and safety and productivity were less jeopardized.

Alcohol was also involved in weddings, baptisms, ministerial ordinations, funerals, military musters, and political gatherings. However, most drinking outside of home and work occurred in taverns. The owners were often the most prominent citizens, and taverns were the most convenient outlets for liquor, food, and lodging. In addition they catered to political, religious, and other public gatherings.

Most Anglo-American colonists would have qualified as moderate, heavy, or serious drinkers. However, despite this degree of consumption, few were classified as problem drinkers, and there was little public outcry against alcoholism. This “lack of anxiety over alcohol problems was one the most significant features of drinking…” in the early colonial society [2].

The reason for this attitude has been attributed to cultural heritage, beverage preferences, and the social norms of the colonial period that held extreme consumption in check. The colonists, by and large, drank the less potent beer and cider as opposed to distilled spirits; most of the colonial drinking was family and community oriented; and social standards restrained problem drinking. “… [F]amilies, friends, ministers and civil magistrates were always there to guard against deviant behavior” [2].

The effects of early distilling

In the late 1600s, the colonists shifted their consumption from beer to distilled spirits. Initially rum, which had about 50% to 100% alcohol content, was imported from the Caribbean, and in 1700, the first distillery opened in Boston. The owner made huge profits, and distilleries sprang up throughout New England. By the early 1700s, rum had become the most popular beverage. As the colonists moved west, grain whiskeys became popular with the frontiersmen. The Revolutionary War accelerated the shift from rum to whiskey because the importation of both rum and molasses was blockaded by the British. Thus, by the end of the 1700s, whiskey had become a premier alcoholic beverage.

However, with the increased prevalence of hard liquor, society was gradually “losing the ability to control drinking excesses” [2]. This was especially true in the frontier areas where the population was less dense and there were “few institutional controls to reinforce personal moral standards or to check deviant public conduct” [2].

In the 1750s and 1760s, John Adams expressed concern over abusive alcohol consumption, a decline in community behavioral norms, and the taverns turning into “dens of iniquity” [2]. In 1774, Anthony Benezet, a Quaker and abolitionist, argued in his book, The Mighty Destroyer Displayed, that distilled liquor was unhealthy, degrading, and immoral. In 1772, Benjamin Rush, a physician and signer of the Declaration of Independence, began to speak out against the consumption of hard liquor, and in 1784, he wrote An Inquiry into the Effects of Ardent Spirits on the Human Mind and Body. Rush had no quarrel with wine and beer, but he pointed out that colonists were now consuming hard liquor, which he stated could cause both sickness and death. He described loss of control and the addictive properties of alcohol and advocated abstinence from hard liquor. He noted that the behavioral controls of the prerevolutionary society were breaking down and that the post-revolutionary doctrine of liberty had “weakened the communal responsibility for individual behavior….” [2] Rush also pointed out that the movement from light alcoholic beverages such as beer, cider, and wine “to distilled spirits had not resulted in new social controls to limit drinking excesses” [2]. There was more drunkenness in the post-revolutionary period, and fewer people seemed to care.

By 1784, both the Quakers and the Methodists urged their members to abstain from hard liquor and not partake in its manufacture or sales. However, despite these warnings, the colonists still viewed “drinking as a positive and personal good” [2].

As the 1800s began, the heavy and frequent drinking of hard liquor continued, and the time between 1790 and 1830 was the heaviest drinking era in United States history. Drunkenness was much more prevalent after independence than before; hard liquor had become a basic part of the diet; and social drinking had increased above that of the colonial era. Frontiersmen often had hard lives as trappers, cowboys, and miners without families and without the social constraint. Frontier drinking often had a binge pattern and was associated with gambling, fighting, and prostitution. However, despite this heavy consumption, during the early 1800s there was still not much of a public outcry against binge and problem drinking.

This lack of indignation was part of the newer post-revolutionary, non-communal, individualistic orientation, which had an emphasis on personal liberty, self-reliance, and equal opportunity without unreasonable social or governmental restraint. This Jeffersonian-Jacksonian attitude exalted the rights of the common man, personal freedom, diversity of ideas, self-sufficiency, and individualism. “Americans…felt that as long as their conduct hurt no one else, it was nobody’s business what they did. Accordingly, as long as drinking harmed no one but the drinker, why worry or…why make the behavior a national issue?” [2] This new attitude contrasted with the prerevolutionary community centered ethos and the directly post-revolutionary republicanism, which emphasized moral and political harmony and common purpose.

Pre-Civil War Immigration In the early 1800s, the United States had its first wave of mass immigration from Europe. The largest group came from Ireland between 1830 and 1860. Most Irish immigrants were poor, lived in the eastern ports of entry, and had sharp cultural differences with the native-born Americans. For one, the native-born were Protestant; the Irish immigrants were Catholic, and strong anti-Catholic sentiment resulted in riots in several cities. In Ireland, heavy drinking was an integral part of life, and during the 1800s the Anglo-neo-republicans viewed the Irish drinking habits with alarm.

German immigrants comprised the second largest group; however, they faced less animosity than the Irish even though they brought not only their beer-drinking habits but also their brew masters with them. Unlike the Irish, the Germans did not engender the reputation of being drunkards.

The Origins of the Temperance Movement

Although there was no organized temperance movement in the very early 1800s, there was disdain towards excess drinking. As mentioned, Methodists and Quakers denounced hard liquor for religious reasons, and Dr. Benjamin Rush preached temperance from hard liquor. The United States was entering an era of social reform which included temperance, the abolition of slavery, and women’s rights. This reform movement became a hallmark of the Pre-Civil War American experience, and temperance became one of the most popular causes. Many reformers believed that drunkenness lay at the root of other social evils and that it was impossible to solve America’s social problems without dealing with the liquor question.

The temperance movement began at the general assembly of the Presbyterian Church in Philadelphia in 1811. Dr. Rush sent 1000 copies of the Inquiry and urged a strong pro-temperance stance. The assembly denounced the drinking habits of the day and appointed a committee to determine how to restrain “the excessive and intemperate use of spirituous liquors” [2]. Presbyterian leaders offered their support against drink, and other societies, such as the Society for the Promotion of Morals and the Massachusetts Society for the Suppression of Intemperance, organized. By 1816, the Methodists, Congregationalists, Baptists, Anglicans and many evangelical sects joined the temperance movement, and these Protestant denominations had both the social influence and the numbers to make a national impact. By 1826, the American Society for the Promotion of Temperance, later known as the American Temperance Society, emerged. However, it is important to realize that this early temperance movement did not campaign for total abstinence but for the prevention of the abuse of hard liquor.

Temperance Becomes Abstinence

Over time, the temperance societies began to believe that moderate use lead to immoderate use, and the fear of addiction was crucial in changing temperance to total abstinence. In 1826, Lyman Beecher’s Six Sermons on Intemperance argued that any drinking would lead to addiction and that individuals were unable to tell when they crossed the line until it was too late. In his opinion, total abstinence was the only sure means to personal salvation and societal stability. Although most leaders of the temperance movement were skeptical of total abstinence, the proponents gained ground, and at the 1836 national temperance convention, total abstinence was formally endorsed.

Drinking had also lost its traditionally high status and “the late 1840s saw a groundswell of prohibition activity” [2]. Employers no longer provided alcohol to workers; railroads began to fire workers who drank on duty; prominent citizens gave dinners without libations; and temperance workers tried to legally restrict the licensing of taverns. Certain temperance-prohibition advocates believed that voluntary abstinence was not fruitful and that legislative action was required to remove alcohol from the market place.

In 1846, prohibition forces under the leadership of Neal Dow persuaded the Maine legislature to outlaw the manufacture and sales of distilled liquors. Within a year, Massachusetts went dry; in 1852, Vermont, Minnesota Territory and Rhode Island followed; in 1853, Michigan; in 1854, Connecticut and Ohio; and in 1855, Indiana, New Hampshire, Delaware, Illinois, Iowa, and New York. By the mid-1850s, prohibitionists had destroyed the consensus that drinking was positive, and they were looking forward to a national prohibition. The movement had etched total abstinence in the popular mind and had convinced many that it was the key to the stability and prosperity of the republic. However, by 1863 eight of the 13 states, that had passed prohibition laws similar to Maine, lost them through repeal, adverse court decision, or modification [3]. Although prohibition collapsed as a major public issue with the start of the Civil War, after the war, the vast majority of temperance advocates advanced legal prohibition.

Post-Civil War Drinking

Taverns had always served as a place for men to discuss politics, local problems, and gossip. However, after the Civil War, brewers and distillers, started to become the retailers, and the formerly, privately-owned taverns became known as saloons. “By 1909, some 70% of American saloons…were owned by, in debt to, or otherwise indentured to breweries“[4], and these manufacturing interests wanted to sell as much alcohol as possible.

In the manufacturers’ controlled saloons, new patrons were enticed with free alcohol, free lunch, credit, inexpensive rooms, gambling, and prostitution. Saloon keepers cashed paychecks, often served as labor contractors, and, in many cases, had the only public toilets and washing facilities in the neighborhood. However, they also sold alcohol during prohibited hours, sold alcohol to the intoxicated, and sold alcohol to minors [4]. The ravages of excessive, saloon drinking had a negative impact on the family with job loss, financial hardship, and mental, physical, and sexual abuse. In 1907, George Kibbe Turner painted a vivid picture of the “saturation of a liquor market” with these “criminal saloons” in McClure’s Magazine [5]. Saloons were also described as “public health, moral, and political cesspools…” in which “vice and gambling went hand in hand” [6]. Indeed, many people believed that they were a major cause of alcoholism; hence, the saloon also became one of the primary targets of the post-Civil War prohibition movement.

The rapid proliferation of urban saloons was abetted by new immigrants from European countries with alcohol consuming customs and by brewers from Germany. “The best estimates indicate that the number of saloons … increased from 100,000 in 1870 to 300,000 in 1900” [4]. Data from the National Institute of Alcohol Abuse and Alcoholism (NIAAA) shows that from 1850 to 1915 the per capita alcohol consumption increased by about 22%. Most of this was attributable to the near 10 fold increase in beer consumption [7].

In contrast to the prohibitionists’ outcry against saloons, in 1908, Hugh Fox, the secretary of the United States Brewer’s Association of New York, wrote “I doubt if 5 per cent of the saloons are of a positively disreputable character” [8]. He stated that over-competition among the saloons forced some to “resort to irregular attractions to draw custom” [8] and that both the brewers and the licensing authorities were responsible. He noted that “…common ground must be regulation, not elimination” [8].

Post-Civil War Prohibition in Kansas

Kansas formed temperance societies as early as the 1850, and after the Civil War, they were joined by the Kansas State Temperance Union (KSTU) and the Woman’s Christian Temperance Union (WCTU) [9]. By the mid 1870’s, Kansas Republicans advocated temperance, and, in 1878, voters elected Governor John St. John, the Republican prohibitionist, whose father had been a severe problem drinker [3]. He called for action concerning prohibition, and the legislature passed a joint resolution stating, “The manufacture and sale of intoxicating liquors shall be forever prohibited in the State, except for medical, scientific, and mechanical purposes” [10]. This resolution became an amendment to the Kansas constitution on November 11, 1880 with a final vote of 92,302 Kansans in favor and 84,304 against. The counties that had voted for prohibition had, by and large, evangelical churches, “Old World” ethnicity, Republican politics, small to moderate-sized towns, and a greater distance from Missouri, a state with much more lenient liquor laws. On February 19, 1881 Governor John St. John signed into law the Benson Act, which enforced the prohibition amendment [10].

Although the Benson Act forbade the manufacture and sales of intoxicating liquor, it did permit the sale of alcohol to the public for medical, scientific, and mechanical purposes. Druggists with permits were allowed sell alcohol to individuals with a physician’s prescription. This was the largest loophole in the law, and physicians were irritated by the requirement of a sworn affidavit to the probate judge that they would prescribe liquor “only in cases of actual sickness” and “faithfully keep, observe and perform all the requirements… regulating the sale and use of intoxicating liquors” [3]. Physicians and druggists had a lucrative business in prescribing and selling alcohol to “cure” a wide variety of “diseases” such as indigestion, malaria, debility, and diarrhea. These illnesses together accounted for “about 60% of the total number of diseases claimed in two Shawnee County drugstores in 1892 and 1893” [10]. In 1882, the Boston Transcript stated, “The physicians help the droughty ones to get around the prohibitionary law by prescribing liquor for all the ills that flesh is heir to. For a boil on the arm, one patient was ordered to take, in eleven days, ten pints of ‘spiritus fermenti’ and thirty bottles of beer…[B]oils are very fashionable in Kansas” [11].

The enforcement of the Benson Act was the responsibility of the county attorney. Penalties for violation ranged from $100 to $500 fines or 30 to 90 days in the county jail. The law also provided for civil action against establishments found to make, sell, barter, or give away alcohol so that they might be declared “common nuisances” and closed. The law also provided for criminal action against individuals

As one might expect, conflict began very quickly after the Benson Act was passed. In smaller towns and rural areas, the law was obeyed and enforced; in larger towns and cities, saloons remained open in flagrant defiance. In 1870, 14% lived in towns with more than 2000 inhabitants; however, by 1910, this figure had reached 31%. In 1880, Leavenworth, Atchison, and Topeka had populations in excess of 15,000, and the major enforcement problems occurred in these cities.

Leavenworth became the ”most celebrated symbol of urban defiance,” [3] and in June 1880, Frank Sibley from the New York Prohibition party filed information that lead to the arrest of three Leavenworth saloon proprietors. The next day he was physically attacked in three separate street incidents, badly beaten, and forced to be protected in a police station from a howling mob. Governor St. John singled out Leavenworth, Atchison, Wyandotte, Topeka, and Dodge City as the worst offenders for selling alcohol and issued a proclamation that offered monetary rewards to “whistle blowers” who provided information leading to the conviction of law violators or the removal of nonfunctioning officials. This proclamation received much attention but no response.

In Atchison, civic leaders complained about the economic impact of prohibition and urged the county attorney to move slowly against violators. In Topeka, the city council authorized the licensing of establishments that sold “German mineral water” as an invitation to liquor establishments. Once a month each saloon paid a $50 fine for operating without a liquor license and more than 30 saloons produced $20,000 annually for the city treasury.

The most intense organized opposition to prohibition came from unassimilated, ethnic communities, particularly those of German origin. The German immigrants were concerned with the threat to their beer supply and the possibility of an adverse impact of prohibition on immigration to Kansas. German newspapers in Missouri portrayed a bleak picture of a “dry” Kansas to attract immigrants to Missouri. Many of the German immigrants were also Catholic, and in Ellis County only about 10% of the Catholics supported the prohibition amendment [3].

Thus, despite prohibition, alcohol continued to be available in Kansas. Druggists and physicians dispensed it for medicinal purposes; proprietors kept their saloons open by paying monthly fines; law enforcement was lax; and individuals persisted in making, selling, and consuming alcohol in their homes. However, by 1914 the country was moving towards national prohibition, and prohibitionists held Kansas up as an example of what should be carried out on a national scale [9]. In 1919, the 18th Amendment to the U. S. Constitution was ratified by three quarters of the states, and in 1920 the Volstead Act was passed to enforce National Prohibition.

As we shall see in part two, the Kansas experience with prohibition foretold what would take place during National Prohibition. Citizens would continue to obtain and consume alcohol; public officials often would refuse to cooperate with enforcement; and certain sectors of society would profit immensely from its illegal trade.

Between the arrivals of the first colonists to North America in the 1600s until the early 1800s, the attitude towards the consumption of alcoholic beverages changed from one of overall acceptance to one of serious concern by certain segments of society. Prior to the Revolutionary War, low alcohol-content beer and cider were considered salutary and were readily consumed at home and community events. Alcohol-related, behavioral problems were well controlled by a tight knit social structure. However, in the late 1600s and early 1700s, consumption began to include higher, alcohol-content rum and distilled whiskey, and by the late 1700s, clergy and community leaders became concerned about the behavioral ramifications of excessive consumption. Indeed, the heaviest period of alcohol consumption in North America was between 1790 and 1830.

The societal response was the development of a temperance movement to combat the excessive consumption of hard liquor. This temperance movement evolved into a powerful prohibition movement, which influenced the passage of both local and state laws against the sale and manufacture of alcohol before the Civil War. The seeds of this early prohibition movement had a number of cultural factors: native-born Americans vs. immigrants, Protestants vs. Catholics, and rural vs. urban. The prohibition movement was also aligned with other social reform movements such as the abolition of slavery and women’s rights.

The prohibition movement was arrested by the Civil War but renewed after its termination. Brewers and distillers began to control retail, and taverns became saloons. The manufactures wished to sell as much alcohol as possible, and the rapidly proliferating saloons were described as “dens of iniquity.” In addition, a second, larger wave of immigration from European countries was taking place; cities were becoming overcrowded; and the country was rapidly becoming industrialized. Many states and localities had adopted prohibition laws, and the momentum was building for a national referendum.

Afterthought

As noted, between 1785 and 1835, the conceptions about alcohol changed. At the beginning of this period almost no one believed that alcohol was a dangerous or destructive substance; however, by the end of 50 years, a temperance movement, which had originally advocated the restraint of the consumption of distilled liquor, was evolving into a prohibitionist movement, which advocated total abstinence.

Levine stated, “From the beginning, temperance ideology contained a powerful strand of fantasy.” [1] “In temperance [and prohibitionist] thought, poverty, crime, slums, abandoned wives and children, business failure and personal ruin were caused by alcohol, and not by any major flaws in the structure or organization of the society and economy.” [1] “Liquor was a scapegoat…” [1] “All would be well if only the nation were totally abstinent.” [1] He further noted that, by the 1830’s, three fundamentals of temperance-prohibitionist thought were:

1. “Habitual drunkenness, addiction, was therefore the common result of the regular use of alcohol.” [1]
2. “A significant portion of poverty and crime…was attributed to the moral degradation caused by alcohol.” [1]
3. “Alcohol…weakened the entire physical constitution as well as the mental and moral faculties; it directly caused a great many diseases and prepared the body for many more.” [1]

 The 20th century prohibition movement continued this ideology that “…abstinence was the panacea” for the nation’s ills [3]. On the first day of National Prohibition, Billy Sunday, one of the most celebrated evangelist of the early 20th century, preached prohibition’s central fantasy. “The slums will soon be a memory. We will turn our prisons into factories and our jails into storehouses and corncribs. Men will walk upright now, women will smile and the children will laugh. Hell will be forever for rent.” [1]

Levine depicted the prohibitionists’ belief that the elimination of alcohol would eradicate the social problems in America as “fantasy,” and stated that they used alcohol as a “scapegoat” to account for them. Let us explore their beliefs from the standpoint of attribution and scapegoat theory.

Cognitive Bias in the Temperance and Prohibition Movements

Attribution Theory: Attribution refers to the “inferred causality individuals engage in while attempting to ‘explain’ reasons” [12] for their own behavior or the behavior of others. The theory “describes the processes that operate as if the individual were motivated to attain a cognitive mastery of the causal structure of the environment” [13]. However, attributions are subject to error. One of the hypothesized reasons for error is that the individual attaches excessive significance to the behavior and minimizes the situational context; the behavior itself overshadows its context. “…[I]n complex causal environments, the relevant causal factors in the situation are not ignored but are simply not perceptible to the person” [13].

Stadler stated, “The fundamental attribution error…may represent a flaw in deductive reasoning…” [14] and a failure of logic. He also pointed out that “fundamental attribution error ha[d] serious social implications, e. g. in how society explain[ed] and address[ed] poverty” [14].

Fiske and Taylor [15] noted that bias is a better term than error in that it may represent a customary emphasis on personal rather than situation causes of behavior. Research has demonstrated attribution biases associated with personal salience, motivational factors, gender, and the behavior of interest [16]. The scientist gathers data as an observer; however, the social perceiver adapts himself or herself as the “central point of reference… [who]… rather than obtaining an unbiased picture, sees as causally significant the information that dominates his or her own perceptual field.” “It seems to matter little if there is contradictory information…” [15]. The socially perceived attribution bias is very stabile, and the social perceiver often attributes behavior to enduring personal dispositions even when contextual factors may fully account for behavior [15].

In the early and middle 19th century, the temperance movement attributed habitual drunkenness to “demon rum” and its addictive properties and not to the drinker or the context in which alcohol was consumed. In the late 19th and early 20th centuries, the prohibitionists still focused on alcohol as the scapegoat; however, they also targeted the alcohol industry and the saloons as the purveyors of this potentially addictive and dangerous substance. Clearly the consequences of excessive drinking such as public intoxication, physical fights, family abuse, criminality, and death were much more egregious than the contextual elements of urban overcrowding, long work hours under harsh conditions, and poverty. Although these contextual conditions did not appear to be addressed by the prohibitionists, they were vigorously attacked by other reform movements during the Progressive Era [17,18].

Attribution biases are, indeed, important because incomplete causal inference is made. An unfortunate implication is that victims (humans, animals, inanimate objects) are held more accountable than they are, and contextual determinates are overlooked [15].

Scapegoat theory: “Attribution theory assumes that we have almost a compulsive need to ascribe causes to observed behavior… [it] can offer an explanation of the way in which the need to blame is laid at the door of a particular person or group…” [19] Using attribution theory, scapegoating plots “a clear inferential path from the awareness of difficulty and frustration back [to] the behavior of certain members of a group or organizations, to their intentions and… their dispositions” [19]. Frazier discusses the anthropological use of scapegoating in terms of “the transfer of evil,” to inanimate objects, to animals, and to humans [20]. In this case, the inanimate object was alcohol and the humans were its purveyors and manufactures.

Lender pointed out that early colonial Puritan churches were forgiving of the repentant drunkard [1] and that Dr. Benjamin Rush was instrumental formulating the concept of habitual intoxication as addiction. This new model identified spirituous liquors as the causal agent, described loss of control, declared the condition to be a disease, and prescribed total abstinence as the only cure [17] .“…[The] notion that the drunkard was a victim of the widespread and socially approved custom of drinking an addicting substance remained central to Rush’s entire case against liquor” [17]. Until the end of the 19th century, the temperance speeches and literature routinely viewed the habitual drunkard was as a victim [17].

Towards the end of the 19th century, the temperance ideology began to shift toward prohibition. Personal addiction became less central, and the prohibitionists focused the societal disruption that alcohol caused, its purveyors, and the wealth and power of its manufacturers. The negative consequences of problem drinking such as industrial and train accidents, worker inefficiency, and family disruption were highlighted; saloons were viewed as the “breeding place of crime, immorality, labor unrest, and corrupt politics;” [17] and the manufactures were looked upon with distrust. With less emphasis on the addicting qualities and more on the social problems, the drunkard became more of a”pest and menace” [17] than a victim.

From this analysis, one might call the thinking of the temperance and prohibition movements an attribution bias which targeted alcohol and its purveyors as the main cause of societal ills. With the exception of saloons, the movement did not appear to address the other contextual contributions to problem drinking. National Prohibition was designed as an intervention to prevent the social problems caused by excessive drinking; however, it was a failure, and the 18th Amendment was repealed after 13 years.

In the part two, we shall explore the public health benefits of Prohibition, its economic impact, and its failure as a preventive intervention. We shall also examine the public reaction to National Prohibition and its decision to repeal the 18th Amendment from a psychological standpoint.

The author expresses gratitude to the Addiction Committee of the Group for the Advancement of Psychiatry and to Dr. Carol North for their review to this article.

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