The Czech Republic is the larger of the two Central European successor states to Czechoslovakia, which was dissolved peacefully in 1993. Czechoslovakia, a liberal democratic state from 1918 until 1938, was founded in 1918 as one of the independent states emerging in 1918 from the ruins of the Austro-Hungarian Empire. A medieval kingdom, comprising the historic lands of Bohemia and Moravia, it was the predecessor of the present Czech Republic. During WW II, Czechoslovakia was occupied by Hitler, and from 1948 until 1989 it was a totalitarian satellite state of the Soviet Union. The Czech Republic joined the European Union in 2004. At present, 90% of the 10.2 million population are Czechs, with Slovaks being the largest minority. Beer has been the main alcoholic beverage in the Czech lands throughout known history, the first written document stemming from the 10th century ad. Since statistical figures were published beer has represented about half the total alcohol consumption, in some years even greater. Wine began to be produced in the country during the early Middle Ages, and the production of distilled beverages also has a long tradition. The significance of beer drinking in contemporary Czech society may be illustrated by a recent symptomatic event, a conference organized in 1994 by the Institute of Czech Literature of the Czech Academy of Sciences under the title ‘Pubs and beer in Czech society’. A leading Czech theoretician of culture, Vladimír Borecký, said in his contribution: ‘without beer we live superficially, losing the chance to integrate our cultural heritage and the stimuli for its development’[1, p. 214]. Only one of the presenters spoke in favour of abstinence, reminding the audience that the founder and first President of Czechoslovakia, the philosopher T. G. Masaryk, was an outspoken abstainer. A more recent event was the realization in 2004 of the research project ‘The institution of the public house in Czech society’ by the Institute of Sociology of the Academy [2, 3]. Of the more than 1000 people interviewed within the project, 76% believed that the pub is an important part of Czech culture and tradition. In his analysis of the results of the project, Vinopal [2] explains that by regular visits to his pub ‘the patron is led to the feeling that life has its inner order; that something stable exists . . .’; but he also says that the role of the pub is declining. Although 93% of respondents regarded beer as ‘the national beverage of the Czechs’, 67% felt ashamed at the extent of beer consumption among Czechs [3]. With its 161.7 litre per capita beer consumption in 2003 [4], the country was the unrivalled world champion. Czech per capita beer consumption has continually topped 150 litres since 1992. The 2003 per capita pure alcohol consumption of 10.2 litres (approximately half of this attributable to beer) given by the Czech Statistical Office [4] is lower than the 11.0 litres found in World Drink Trends 2005[5] and lower than the figure of 13.7 litres given by the World Health Organization (WHO) [6]. These discrepancies can evidently be explained by the differing definitions of the alcohol content of beer and wine. For 2003, the Czech Statistical Office took, as alcohol content by volume, 3.1% for beer, 11% for wine and 40% for distilled spirits (personal communication, Z. Kobes, Czech Statistical Office, 2 March 2006). In litres of pure alcohol the 2003 per capita consumption has accordingly been 5.0 (beer), 1.8 (wine) and 3.4 (distilled spirits). With this consumption profile, the Czech Republic’s closest neighbour in Europe was Ireland. Looking at the time-series of per capita alcohol consumption in the official statistical yearbooks [7], it can be seen that there is a value of about 4 litres for 1949 and a continuous increasing trend (with small downturns in some years) in 1949–84, culminating with over 9 litres in the early 1980s. In 1986–89 consumption decreased (to 8.0 litres in 1987). This downturn coincided with a weak imitation of Gorbachev’s anti-alcohol campaign by the regime [8-10]. It may be supposed that the Communist rulers of the country thought that a moderate anti-alcohol campaign would be politically less dangerous than an imitation of Gorbachev’s glasnost (openness). Since the fall of the totalitarian regime in November 1989 per capita consumption has increased almost continually, by 0.7 litre in 1990 and in smaller steps in following years. Reasons for the increase of alcohol consumption following the reinstallation of liberal democracy and market economy since 1990 may be seen in the abolition of political control over drinking, the easy economic (and distributional) availability of alcoholic beverages and the ‘everything is allowed’ attitude spreading throughout Czech society since the change of political regime, as illustrated among other phenomena by increasing common criminality (see [8, 9]). In the latest national survey of the Czech adult (aged 18–64 years) population’s drinking habits [11], 22.6% of men reported an average daily consumption of > 40 g ethanol and 10.6% of women admitted a > 20 g average daily alcohol intake. The consumption of > 75 g alcohol at a single session in a month, or more frequently, was reported by 26.1% of men and 8.0% of women. At least one of the two above-mentioned hazardous patterns of alcohol use was reported by 33.4% of men and 14.1% of women. Daily beer drinking was reported by 18.9% men and 2.1% women. Mean beer consumption per occasion was 1.5 litres (men) and 0.7 litres (women). As always, some under-reporting must be supposed in the survey results. The European School Survey on Alcohol and Drugs (ESPAD) Report 2003 [12] on alcohol and drug use among 16-year-olds in 35 European countries has shown Czech boys and girls to be among the five to 10 highest-ranking countries in various aspects of alcohol use, and to be the leading country in life-time experience of any illicit drug. The serious negative effects of alcohol use on the health of the Czech population is documented in Table 4 of WHO/Europe [13], giving the deaths and DALYs (disability adjusted life years) attributable to the 10 leading causes in European countries for 2002. Ischaemic heart disease, cerebrovascular disease, colorectal cancer, cirrhosis of the liver, falls and self-inflicted injuries were among the 10 leading causes of death in the Czech Republic. Alcohol use disorders were the fourth leading cause of DALYs in the country. The SDR (age-standardized death rate) for colorectal cancer in 2003 was 36.5 in the Czech Republic, being surpassed in the European region only by Hungary’s 38.2 [6]; the mean SDR in the European region was 19.8 in 2002. A weak but supposedly causal association between heavy beer drinking and colorectal cancer has been reported in the literature [14, 15]. In their discussion of Czech drinking patterns, the authors of the 2002 survey [11] concluded that harmful effects outweighed possible cardioprotective effects in both genders. However, despite the rising per capita alcohol consumption, life expectancy in the country had increased since 1990 by 5.0 years (males) and 3.6 (females), although with 72.6 and 79.0 years [16] it still lagged behind that of the western members of the EU. Jaroslav Skála’s (1916) pioneer work, beginning in 1948, laid the foundation for the country’s treatment provision for people with alcohol-related problems [17]. The socio-political transformations after 1990 caused some discontinuation in the well-organized system of institutional and out-patient care but, in general, people with alcohol-related problems have good access to care financed by obligatory health insurance. Skála’s foundational approach was developed creatively by Karel Nešpor [18]. Self-help organizations are also active in the country. Although the Czech Republic participated in the European Alcohol Action Plan 2000–05 [19], and despite the vigorous efforts of Karel Nešpor, the Czech coordinator of the plan, results in the prevention domain have until now been only very modest [20]. The country has zero tolerance of alcohol for drivers and enforcement includes some random breath testing. The prohibition on selling alcoholic beverages to people under 18 years is frequently violated (sanctions were increased in a law valid from 2006). Alcoholic beverages are available in all food shops and restaurants at all times and can be advertised freely. It is sometimes said that Czech beer is both the best and cheapest in Europe. The price of a 0.5-litre bottle of the commonly consumed beer of 8.5 Kč (‰0.3) is less than 0.05% of the average monthly salary. Taking 189 litres of beer as the average annual consumption of people aged over 15 years, the cost of 3213 CZK represented 1.4% of the average annual salary in 2005. Paradoxically, the great significance of alcohol consumption for Czech society and the gravity of its negative consequences have evoked a relatively modest research response. No research institute specializing in alcohol use exists in the country; of course, many workers in different fields have been involved in significant research studies over the years within their broader interests. A few illustrative examples may be given. In the 1970s Kršiak published innovative experimental studies of the effect of ethanol on the behaviour of mice, stressing the effects on aggression [21, 22]. Zima and co-workers were involved in studies of the metabolism of ethanol and alcohol-related diseases (e.g. [23]). To our knowledge, the only research unit specializing predominantly in alcohol research was established in 1970 within the Psychiatric Research Institute (now Prague Psychiatric Centre). This mini-unit never included more than two researchers, of whom only Kubička’s interests were focused primarily on alcohol research (e.g. [8, 9, 11, 24, 25]); Csémy’s research themes also included other substances [26]. Bobák, a Czech epidemiologist interested in alcohol research, is currently active in England (e.g. [27]). The contemporary French historian Alain Soubigou [28] observed that, unlike most European nations, the Czechs see their great intellectuals as the source of their national identity: for example, the philosopher Tomáš G. Masaryk, whose excellent biography was written by Soubigou [29]. The great sympathy of Czechs for the hedonistic, cynical and authority-ridiculing soldier Švejk (whose adventures begin by the consumption of five beers in a pub), created by the always drunken writer Hašek (1983–23) [30] is, for the French historian, an unwelcome exception to his thesis and Soubigou marginalizes Švejk as a stupid figure. In my view, a polarity between the two value orientations symbolized by Masaryk and Švejk is inherent in Czech society. That both poles may reside in the same individual is exemplified by President Masaryk’s son Jan who, as the Czechoslovakian Minister of Foreign Affairs, committed suicide (or perhaps was murdered) shortly after the Communists had seized power in Prague in 1948. Jan Masaryk left two books on his bedside table: his father’s Bible and Hašek’s novel about Švejk. The Czech championship of beer-drinking seems to indicate that the hedonistic value orientation symbolized by Švejk is for many (or the majority of) contemporary Czechs more typical than the value orientation represented by the abstainer and moral idealist Masaryk. Lest the admiration of Czechs for Švejk and their high beer consumption be seen as a sign of a unique national weakness, let us remind ourselves of the world-wide popularity of the good soldier Švejk and, of course, of beer. Preparation of this paper was supported by the project MZ0PCP2005 of the Ministry of Health of the Czech Republic. The author is indebted to Ladislav Csémy, Karel Nešpor and Clare Wille for helpful suggestions.
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L Kubicka (2006) studied this question.
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