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One thing I am curious about is why tobacco use has been treated like a public health concern with governments and other respected institutions actively and loudly discouraging its use, and alcohol has not been treated that way. As the campaign to reduce smoking has been very effective in the US, so it is easy to imagine that a similar campaign against alcohol use succeeding in dramatically reducing alcohol consumption and problematic alcohol use. My best guess is that alcohol is tied to social rituals in a way that cigarettes were not, and also that cigarettes were not viewed as fun either. So being against cigarettes wasn’t viewed as being a killjoy, nor did it interfere with rituals like toasts at weddings or other celebrations, or other social activities. But that is just a guess. Also, the campaign against cigarettes was never associated with religion so far as I know, nor so far as I know with gender, whereas the temperance movement in the US was associated with Protestants, rural areas, and with feminism. I also wonder about social class, as I have read that wealthier and more educated people drink more than others in the US. So desiring to see less drinking in the US would look like something low status.

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Tobacco has a higher immediate negative externality?

Alcohol is more fun?

Or perhaps most important:

Alcohol is highly consumed by the richest in the U.S.?

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Within our lifetime semaglutide may become as consequencal as condoms and birth control pills were in the 20th century. Techno-optimism for the win.

We might be a revival of the temperance movement of the early 20th century.

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If magic pills will be the solution to excessive consumption of food and alcohol that's fantastic imo

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For alcohol consumption going up in countries like India — I wonder if this is related to women working more, moving to cities, experiencing greater autonomy ? Of course it’s far from perfect in India (the country where I was born) and also the US (the country where I grew up and continue to live). But it is better for women than in the past. I feel like an upside to alcohol- it’s associated with women going out, socializing with their peers, meeting new types of people, expanding their horizons. And, I wonder if men were more used to seeing women out and drinking like them, things would be better for women?

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And this doesn’t even address the much, much larger negative effects of drinking on liver cancer, overall health, obesity, employment, accidents, and family sanctity. Anything we can do to effectively reduce alcoholism can lead to huge potential benefits.

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