Kettil Bruun is more relevant than ever

Abstract

Kettil Bruun is best known for the total consumption model introduced in 1975 in the collective work “Alcohol control policy in public health perspective”. There were three tracks in particular that led Bruun's research towards the total consumption model: research on the distribution of power, research on international drug policies, and his contributions to criminology and social policy. Kettil Bruun’s lifework shows that the innovation, intersectionality, and synergy which are now rehearsed in pompous research strategies were a non-question 40 years ago. These aspects were a natural part of the scientific pursuit of answers. Maybe in a much more modest and homemade form, but all the more import in terms of applicability at the general level of principle.

During the past year, people all over the world have watched the spread of the coronavirus. The wearing of a face mask, social distancing, and hand hygiene have been entered into statistical graphs and tables to inform us of the spread of the virus in the population. Such steering of people’s behaviour to achieve societal impact is known as control policy. The contribution of the Finnish-Swedish social scientist Kettil Bruun to understanding how universalism and particularism can be balanced in a society's control policies is as important as it is undisputed.

Kettil Bruun is best known for the total consumption model introduced in 1975 in the collective work Alcohol control policy in public health perspective (Bruun et al. 1975). The model proposes that the more alcohol is consumed in a society as a whole, the more extensive the alcohol-related harms and the greater the societal costs. This may sound self-evident, but the theory was in fact the beginning of an empirically based alcohol policy at a time of optimistic liberalism, which had emerged in the wake of the temperance movement. The total consumption model has enabled researchers to show that the most problems are caused by heavy and moderate drinkers rather than by the most marginalised and problematic alcohol users. The public health perspective helped to decouple responsibility and the burden of guilt from moralism and conflicts of interest.

While the mechanisms behind alcohol problems and the spread of a virus are different in nature, the year of the COVID-19 pandemic has exposed us all to various forms of control-political reasoning. We know that if everybody, low-risk groups as well as the young and healthy, worked remotely and wore a face mask, we would at the same time protect the most vulnerable high-risk groups. It would have been interesting to hear Kettil Bruun's views about the different ways of implementing strategies to deal with the pandemic. Cultivating an integrated epistemic approach, Bruun cuts a fine figure of a researcher from a bygone era. The education system and the world of research could still learn a lot from him.

Universalism

The progress of the pandemic has been stemmed by such control policy tools as remote work and face masks. In the world of alcohol policy, the corresponding tools might be availability and price. In both cases, the ideal behaviour of the population rests on assessing the collective good, and in both cases this calls for universal solidarity in our day-to-day lives.

Those who champion the cause of making wines and spirits available in grocery stores argue that the moderate drinkers’ freedom to drink should not be restricted just because problematic consumers are a burden on the society. The core question of individual freedom versus the collective good continues to be of the essence in the official alcohol-political debate – 46 years after the total consumption model was established. The model has, with the aid of empirical evidence, enabled a shift of focus from the rights of competent individuals to total availability as a marker of the extent of societal problems.

Still, the principles laid down in the total consumption model rely not only on statistical evidence, but are also linked to ideas of how societies incorporate universalism and particularism. It is desirable to pursue tenable practices in the social contract between citizen and state.

Kettil Bruun’s colleagues Pekka Sulkunen and Leena Warsell suggested in an article in 2012 that there were three tracks in particular that had led Bruun's research towards the total consumption model: research on the distribution of power, research on international drug policies, and his contributions to criminology and social policy. The model was launched at a time when research had shown that economic interests often worked against public interests and would lead to a selective social policy and to discrimination against vulnerable groups. In order to avoid partisan lobbying by privileged groups, Bruun advocated transparency in social policy and prioritised the public good. According to Sulkunen and Warsell, it was precisely this universalism which characterised the Nordic societies that laid the foundation for the total consumption model.

While similar theories – such as the prevention paradox – emerged elsewhere in the world, the total consumption model is unique in its Nordic context of origin. Nor was this a coincidence: Bruun perceived early on the value of comparative Nordic studies and in addition to initiating a number of Nordic research projects he was also involved in creating a Nordic research council and the Nordic scholarly journal, in which this text is published.

A unique research figure

In the 1960s, 1970s, and the 1980s, several Finnish social scientists began their research careers at the Social Research Institute of Alcohol Studies or in alcohol-related projects funded by the Finnish Foundation for Alcohol Studies. This was thanks to the research funding system that was based on the revenues from the Finnish alcohol retailing monopoly ALKO. Since the 1980s, Nordic researchers have been able to work in Helsinki at the Nordic Council for Alcohol and Drug Research (today: the Nordic Welfare Centre) or contribute to the journal of Nordic Studies on Alcohol and Drugs (which started out as Alkoholpolitik). To an extent, Kettil Bruun left his mark on all these institutions and thereby on the overall development of the social sciences in Finland.

In the obituary to Den omutlige Kettil Bruun (The unimpeachable Kettil Bruun) in 1986 , the sociologist Klaus Mäkelä portrayed a character whose intellectual breadth and curiosity created a wealth of different kinds of research on different kinds of themes (Mäkelä 1986). That Finnish research on substance use (and today also Finnish gambling research) is still held in high esteem internationally surely goes back to the creativity and inspiration that Kettil Bruun cultivated in his various research environments.

Bruun mixed methods and different philosophies of science with a pragmatic approach that was typical of his day. He had been a humanities student, majoring in history, but as early as the 1950s he published several studies at the Statistical Office of the City of Helsinki. His doctoral dissertation from 1969 is an experimental study of the dynamics of drinking cultures. In the words of Klaus Mäkelä, it not only ‘meets the strictest criteria of a positivist scholarly work, but also paints a complex picture of the Finnish drinking culture’ (Mäkelä, 1986, p. 57). Today, it would be an absurd idea for the same researcher to engage in an experimental study of twins’ genetic predisposition, research on different treatment methods, critique of the authorities’ conduct, epidemiology, cultural studies, and so on. Perhaps it says something about the scope of the world of research in Bruun's day and how unspecialised the disciplines and research fields still were. There was room for researchers to follow up on ideas and boldly adapt their perspectives to suit a specific question.

After the great social constructionist and postmodern turns of the 1980s and 1990s, sociologists came to seek new horizons further beyond statistics and positivism. For Kettil Bruun and his contemporaries, social constructionism and positivism were not mutually exclusive: consumption patterns, social systems, and cultures could be studied in different ways. One can still meet international researchers who are surprised to see that Finnish social epidemiologists can be trained in sociology.

Also, one can still today in Finnish alcohol, drug and gambling research detect signs of the pragmatist research approach which is nevertheless sensitive to cultural aspects. This is evident, for example, in the recent volumes on the Finnish drinking habits – Finland dricker in Swedish / Suomi juo in Finnish – issued by the Finnish Institute for Health and Welfare (Mäkelä et al. 2010; Mäkelä et al. 2018). Also, the section 52-funded research on gambling-related harm has managed to stay mainly social scientific in its focus, even if psychology and medicine paradigms have come to dominate this area of research globally (Hellman, 2019).

As recently as 2018, an international research group released the book Setting limits: Gambling science and public policy (Sulkunen et al., 2021), in which they put to the test the applicability of the total consumption model to gambling policy. The model has by now been tested and verified in hundreds of studies, and continues to underpin alcohol policies in Sweden, Norway, Finland, and Iceland, as well as in Canada and parts of the United States. The model is also in use in the guidance provided by the WHO and the OECD.

Science policy insights

Both the most ardent apostles and the most tenacious critics of neoliberal research policies could learn a thing or two from Kettil Bruun. He makes an excellent role model for those wanting to blur the boundaries between empirical and theoretical research, between basic and applied research, and between sectoral and university research. While it may be true that the social scientific literature of the 1960s, 1970s, and the 1980s often showed a blatant and at times a naïve ideological backdrop, one is amazed by how consistently the researchers kept their focus on the essence of the contract between citizen and the collective. Weak and marginalised groups were seen as pawns to, and emerging from, the overwhelmingly value-based strategies. The lot of the weak and marginalised also lay behind pleas for humanity. In comparison, researchers today appear at the same time more specialised, segmented, and – well, perhaps ‘whimsically politicised’?

Kettil Bruun's lifework shows that the innovation, intersectionality, and synergy which are now rehearsed in pompous research strategies were a non-question 40 years ago. These aspects were a natural part of the scientific pursuit of answers. Maybe in a much more modest and homemade form, but with all the more import in terms of applicability at the general level of principle.

In June 2021 the annual Kettil Bruun Symposium was an online event of over 200 alcohol researchers from all corners of the world. Among the hosts of the symposium were the University of Helsinki, the Finnish Institute for Health and Welfare THL, and the Finnish Foundation for Alcohol Studies.

Kettil Bruun (1924–1985)

Kettil Bruun made his greatest contributions as the director of the Social Research Institute of Alcohol Studies in Helsinki and as the longstanding secretary of the Finnish Foundation for Alcohol Studies. He also served in a number of expert capacities for the World Health Organization and subsequently held a professorship at Stockholm University.

The book Alcohol control policy in public health perspective (1975) is also known as the Purple book from the colour of its cover in the English-language edition. The collaborative work was written by 11 researchers.

The international Kettil Bruun Society for Social and Epidemiological Research on Alcohol was founded in 1986. The society has more than 120 dues-paying members and about three times as many active subscribers on its mailing list.