One irritating thing about South African scandals is that you never hear the end of the story. Like what happened to the lawsuit threatened by BAWSI, the Black Association of the Wine and Spirits Industry, demanding a fund be established to deal with endemic alcoholism in the Western Cape?

The war against smoking in the first world is all but over, bar the coughing. Which promotes alcohol to the role of prime target for public health policy makers. Rated in terms of addictiveness, alcohol is ranked behind heroin and cocaine but above tobacco, marijuana, LSD and ecstasy.

In Paying the Tab (Princeton, 2007) professor of public policy at Duke University Philip Cook asks “what drug provides Americans with the greatest pleasure and the greatest pain? The answer, hands down, is alcohol. The pain comes not only from drunk driving and lost lives but also addiction, family strife, crime, violence, poor health, and squandered human potential. Young and old, drinkers and abstainers alike, all are affected. Every American is paying for alcohol abuse.”

Alcohol causes more than 100 000 deaths a year in the US and is a factor in over half the murders. Professor Cook points out that alcohol is too cheap. “Beer and liquor are far cheaper and more readily available today than in the 1950s and 1960s.” Robust financial results from international liquor giants Diageo and Pernod Ricard in a recession confirm that alcohol remains popular. A global trend expected to be confirmed when Distell report next week.

With SA red wines routinely clocking in at 15% alcohol by volume and above, alcohol is the elephant in the drawing room of SA wine. Back in June 2007, the Black Association of the Wine and Spirits Industry (Bawsi) threatened legal action against the government and industry over the issue of alcohol abuse in the Western Cape. According to press reports, Bawsi demanded that a fund be established to deal with endemic alcoholism and to set up an institution for the treatment of alcoholics.

Without denying the moral and social responsibility of the wine industry to alcoholics (after all, the dop system was a reality on wine farms as recently as a generation ago) the Bawsi initiative falls into the trap of regarding alcoholism as a disease. This disease theory is a socially useful interpretation for producers as they can ramp up production with a clean conscience while the afflicted go for treatment without stigma.

Unfortunately, the disease theory is largely a myth. Professor Cook presents the work of French demographer Sully Ledermann who showed back in 1956 that alcohol consumption follows a fixed distribution – in America, 1/3 of adults are teetotal while a merry 10% drink ¾ of all the booze. If you want a big decrease in the number of pathological drinkers, make a small decrease in average consumption.

Cook proposes a simple supply side solution – raise sin taxes. Increased alcohol excise taxes will decrease consumption which will ameliorate the abuse problem. As the blurb for his book puts it “the scientific evidence that has accumulated over the last twenty-five years of economic and public-health research, demonstrates that higher alcohol excise taxes and other supply restrictions are effective and underutilized policy tools that can cut abuse while preserving the pleasures of moderate consumption.”

Which is not necessarily all bad news for the wine industry. At alcohol levels of 40% and above, SA whisky and vodka markets will be the first to feel the crunch and a swing back to the lower alcohol wines of a decade ago makes a lot of sense.

Not that teetotalism is the aim. Even the ominously named US Bureau of Alcohol, Tobacco and Firearms agrees that US wine producers may include the statement that “current evidence suggests that moderate drinking is associated with a lower risk of coronary heart disease in some individuals” on their bottles.

Winston Churchill had no need of a note from the US government that a drink was good for you. As an elder statesman on the lecture circuit, he insisted as part of his contract that a bottle of champagne be included in his remuneration – to be consumed before the lecture.

Alcohol is the most powerful non-prescription legal drug around and has a powerful effect on the human body – not all negative. In fact a moderate amount of alcohol improves short term memory, the performance of some higher cognitive functions (especially in older people) and may also enhance manual dexterity – such as tinkling the ivories of your computer keyboard. Alcohol also stimulates the production of serotonin – which is probably why you drink, after all.

It is now widely accepted that moderate drinking (that means four glasses of wine a day for men and two for women – sorry ladies) can prevent heart attacks and cardiovascular disease, stimulate digestion and even ward off certain cancers. By boosting the levels of high-density lipoproteins, the so-called “good cholesterol” in the blood, alcohol reduces the risk of heart attacks and also prevents the formation of clots in the arteries. Since about half the deaths in the Western World are due to vascular disease, alcohol is an important prophylactic.

Marie Antoinette used to wash her face in red wine, believing it helped prevent wrinkles. Modern scientific research confirms her actions as being well founded. Red wine contains tartaric acid, which belongs to the family of alpha hydroxyl acids or AHAs for short. AHAs are the secret ingredient in a new generation of face creams. The theory is that AHAs speed up the shedding of the outer layers of the epidermis and also encourages the elastin fibres in the dermis to retain their resilience and stretchability. A case of let them eat cake and bathe in wine, perhaps.

But if you overstep the mark and increase alcohol consumption beyond your allotted daily allowance, health ill-effects mount rapidly. Burning the candle at both ends increases blood pressure and the risk of liver disease as well as impairing cognitive function. Alcohol reduces the activity of the hippocampus, a structure in the brain connected with memory and balance while simultaneously raising activity in those regions concerned with speech (hence the talkative drunk), regulation of emotions and the processing of sensory stimulation information.

Alcohol is also a powerful diuretic. By inhibiting the hormone which controls urination, drinkers micturate more often with the result that the whole body dries out – the exception of the brain, which swells up. One of the few benefits of age is that hangovers are less likely. Even the planet-sized brains of Nobel laureates shrink with age, so the odd binge merely finds the brain reclaiming lost skull space. With no nervous tissue getting compressed, there are no throbbing headaches.

Alcohol inhibits the production of saliva and so it is a silly, albeit fashionable, thing to drink an aperitif before dining. Still the brain’s anticipation of food counteracts this drying out process and primes the taste buds for further delights in store. Everything in moderation, especially in drinking as excessive alcohol consumption depresses blood sugar levels, causing feelings of weakness, sweating and a general state of nervousness.

The long term effects of over indulgence are horrific. In men, the testicles atrophy, the penis shrinks, the cheeks enlarge, there is a loss of body hair, the palms go pink and the breasts and belly swell while the arms and legs become spindly. In addition, the long-term male drinker may develop spider naevi, a condition so gruesome it prevents me from reaching for a dictionary to find out what it means. Perhaps in the same way that health warnings on cigarette packets have been superseded by photos of diseased lungs and tumors, perhaps high alcohol wines could have spider naevis as back labels. That should bring consumption down a treat.