Elements of social control include both protective and risk environments that primarily operate to constrain or enable opportunities to use alcohol, thereby influencing the contribution of genetic effects to AUD. Shanahan and Hofer11 emphasized elements of social control such as social norms or structural constraints that help maintain social order by decreasing deviant behaviors such as excessive alcohol use. They highlighted involvement with community institutions including churches and social norms surrounding alcohol use. For example, the Higuchi et al.13 study is often highlighted in discussions of the relationship of societal-level effects on genetic influences for alcoholism, as the protective ALDH2*2 variant was reported to be weaker in younger Japanese cohorts, suggesting a link to more liberal drinking norms and an increase in per capita alcohol consumption. In the U.S., there is evidence for strong cohort effects on drinking, with some birth cohorts drinking much more heavily than others14,15; however, corresponding studies in U.S. samples on the relationship of these changes to genetic influences for alcohol use have not been conducted. Dick and Kendler10 and Sher et al.12 also underscored more
