Personal and social consequences were found to reflect similar rankings among countries with the exception of Japan which ranked significantly lower than other countries on personal consequences but significantly higher on social consequences. Although this difference occurred only for one country, the finding suggests that in order to develop a better understanding of drinking patterns and perceived negative consequences from drinking around the world, it is important not to assume that clustering of negative consequences will be the same in all countries. With regard to the findings for Japan, one possible explanation for the anomalous finding is that alcohol consumption, even heavy consumption, is widely tolerated in Japan but bad behavior while drinking is not (51). Thus, the difference in ranking for personal versus social consequences may be due to Japanese respondents having a lower threshold for perceiving social harms compared with respondents from other countries even though social harms may not be objectively more frequent in Japan (52). This interpretation is supported by the relatively high proportions of Japanese respondents (compared to other countries) reporting perceived harmful effects such
