The first three verses of the Word of Wisdom, which tend to mitigate against a strict adherence, may not have been part of the revelation. By one account—single, late, and otherwise undocumented—they were added over Joseph Smith's objections, but this single source must be regarded with considerable skepticism. All canonized, printed versions of the Doctrine and Covenants from 1835 through the 1869 edition, begin the revelation with our physically separate the caption from the text, and usually set italic font.

In Kirtland, all official pronouncements required strict abstinence for a member to remain in good standing and to hold an office. Semi-official sources and anecdotal information confirm this strictness. Some overzealous individuals sought to make obedience a test of membership, but the Church never officially took that position. From Missouri the evidence, though not consistent, points to non-compliance by some prominent leaders and the Saints in general. The Mormon War of 1838-39 disrupted community life before the beginning of a renewed emphasis on abstinence could coalesce. The evidence from Nauvoo is also mixed, with some groups and individuals choosing a strict interpretation while others pressed for moderation rather than abstinence.

By 1844, eleven years after the Word of Wisdom had been received, the standard of strict obedience that had been required in Kirtland had become a thing of the past. Contributing factors for the relaxed standard in Nauvoo were (1) the continued and intensified use of prohibited substances for medicinal purposes; (2) the preaching of moderation rather than strict abstinence by some prominent leaders; and (3) the fact that some prominent members did not keep the Word of Wisdom.

In conclusion, when the Word of Wisdom was received, it was intended as binding on the members, within the limits the Word of Wisdom itself imposes. Members were required to keep it to hold office or to remain in good standing. This is the same standard that is applied today in the Church of Jesus Christ of Latter-day Saints. Opposition to this understanding during the Kirtland period, both to be more strict and to be more lenient, came from some groups and individuals. Not until Far West were attempts made in Missouri to require obedience to the Word of Wisdom. From the beginning in Nauvoo, the Word of Wisdom was generally not enforced, though some groups and individuals tried. By the time the Prophet was martyred in 1844, the standard set in Kirtland had been abandoned. It would take the Church as a whole about a hundred years to return to that standard.