Safer Bars, Safer Streets?

Controlling alcohol problems: different approaches or different priorities?

The adverse effects of alcohol consumption are massive. Alcohol is deemed to be the major factor in four per cent of the global burden of disease mortality (World Health Organisation, 2004). It has been suggested that there are two quite separate approaches to alcohol control policies. These supposedly different approaches are called the ‘public health approach’ and ‘harm minimisation’ or ‘harm reduction’. In fact, while there has been a clear difference in emphasis between some expressions of these two approaches, so much of what their exponents advocate is the same that there would appear to be no merit in continuing to regard them as mutually exclusive or in conflict. The public health approach emphasises curbing the level of alcohol‐related problems by reducing the per capita alcohol consumption (eg. Bruun et al, 1975; Edwards et al, 1995; Babor et al, 2003). Harm minimisation or harm reduction is intended to reduce the level of alcohol's adverse effects without necessarily reducing per capita alcohol consumption (Plant et al, 1997).