EDITORIAL - Safer Bars, Safer Streets?
Journal of Substance Use, June 2007; 12(3): 151–155




The debate about controlling alcohol-related problems is rather different from that related to either tobacco or illicit drugs. Tobacco is now increasingly viewed as being a pariah substance in most industrial societies, while the prevailing approach to illicit drugs is a punitive one. The consumption of beverage alcohol, outside much of the Moslem and Hindu world, is normative and esteemed. This is true even though the heavy and inappropriate consumption of alcohol causes massive health and social problems.

There are two distinctive approaches to alcohol control policies. The first of these is known as the ‘Public Health Approach.’ The second is called ‘Harm Minimization’ or ‘Harm Reduction.’

The Public Health Approach aims to curb the overall level of alcohol-related problems by reducing the per capita alcohol consumption (e.g. Bruun, Edwards, Lumio, Ma¨kela¨, Pan, Popham, Room, Schmidt, Skog, Sulkunen, & O ˝ sterberg, 1975; Edwards et al., 1995; Babor, Caetano, Casswell, Edwards, Giesbrecht, Graham, Grube, Gruenwald, Hill, Holder, Homel, O¨ sterberg, Rehm, Room, & Rossow, 2003). Harm Minimization aims to reduce the level of allcohol-related problems without necessarily reducing per capita alcohol consumption (Plant, Single, & Stockwell, 1997).

Apart from the degree of emphasis on reducing overall alcohol consumption levels, most of the measures suggested under the rubric of both approaches are similar. Recent reviews of the effectiveness of alternative approaches to bringing down the levels of alcohol-related problems have reached broadly similar conclusions (e.g. Plant et al., 1997; Babor et al., 2003; Stockwell, Gruenewald, Toumbourou, & Loxley, 2005; Plant & Plant, 2006). It could now be argued that these two approaches should no longer be viewed as being opposed to each other. This view is expounded below.
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