Alcohol policy--evaluating the options.

All policy interventions have costs and benefits and the 'harm' created by the use of alcohol can only be mitigated at a cost. The purpose of economic analysis is to measure these costs and benefits in an explicit way and to use these results to inform policy. Policy makers like to use estimates of the social costs of alcohol use but such data are of little use in identifying which interventions reduce harm at least cost: knowing alcohol use costs in local currencies $6 million in Australia, $5.8 billion in the USA, $5.7 billion in Canada and $2 billion in the UK may fuel political debate but does not identify the intervention where investment produces the greatest increase in benefit at least cost. Integrated policies to raise taxes in relation to price and income changes have significant impacts on alcohol consumption and, if complemented with advertising controls and limits on availability have even larger effects. The quantity and quality of economic evaluations of health care interventions is inadequate. What little evaluation that has been undertaken indicates that low cost minimal interventions may be cost effective for the wider population of problem drinkers. Other more intensive interventions are likely to be cost effective only if well targeted on appropriate client groups. There are many effective ways of reducing alcohol consumption. The industry will lose and oppose change but improvements in health and other aspects of life (eg civil order) will be significant.