This report reviews international experience of community-based prevention programmes to address alcohol-related harms at local level. Debate following the publication of the "Alcohol Harm Reduction Strategy for England" (2004) and the implementation of the Licensing Act (2003) raised concerns about the cost of alcohol misuse to individuals and communities. A key part of national strategy is a focus on local responsibility for policy implementation and an expectation that stakeholders - local authorities, professional groups, the alcohol trade and 'communities' - will work together to reduce the problems. The report describes a 'multi-component' model to prevent and reduce harm with evidence from programmes in the USA, Australia and Scandinavia. This approach typically requires a programme of multiple, co-ordinated initiatives, rather than 'stand-alone' projects, and an emphasis on encouraging change in local policies, structures, systems and drinking cultures. The involvement of local communities is central to most programmes and the report considers the problems of implementing and sustaining this approach as well as the advantages it offers.
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Betsy Thom is a Reader in Drug and Alcohol Studies and Head of the Social Policy Research Centre, Middlesex University. Mariana Bayley is a psychologist and a research fellow attached to the Social Policy Research Centre.
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