Population level policies on alcohol: are they still appropriate given that "alcohol is good for the heart'?

The research finding that a reduced risk of coronary heart disease is associated with alcohol use has been widely disseminated. This paper addresses the significance of this research finding for decisions about what kind of alcohol harm reduction policies it is appropriate to implement. The public policies of greatest concern to the vested interest groups are population-based policies such as taxation and restrictions on availability. Other public policies which impact on the drinkers' environment are minimum drinking age laws, drink drive deterrence, prevention of intoxication in public drinking places and restrictions on advertising. A review of the effectiveness of the available strategies provided strong support for environmentally focused approaches rather than education targeting high-risk drinkers. Many of these environmental strategies seem unlikely to have a significant direct effect of reducing "heart healthy' drinking by older people. Furthermore, the impact of alcohol on premature mortality among the older sectors of the population has to be weighed against any possible impact on younger drinkers resulting in loss of or disability in many years of life. Given the relative effectiveness of environmental strategies for reducing harm and the likely low level of impact of these strategies on the heart healthy drinking of older people it is concluded that the evidence of reduced risk of coronary heart disease does not preclude their implementation.