The evidence is clear. We should drink less. As a nation, we stumble and fall after lengthy bouts of drinking. Pints are downed and spirits are necked.

Lads sing "here we go, here we go" as women stagger and fall. Our European neighbours shake their heads in disgust.

National campaigns are challenging our behaviour. Young men fall from scaffolding as the methanol that courses through their veins gives them an unprecedented sense of indestructibility. Middle class women reach for bottles of chilled sauvignon blanc to erase the memories of a difficult day in the office, unaware of the consequences of their excess. A barman intervenes to dissuade a driver from having a final drink. My favourite? A young woman smears her mascara, vomits on her hair and breaks the heel of a shoe as she leaves for a night out: "You wouldn't start your evening like this… so why end it that way?" Inspired.

The effects of excessive drinking on our livers, hearts and waistlines are disastrous. And the risks we take as a result are equally problematic: people are attacked, fall under cars, have unsafe sex. Accident and emergency departments across the land are filled with casualties. Drinking is a burden on society and a drain on the NHS.

Changing behaviour

The reasons people drink excessively are complex and diverse. For some, it is anaesthesia, a constant way of easing the pain of some former distress, perhaps buried deep in their memories. For others, it might be a way of dealing with the stresses of the present, a temporary release from the misery of poverty or relationship failure. Each person who drinks to excess will have their own reasons.

To reduce drinking on an industrial scale, we need to think creatively and really understand individual behaviours, factoring in the pleasure that drinking brings in the moment, as well as the long-term harm it might do. Campaigns are a good start, but systematically addressing the reasons why people drink needs consideration. Access to alcohol needs to be modified too. Efforts have to be nuanced, targeted and engage with the realities of people's lives.

For people whose drinking is sustained and excessive - those who are addicted to alcohol - campaigns and advice have a limited effect. Once past a certain point, alcoholism has to be addressed by teams of trained personnel. The road to quitting alcohol, to becoming a dry alcoholic, is long. It takes untold courage and determination.

Social harm

When it comes to limiting the negative health effects of alcohol, do we consider the broader consequences of drinking? Are the effects of excessive drinking on others sufficiently considered?

Living with - and loving - an alcoholic is challenging. For the drinking family member, alcohol takes priority over all else. They love the drink. They need to drink. Alcoholics are seldom where they say they are going to be and are seldom able to face the consequences of their actions.As routine slips away, partners lie awake wondering why the one they love would sooner sit up with a bottle than come to bed. On occasion, impotence and heavy fists serve to make sustaining a relationship difficult. One person's excess eats away at another's well-being and in time can trigger poor mental health. Family members struggle with feelings of guilt and despair.

Ill health is seldom experienced in isolation; its effects are far and wide. To tackle the effects of alcohol, we need to think broadly and work with families as well as individuals, an approach that could engage health visitors and social workers and limit the negative impact of one of the nation's favourite pastimes.

Topics