Grasping the thistle: The role of alcohol brief interventions in Scottish alcohol policy


Lesley J. C. Graham MBChB, MSc, DRCOG, MRCGP, DFPH, Associate Specialist Public Health, Donna MacKinnon BA (Hons), MPhil, PhD, Head of Delivery. Dr Lesley J. C. Graham, Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh, EH12 9EB, UK. Tel: +44 0131 275 6322; Fax: +44 0131 275 7514; E-mail:


Issue.Scotland has experienced a substantial rise in alcohol-related harm, which is now one of the biggest public health challenges it faces.

Approach.Alcohol problems in Scotland are described along with national alcohol policy response in addressing them. The role of a program of Alcohol Brief Interventions is discussed therein.

Key Findings.In Scotland, considerable proportions of the population are drinking hazardously or harmfully, common across different age and socioeconomic groups. Rising consumption has been set in wider environmental changes with alcohol becoming more available and affordable. Scotland has had one of the fastest growing chronic liver disease mortality rates in the world at a time when rates in most of Western Europe are falling. Scotland's alcohol policy has an explicit aim to reduce population consumption and includes legislative measures to tackle price and availability. A national program to deliver Alcohol Brief Interventions for hazardous drinkers is a key plank of this wider strategy. A portfolio of studies will monitor and evaluate national policy and, through contribution analysis, describe the role Alcohol Brief Interventions play in reducing alcohol misuse.

Implications.Effective alcohol policy recognises that determinants of health not only lie at individual level, but include wider social, environmental and economic factors. Scotland's policy is addressing these determinants with both population-based and population-targeted interventions.

Conclusion.Scotland has a serious problem with alcohol. A comprehensive, evidence-based, resourced alcohol policy is being implemented, which will need continual review to ensure it remains anchored in evidence while maintaining its ambition.[Graham LJC, MacKinnon D. Grasping the thistle: The role of alcohol brief interventions in Scottish alcohol policy. Drug Alcohol Rev 2010;29;603–607]