Drinking prototypes, programs and alliances.

Stimson, G., Grant, M., Choquet, M., & Garrison, P. (2007). Drinking in context. Patterns, interventions, and partnerships. New York: Routledge, Taylor and Francis Group. [Hardbound; ISBN-10 0-415-95447-9; $ 49.95]

Drinking alcohol is responsible for substantial morbidity and mortality. In the United States, 14 million people are dependent on alcohol and in 1995, 105,000 deaths occurred from alcohol abuse (McGinnis, & Foege, 1999). One study found that approximately 4.8% of all the deaths and 9.7% of all disability-adjusted life years (DALYs) lost in the year 2000 were attributable to drinking (Rehm & Monteiro, 2005). In 2001 binge drinking episodes in the US were found to be 1.5 billion with 7.4 episodes per person per year (Naimi, Brewer, Mokdad, Denny, Serdula, Marks, 2003). It is in this context that a policy book on alcohol is very much needed and this book serves that need.

The book is organized into ten chapters. The first chapter is called new solutions to changing problems and it begins with a discussion on drinking problems in a changing social context. Examples from both developing and developed countries are presented. A case is built for developing policies with cross cultural variation.

The second chapter is called patterns of drinking and their outcomes. Three dimensions are discussed in this chapter. The first are the variations due to gender, age, socio-economic conditions, genetic and biomedical conditions. Second the context of drinking is discussed. This includes the culture around alcohol in a given society, availability of non commercial alcohols (such as opaque beers in Africa, arrack in India, home produced wines in Europe), and settings and venues for alcohol consumption. The third dimension is behavior whether it is done for leisure, or for heavy drinking. Following the discussion of these three dimensions the relationship between drinking pattern and physical, mental, and social outcomes is presented.

The third chapter is about selecting the interventions for preventing harm from alcohol. The chapter begins with a discussion on reasons to assess drinking behavior. Common sources of information used in epidemiological needs assessment such as population consumption data, arrest and conviction data, alcohol-related mortality data, alcohol-related morbidity data, general population surveys, and surveys of special populations are discussed. Also discussed are rapid assessment methods such as rapid rural appraisals (Chambers, 1980).

The fourth chapter is called opportunities for targeted and tailored interventions. The chapter begins with a discussion on characteristics of national level regulatory measures. This is followed by a discussion on targeting populations at high risk. Following this discussion, the strategies for targeting drinking behaviors and drinking contexts are presented. The chapter concludes with a recommendation for creating balanced alcohol policies.

The fifth chapter is about targeting alcohol impaired driving. A recent study, in the US, found alcohol impaired driving to involve 159 million people (Quinlan et al, 2005). The chapter begins with a discussion on the problem of road traffic injuries and alcohol. Then the issue of blood alcohol concentration (BAC) limits is discussed in detail. The highlight of the chapter is its discussion of interventions to reduce alcohol impaired driving such as roadside checkpoints, designated driver programs, alternative transportation schemes, on site education campaigns, server training programs, education programs, holiday and fiesta campaigns, and alcohol ignition interlock device on vehicles.

The sixth chapter is about targeting drinking and public disorder. The chapter begins with a description of public disorder and antisocial behavior as a result of intoxication. Various programs such as modifying the environment, training servers and security personnel in handling intoxicated patrons, and community interventions are discussed.

The seventh chapter is about targeting young people. The chapter begins with a description of international levels of minimum legal drinking age and minimum legal purchase age across the countries of the world. Then the reasons why young people drink are explicated. Finally various opportunities for intervention such as drinking age, targeting drinking venues, alcohol education, and focusing on groups at risk are explained.

The eighth chapter is labeled, "feasible interventions for minimizing harm." Various interventions have been discussed such as total ban on sales, taxation and pricing, government monopoly of retail sales, restricted hours and days of sale, restriction on advertising and promotions, responsible drinking messages, minimum legal purchase/drinking age, school-based education, life skills, early identification and brief intervention, server training, restrictions on density of serving and retail outlets, local accords and community action, breath testing in high injury-risk workplaces, social norms marketing, and random breath testing/sobriety checkpoints.

The ninth chapter is called key players and partnerships. It discusses the role and collaboration between government, scientific communities, nongovernmental organizations, and for profit private sector. Social marketing model is also discussed in this chapter.

In the final chapter, the issue of potential conflicts of interest is discussed in an attempt to demonstrate how to find common ground that enables mutual efforts for collective solutions. The concept of corporate social responsibility has also been introduced in this chapter. The book concludes with one and a half pages of conclusions and an "afterword" by Norman Sartorius.

The layout of the book and the front and back cover are appealing. Each chapter is interspersed with box items which makes it an interesting reading. However missing is a summary at the end of each chapter. A summary of each chapter would have helped the reader and improved the readability.

Overall, this is a very timely book on alcohol drinking prototypes, concerted programmatic interventions, and multi-stakeholder alliances toward alcohol prevention and control. A must read book for all policy-makers, program designers, and health professionals.

REFERENCES

Chambers, R. (1980). Rapid rural appraisal: Rationale and repertoire. Discussion paper 155. Brighton, UK: Institute for Development Studies.

McGinnis, J. M., & Foege, W. H. (1999). Mortality and morbidity attributable to use of addictive substances in the United States. Proceedings of the Association of American Physicians, 111(2),109-18.

Naimi, T. S., Brewer, R. D., Mokdad, A., Denny, C., Serdula, M. K., & Marks, J. S. (2003). Binge drinking among US adults. JAMA, 289(1), 70-75.

Quinlan, K. P., Brewer, R. D., Siegel, P., Sleet, D. A., Mokdad, A. H., Shults, R. A., et al. (2005). Alcohol-impaired driving among U.S. adults, 1993-2002. American Journal of Preventive Medicine, 28(4), 346-350

Rehm, J., & Monteiro, M. (2005). Alcohol consumption and burden of disease in the Americas: Implications for alcohol policy. Revista Panamerieana de Salud Publica, 18(4-5), 241-248.

Review by Manoj Sharma, University of Cincinnati