The concept of harm reduction emerged from the drug field in the 1980s in the context of reducing the risk of the spread of blood-borne viruses without necessarily reducing drug use. The concept has since become increasingly influential in the alcohol and even tobacco fields. In Australia, for example, most state liquor acts now identify harm reduction (or harm minimisation) as a principal objective. The concept of harm reduction has been highly controversial and there have been many attempts to redefine it towards politically acceptable positions.
In the alcohol field the concept has sometimes been proposed as an alternative to the view that the prevention of alcohol related harm can only be achieved through a reduction of the total population consumption of alcohol. This paper will present evidence to suggest that most effective interventions o reduce alcohol-related harm require reductions in the quantity of alcohol consumed per occasion. Furthermore, it is highly unlikely in most modern drinking societies that significant reductions in alcohol-related harm can occur without also a principle in alcohol policy that can be incorporated alongside controls on the physical and economic availability of alcohol.
It is recommended that the term risk reduction be applied to the many strategies that fall between harm reduction and abstinence-based approaches that require a reduction in amount of alcohol consumed. Finally, emerging evidence regarding common risk and protection factors for adolescent substance use as well as other mental health and behavioural problems is briefly discussed. It is recommended that the concept of risk here is broadened to include a wide range of social and economic factors which, when addressed, can have multiple benefits in in relation to the reduction of both substance use and other adolescent problems.