An argument is presented for shifting the main focus of the alcohol policy debate away from aggregate level of consumption as the key determinant of alcohol problems in favour of a sharper focus on the reduction of harm and of high risk drinking. This argument is developed by highlighting the advantages of the latter approach in relation to: (i) the ability to distinguish between low risk and harmful consumption of alcohol (ii) the ability to predict which drinkers are most likely to experience harmful consequences of drinking (iii) the acceptability of policy objectives to government and industry, and (iv) the acceptability of prevention strategies to the general public. It is suggested that this focused approach to the measurement and reduction of alcohol related harm is more likely to achieve tangible success in the policy arena than one which is overtly predicated upon the need to reduce total population consumption of alcohol.