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Drinking can increase the risk of injury and death depending on the activity or situation in which the drinkers find themselves. As a result, strategies to prevent or reduce the risk of alcohol-related trauma are best directed at drinking patterns or at drinking settings that involve risk or harm. The review of potential prevention strategies in this chapter identifies alternatives that have actually been implemented to reduce alcohol problems, whether they have been evaluated or not, and the available research evidence concerning the potential effectiveness of each strategy.

Health professionals concerned with the prevention of chronic diseases have accumulated over 20 yr of experience in programs designed to reduce cardiovascular disease (CVD). Some of these studies were carried out in clinical settings or in worksites.1,2 Other studies in CVD prevention were directed at the entire populations in communities and involved comprehensive approaches combining community organization and multichannel health education.3–7These earlier studies represent a rich source of both technical expertise and practical experience that alcohol problem prevention professionals should consider before they design similar projects. However, because most knowledge of community-based public health interventions derives from programs to reduce high-risk medical conditions, the relevance of the medical trials for the management, design, and implementation of alcohol problem prevention should not be automatically assumed.8,9 For these reasons, the development of a comprehensive community-based program for prevention of alcohol-related injuries and deaths requires attention to linkage of public education and community organizers with agencies involved in regulatory and environmental policies. Strategies used in such interventions will require many innovations beyond those used for other health domains to insure their relevance to alcohol-related trauma.