This study compares primary alcohol prevention in Scotland and Sweden and the effectiveness of preventive actions with special reference to developments from the mid- or late 1970s when alcohol consumption peaked in both countries and when changes were made in their alcohol policies. A short historical overview shows many similarities between the countries, e.g. strong prohibition-oriented temperance movements, a history of alcohol (spirits) abuse and restrictive legislation. A major difference is the much more dominating role of private profit motives in Scottish alcohol trade. During the last 15-20 years, the two countries have chosen different strategies to prevent alcohol-related problems. Sweden has put heavy emphasis on restricting the availability of alcohol but also invested substantially in information, whereas Scotland has concentrated on the latter. A comparison of the trends during the last 15-20 years suggests that whereas Swedish alcohol control reduced the level of alcohol consumption and related problems in the late 1970s and early 1980s, the Scottish did not, even though the upward trend was broken for most indicators. The drinking sensible message has not been powerful enough to reduce the number of non-sensible drinkers. In fact, a continuing upward trend of liver cirrhosis deaths in Scotland, especially for women, may suggest the opposite. The study also shows that, despite rather stable overall consumption for the last 10 years, the specific alcohol-related problem of drinking and driving has been decreasing in both countries. This indicates that even if consumption increases in the future, as is likely in Sweden due to current changes in alcohol control policy, drinking in specific contexts may still be preventable.
