Alcohol misuse and the predisposing environment.

Abstract

In recent years, the aetiology of alcohol misuse has come to be conceptualised in terms of risk factor models. Risk can emanate from a number of sources ranging from the genetic to the sociostructural. This chapter reviews the major environmental risk factors under two broad headings--those that affect the availability of the agent and those that affect the vulnerability of the host. The former include a variety of economic, social and physical factors such as price, advertising and licensing laws. The latter include broad socioeconomic and sociocultural factors, as well as interpersonal influences such as family, peers, employment and stress. Practitioners (as distinct from policy-makers) concerned with prevention and treatment of alcohol misuse can most effectively intervene at the interpersonal level, and the paper concludes with a discussion of the implications for clinical practice of the research reviewed in this domain.