Compared with the tobacco industry, the companies that provide us with wine, beer and spirits have a glowing reputation. They have promoted campaigns to discourage drink driving and to educate the public in ‘sensible’ patterns of drinking.

Indeed, such is the drinks industry's status as a valued stakeholder that when the world's biggest research agency dealing with alcohol-related health problems, the US National Institute on Alcohol Abuse and Alcoholism (NIAAA), was looking for a new director in 2002, a representative of the San Francisco-based Wine Institute served on the search committee.

One popular refrain for the drinks industry is that, in moderation, alcohol can improve health. When the US Department of Agriculture revised its Dietary Guidelines for Americans in 1995, for example, the wine industry lobbied successfully for mention of the beneficial effects of moderate alcohol consumption on cardiovascular disease.

But you're unlikely to have heard industry representatives explaining that the beneficial effects of moderate drinking are limited to a relatively small proportion of the population. Many of the rest of us, lulled into thinking that our ‘social’ consumption of alcohol is good for us, are literally drinking ourselves to death (see page 598).

The industry's preferred message has found subtle echoes in the research agenda. From the mid-1990s, language in the reports accompanying spending bills passed by the US Congress urged the National Institutes of Health to support research into the effects of moderate alcohol consumption. This coincided with the first moves by the NIAAA to fund substantial research in this area. In 1996, grants given to study the risks and benefits of moderate drinking totalled $2.2 million. Although that was just 1.5% of the agency's budget, enthusiastic media coverage has since ensured that the findings from these projects have captured disproportionate attention.

Given the enormity of the world's drink problem, there is an urgent need to refocus public scrutiny on the harm caused by alcohol. If this harm is to be reduced, policy-makers will need to continue working in partnership with drinks manufacturers. But they should also put the alcohol industry's message of ‘a little is good for you’ in its proper context.