here has been considerable academic and media interest in recent times in T the allegedly beneficial effects of specific varieties of alcoholic drinks. A study published in The Lancet in 1995' purported to demonstrate that wine drinkers lived longer than beer or spirit drinkers, even when potentially confounding sociodemographic factors were allowed for. Laboratory studies have indicated that red rather than white wine contains ingredients (clearly not alcohol) which are effective in reducing blood lipoprotein levels? Other studies have found that red grape juice is equally efficacious in this regard.3There are considerable demographic and behavioural differences between persons who consume different beverages that may also account for such findings. Wine drinkers are more likely to be older, female, educated, affluent, to drink socially at private homes, drink less frequently and less per occasion than beer or spirit drinker^.^,^ They are also more likely to be healthy6 and less likely to drink and drive.5 It is hard, therefore, to sustain the argument that the apparently beneficial effects of wine consumption are solely explicable by a biological mechanism. This is particularly so considering recent evidence that health benefits are more likely to be conferred on drinkers who space out their drinks over the week rather than binge.' The former pattern is more usual among wine drinkers and the latter among beer and spirit drinkers5 (It is unclear whether these drinking patterns apply to both consumers of bottled wine and cask wine, a central distinction for the present paper.) A recent review of ecological, case-control and cohort studies contrasting the different alcoholic beveragesu concluded that the beneficial effects of alcohol are not peculiar to, or more marked in, any particular beverage variety.The debate about whether wine should be regarded as, in essence, a health drink has taken on particular significance in Australia since early 1994 when a national inquiry was AbstractObjective: To determine whether population levels of consumption of some alcoholic beverages are more closely associated with levels of harm than others, particularly if consumption of cask wine is more strongly related to rates of acute alcohol problems than consumption of bottled wine as a consequence of the extremely low rates of federal tax levied on the former. Method: A database of alcohol consumption and related problems was established for 130 areas of Western Australia. Demographic and economic data for these areas were included from the 1991 census. Empirically derived assumptions regarding the mean wholesale price of cask and bottled wine were utilised. Regression analyses examined the extent to which the consumption of different alcoholic beverages predicted levels of major varieties of harm. Results: Only cask wine and high-strength beer consumption were significantly associated with rates of night-time assault; consumption of all beverage varieties except bottled wine was significantly associated with rates of acute alc...

Geographic information systems technology was used to describe, in geographical terms, the nature and strength of the relationship in Western Australia between alcohol consumption and the rates of related injury: night-time assaults (10 p.m. to 6 a.m.); minor night-time road crashes (10 p.m. to 6 a.m.), weighted by traffic density; and hospital E-code (externalcause) morbidity, weighted by alcohol aetiologic fractions. The data were aggregated by five conventional state regions: northern, central, western, southern and Perth metropolitan. There was a general association, of equal significance for males and females, between estimated per capita alcohol consumption and the selected rates of injury in the five regions. However, the nature and strength of association between alcohol consumption and individual injury measures varied. Night-time assaults and hospital Ecode morbidity were strongly associated with consumption. Minor night-time crashes had only a weak association. The variation in the relationship between alcohol consumption and injury suggests that prevention strategies need to take into account the particular drinking patterns and associated harm that occur in different regions of the state, and to develop a range of targeted responses. High rates of consumption and injury in most country areas support the need for greater regional prevention efforts. (Aust N 2 J Public Health 1998; 22: 80-5)

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The multilevel integrated practice and coordinated communication model was successfully spread and sustained. Key elements contributing to this success included developing and maintaining evidence-based guidelines, ensuring leadership buy-in and support, collecting and reporting performance measures, holding teams accountable, providing training, and ensuring transparent communication.