Recently, David Cameron called binge drinking "one of the scandals of our society", but who is to blame: drinkers or the drinks business?
That is something the government will wrestle with as it prepares to launch its Alcohol Strategy in the next few weeks. In 2004, when Labour launched its Alcohol Harm Reduction Strategy for England, the unfortunate acronym seemed apt to many health professionals. The 'AHRSE' insisted that industry self-regulation, voluntary codes and education were the key to reducing alcohol-related harms, despite the government's own research suggesting legislative action on price and availability were more effective.
Since then, battle lines have been drawn between public health lobbyists who demand intervention to reduce overall consumption, and a drinks industry that promotes voluntary action to target problematic minorities.
The coalition has gone in two directions on the issue. While the Home Office has moved to tighten licensing law, the Department of Health has put its faith in a 'responsibility deal' with the drinks industry based on self-regulation and public education. However, days before the responsibility deal was launched in March 2011 six major health bodies withdrew from the process. One of those groups, Alcohol Concern, claimed the light-touch approach revealed that the government's "first priority is to side with big business and protect private profit."
The new Alcohol Strategy, therefore, has to straddle not only a rancorous divide between public health and industry, but between government departments with their own agendas - all of whom ultimately defer to the treasury, whose interests in these matters rarely strays far from the question of tax receipts.
What, then, are the issues the strategy will have to resolve? Three stand out: pricing, supermarkets and education.
Health campaigners are urging the coalition to follow the SNP in introducing a minimum unit price for alcohol. When the Chief Medical Officer proposed a minimum unit price in 2009, David Cameron swiftly and publicly opposed it on the grounds that it would unfairly target moderate drinkers.
More recently he has warmed towards the idea, and signs that something stronger than the proposed ban on selling alcohol at 'below-cost' may be included in the new strategy speaks volumes about changes in the political climate around alcohol over the last five years or so.
Another, longer-term, shift has been the dwindling influence of the pub trade on the Conservative Party. Once natural bed-fellows, the pub trade feels increasingly alienated from the Tories: many landlords are incensed by the coalition's new licensing restrictions, which were introduced within months of gaining power.
Tackling 24-hour drinking fitted with narrative of 'Broken Britain' that played so well for the coalition in the run-up to the general election; in reality, however, it is supermarkets that have seen across-the-board increases in alcohol sales, while pubs have been closing at a rate of around 25 a week in recent years.
If the new strategy continues to target the on-trade, while leaving supermarkets to stack their aisles with cut-price deals, questions will be asked about the commitment to tackling consumption levels at home, or protecting responsible pubs.
Finally, if self-regulation and voluntary partnerships form the core of the strategy, then it may appear that little has changed from the previous administration. Supporters of voluntary approaches point to the success of Community Alcohol Partnerships in reducing drunken behaviour in the streets of towns such as Newquay, while critics note the lack of evidence that the Responsibility Deal has made much difference in the alcohol aisles of supermarkets.
Baroness Newlove, whose response to the death of her husband at the hands of drunken thugs in 2007 did much to change the debate on alcohol, is currently heading a £1 million scheme to promote Community Alcohol Partnerships across the country.
Should these prove successful, then the argument for voluntary action will be strengthened. However, should the legislative, supply-side interventions currently being adopted in Scotland have a more dramatic impact then it will become increasingly difficult for Westminster to ignore the demands of the public health lobby.
The Alcohol Strategy Unit have an unenviable task, and it is unlikely that the new strategy will please everyone. However, if it simply reaffirms the current approach then an unlikely coalition of landlords, small brewers and alcohol health campaigners will cry foul.
Furthermore, if it appears that multinational producers and supermarkets are being left to regulate themselves while everyone else takes the blame for alcohol-related harm, then it will do little to support the idea that, where alcohol is concerned, we are 'all in it together.'
In 2004, Labour's AHRSE took quite a kicking; it may be hard for the coalition strategy to avoid a similar fate.
Follow James Nicholls on Twitter: www.twitter.com/jamesqnicholls