Through adept lobbying the alcohol drinks industry has been successful in normalising perceptions of the drug and shifting policy makers' attention away from rising patterns of consumption, particularly among vulnerable groups. This chapter sets out the health and social impact of alcohol, examines the economic position of the alcoholic drinks industry, and details the recent evolution of alcohol policy. In the UK high consumption of alcohol over a short period (binge drinking), linked to antisocial behaviour, has largely displaced older images of alcohol misuse focused on street alcoholism. A key element to the evolution of public policy on alcohol – and prominently featured in the opening pages of government reports – is the economic position of the alcoholic drinks industry. Despite rising media attention given to alcohol-linked antisocial behaviour the power of the industry and its sway of government helps explain why public health considerations have been marginalised and interventions to curtail patterns of harm limited in their impact.