KEY POINTS:
When Californian midwife Susan Parker arrived in Christchurch in 2001, she found she had settled in "the most alcohol-driven country I have ever encountered".
It's not that we drink more than anyone else, although we do drink about 15 per cent more than Americans and almost twice the world average. A World Health Organisation survey in 2004 placed us 27th out of 185 countries, behind most European countries.
But whereas most of Europe has what has been called a "wet" drinking culture based on wine with meals, New Zealand and other Anglo-Saxon countries are said to have "dry" cultures - where drinking is discouraged but most alcohol is consumed in periodic binges where drinkers actually aim to get drunk.
Ms Parker, a recovering alcoholic who has been sober for 27 years and has lived in Britain, Ireland and Denmark as well as the US, says Kiwi drinking is "even worse than Ireland".
"I've never seen such an alcohol-fuelled country."
Alcohol is literally in our blood. Our colonial forebears brought a culture of heavy periodic drinking with them from Britain, which even today consumes about 6 per cent more alcohol per capita than we do.
By 1960, allowing for understatement in our official statistics, the average adult New Zealander probably consumed about six litres of pure alcohol, compared with a world average of four litres.
Since then our drinking has tracked our economy, rising more strongly than the world average in our halcyon days of full employment and steady economic growth until the world recession of the early 1980s, then falling back more sharply than the world as our unemployment soared from the double whammy of recession and free trade.
There has been a slight upward trend again with the economic growth of the past decade, plus a small extra kick from lowering the drinking age from 20 to 18 in 1999. But broadly speaking, our consumption seems to have levelled out at around nine litres of alcohol a head, compared with a world average which is now around five litres.
Gerard Vaughan of the Alcohol Advisory Council says a levelling out, or even a fall, should be expected as our population ages because heavy drinking generally declines with age.
Our problem, he says, is not our total level of drinking, but the way we binge-drink to get drunk. As Alac's hard-hitting TV ads put it: "It's not the drinking. It's how we're drinking."
Although Alac's campaign has been criticised for being too soft on drinking, Vaughan says its stand against intoxication is actually "quite a radical position to take" in a culture where drunkenness is widely tolerated - even glorified.
An Alac survey in 2005 found that only 49 per cent of adults aged 18 and over, and 33 per cent of adolescents aged 12 to 17, agreed that "It's never okay to get drunk". About a third in both age groups disagreed with that statement, with the rest unsure.
Nine per cent of adults, and 14 per cent of adolescents, told Alac that they personally "drink to get drunk".
A Ministry of Health survey in 2004 found that a quarter of all drinkers actually drink more than the recommended guidelines of six standard drinks for men or four for women in a single drinking session (see box).
This percentage peaks at 54 per cent of those aged 18 to 24, but falls quickly as people pair up and acquire children and mortgages, dropping to 29 per cent of those aged 25 to 34, 19 per cent in the 35-44 age group, 13 per cent at 45-54 and just 7 per cent over 55.
Australia is revising its drinking guidelines. A draft in 2007 recommended a maximum of only two standard drinks a day for both men and women, and zero for adolescents under 18 and pregnant women.
Explaining the draft, the National Health and Medical Research Council said there was in fact no "safe" drinking level. Rather, the risk of injury and admission to a hospital emergency department doubled with even one standard drink compared with no drinking, and doubled again with two more standard drinks.
With five standard drinks you are six times as likely to be injured, and with seven standard drinks you are 10 times as likely to be injured compared with not drinking at all.
The council says its recommended maximum of two standard drinks a day would "reduce the lifetime risk of death from an alcohol-related injury or disease to less than one in 100 people who drink at that level".
In New Zealand, Mr Vaughan says Alac's goal is simply to "reduce harm".
"We know that if you've got alcohol, and you're inheriting a history like New Zealand has, you are never going to eliminate people getting drunk," he says. "What we want to change is the social norm that actually that is quite a normal part of being a New Zealander.
"If we do shift that, we know we will reduce the level of harm from drinking to get drunk. And you do see that with other countries that have a social stigma around drinking to get drunk."
DRINKING GUIDELINES
* Alac recommends that men should drink no more than six standard drinks, and women no more than four standard drinks, in a single session.
* A standard drink is 10 grams of pure alcohol - roughly one glass of wine, a 330ml can of beer or a 275ml bottle of a ready-to-drink mix such as Vodka Cruiser.
