These recommendations are in line with the public health guidance Alcohol-use disorders: preventing the development of hazardous and harmful drinking, published by the National Institute for Health and Clinical Excellence (NICE) [NICE, 2010c], and with guidelines published by the National Treatment Agency for Substance Misuse [Raistrick et al, 2006] and the Scottish Intercollegiate Guidelines Network (SIGN) [SIGN, 2003].

• 'Brief intervention' is an umbrella term covering a range of therapeutic activities with the aim of alerting people who are drinking too much, and getting them to cut down before they come to any significant harm. The primary healthcare professional is key to the recognition and implementation of any intervention that is needed to help reduce alcohol consumption. A brief intervention:
• Is usually carried out immediately after the opportunistic detection of hazardous or harmful drinking, or at another suitable moment when the time becomes available.
• Should be given with an empathetic manner, to increase a person's confidence to make a change in their alcohol consumption. There should be a discussion of the personal risks related to their level of alcohol consumption, and practical advice on how to reduce their alcohol intake.
• NICE recommends using FRAMES as the basis of brief advice. FRAMES is 'an acronym summarising the components of a brief intervention, which are Feedback (on the client's risk of having alcohol problems), Responsibility (change is the client's responsibility), Advice (provision of clear advice when requested), Menu (what are the options for change?), Empathy (an approach that is warm, reflective and understanding), and Self-efficacy (optimism about the behaviour change)' [NICE, 2010c].
• There is a large amount of evidence to support the use of brief intervention to reduce alcohol consumption in a primary care setting [Babor and Grant, 1992; Raistrick et al, 2006]. A recent Cochrane systematic review has shown that brief intervention consistently produces reductions in alcohol consumption. It is ranked as number one in the Mesa Grande ranking of evidence-based alcohol interventions.
• There is evidence to show that self-help manuals provide an additional benefit to simple advice and are cost effective at reducing alcohol consumption, improving physical health, and reducing alcohol-related problems when aimed at people with hazardous and harmful drinking. Also, in people with low levels of dependence, self-help manuals appear to be as effective as one-to-one or group therapy.
• The benefits of brief interventions are currently being addressed by a pragmatic multicentre randomized trial (Screening and brief Interventions for hazardous and harmful alcohol use in Primary care [SIPs trial]) [Kaner et al, 2009].
• In addition to the individual's benefit from brief intervention, the public health impact of the widespread implementation of simple brief interventions is likely to be very large [NICE, 2010c].