It is too easy to blame the Scottish Executive for a phenomenon that has far more to do with cultural change and increases in disposable income than politics and policy-making. There was no way of putting a decent gloss on yesterday's figures on the death and destruction being wrought by alcohol in Scotland. Alcohol-related illness and injuries now account for 4% of all hospital cases and are a factor in many more. Drink-related deaths are continuing to rise. And, within the overall figures, there are dramatic and worrying trends. Two decades ago, many women did not drink and female alcoholics were relatively rare. Yet, in 2005, alcohol was a "significant contributor" in the deaths of more than 700 women, a 25% increase in five years.

Despite the target of reducing underage drinking by 16% by 2010, the number continues to rise, with 246 under-15s hospitalised with "acute intoxication" last year. Anyone who has taken a stroll through a city centre on a Friday or Saturday night knows this is the visible tip of a gigantic iceberg. Recently it emerged that the level of underage drinking among girls now exceeds that among boys. Not only are they more likely to have accidents and consent to unprotected sex when drunk, they are also increasing their long-term risks of contracting breast cancer, liver cirrhosis and other life-threatening conditions. We cannot dismiss this ladette culture as girls acquiring the freedoms enjoyed by boys. It is sad but true that girls get drunk and suffer permanent physical damage from alcohol abuse more quickly. A publicity campaign and an extra £10m for alcohol services are measures of the executive's determination to tackle the issue but they have been about as successful as King Canute in tackling a wave of alcoholism resulting largely from two factors: the cultural acceptance of drunkenness and alcohol that is relatively cheap (alcohol is 62% more affordable today than in 1980).

Much needs to be done to control a culture of excess that threatens to overwhelm the NHS. We need greater use of the new Licensing Act to control underage drinking, controls on supermarket drinks promotions and a drive against retailers who sell alcohol to children. More must be spent on rehabilitation and warning young people against flagrantly squandering their health. But, ultimately, this issue has more to do with personal and parental responsibility than politics.