This article surveys alcohol consumption, taxation and regulation in the European Union (EU). It uses the estimates of cost-of-illness studies to gauge the external costs of harmful alcohol use. In all but one member state, the costs exceed alcohol excise duty collections. An optimal alcohol excise is difficult to design, because the welfare gains from a reduction in socially costly heavy drinking must be balanced against the welfare loss from a fall in moderate drinking. This suggests that while an alcohol excise increase may be efficiency improving, complementary regulatory measures, which focus on specific problem groups, should be an important element of the policy package. A case can also be made for reducing wasteful cross-border shopping by raising