A SEVEN-YEAR-OLD caught drinking strong cider in a park. One million people regularly knocking back too much alcohol one night a week. The headlines of the past week have made uneasy reading when it comes to Scotland's binge-drinking culture.

The country's relationship with alcohol is under more scrutiny than ever before following years of rising levels of alcohol-related disease. Now a number of new initiatives to tackle the nation's excessive drinking are under way.

Tomorrow the first-ever alcohol awareness week in Scotland will be launched by public health minister Shona Robison. Thousands of leaflets, beer mats and alcohol-unit calculators will be distributed in pubs, clubs and supermarkets to encourage people to think about how much they are drinking.

The Sunday Herald can also reveal that a programme for screening people for alcohol problems is to be rolled out across health boards across Scotland next year. Patients identified as being at high risk of drinking more than recommended limits will be asked about their consumption of alcohol by their GP and offered advice.

Other measures include a roll-out of test purchasing "sting" operations across all police forces by the end of this year, to help tackle under-age drinking. Results from a pilot carried out in Fife, just published, found one in five licensed premises was breaking the law by selling alcohol to under-18s.

For the first time it appears alcohol is firmly at the top of the health agenda. But, while the emphasis of the aware-ness week is on personal responsibility, doctors are arguing that more needs to be done to counteract the marketing and promotion of products by the multimillion-pound alcohol industry.

A quick glance at the statistics reveals why the medical profession believes urgent action is needed to tackle alcohol-related harm. Drinking is now a factor in more than one in 10 of all attendances at hospital casualty departments. Alcohol problems costs the Scottish economy at least £1 billion a year, through lost days at work, accidents and injuries and direct costs to the NHS.

Latest figures show the number of women dying from drink in Scotland reached record levels in 2005 - 492, compared to 224 in 1980. The figures have been rising for men too, with 1021 dying from diseases such as cirrhosis of the liver, alcoholic pancreatitis and mental and behavioural disorders caused by alcohol, compared with 371 in 1980.

It's a situation psychiatrist Dr Iain Smith, who specialises in alcohol and drug problems, has seen reflected over the past two decades at Gartnavel Royal Hospital, Glasgow. "We are seeing more women with problem drinking, which I think is a marker of it becoming more socially normalised," he says. "There are also more younger people - on occasion we have seen a 16-year-old who has been hooked on alcohol for four years, which I wouldn't have seen perhaps 15 years ago."

Alcohol awareness week aims to provide consumers with information on what a unit of alcohol is; for instance, while a pint of standard beer at 3.5% strength is 2 units, a pint of premium beer at 5% strength equates to 2.8 units. The campaign is also urging people to evaluate if they are sticking to recommended maximum limits of 3-4 units per day for men and 2-3 per day for women.

However, yesterday it was reported that these guidelines, introduced 20 years ago, were based on no more than an "intelligent guess". Richard Smith, a member of the Royal College of Physicians working party that produced the recommendations, admitted the limits were prompted by "a feeling that you had to say something".

Health secretary Nicola Sturgeon describes the awareness initiative, which is one of the first under the government's partnership agreement with the alcohol industry, as "groundbreaking".

"One of the important things to stress is that the message promoted next week is not in any sense an anti-alcohol message, it is a message about safe and responsible consumption of alcohol," she says.

But the British Medical Association is among those who argue that clear compulsory labelling on all alcoholic products could achieve this. Dr Andrew Buist, deputy chairman of the BMA's Scottish general practitioners committee, says the current system, which is voluntary, does not always give easily understandable information. "We are proposing it is mandatory and alcohol is clearly labelled in a standardised way that consumers can understand," he said.

Among the numerous industry representatives backing the awareness week is the Scottish Licensed Trade Association. Senior vice-president Steve Mudie argues it is important to provide a "balance" to the messages going out on the dangers of alcohol.

"We are opening doors to the concept of alcohol awareness week so that people can actually understand what alcohol is and then make their own decision as an adult," he says. "Providing it is taken responsibly and with some care, there is nothing wrong with consuming alcohol - however, you do have to be aware of the fact that alcohol is a drug."

While the industry has been keen to back this initiative, it has not been so quick to lend support to others. When justice secretary Kenny MacAskill outlined plans to ban the sale of cut-price and free alcohol offers in shops, the Scottish Retail Consortium attacked the move as "dubious but headline grabbing". The Wine and Spirit Trading Association has written to Westminster urging it to step in to block the "anti-competitive" proposals.

Yet some medical experts believe that tackling the issues of price and availability is the only way forward in curbing Scotland's drinking. The Scottish Health Action on Alcohol Problems, a body set up by the Scottish Medical Royal Colleges, is supporting alcohol awareness week. But director Evelyn Gillan also argues that urging individual restraint in an environment which is promoting excess at the same time is "problematic".

"The message to people is you need to drink less - but then we are making it easier for them to buy two bottles of wine instead of one when they are going to the supermarket," she says.

Gillan says that, while there is strong evidence putting up the price of alcohol was linked to a reduction in alcohol related harm, it is an approach not welcomed by the "highly influential" drinks industry. "If you look at alcohol policy over the past 10 years, the focus of alcohol policy has been very much on individual responsibility and problems - that certainly chimes with the industry's analysis of alcohol problems," she says.

"They have shied away from the policies that regulate the market like price and availability, even though there is a huge body of evidence now saying that is the most effective thing you can do."

However, while Sturgeon agrees there are "issues" around alcohol products or advertising aimed at a younger audience, she argues that working with the industry is the best way forward.

"I would like to get as far as we can with them the alcohol industry co-operatively and if there comes a point where we think we have to look at other options because they are not prepared to go far enough, then that is what we will do."

One difficulty for the Scottish government - which will publish a five-year action plan on alcohol in 2008 - is that its powers are limited. But Sturgeon points to the example of moves to ban airguns, which is being considered as separate legislation for Scotland, subject to agreement from Westminster.

There appears little doubt that alcohol-related harm is taking its toll in Scotland - whether the situation can be reversed remains to be seen. As Sturgeon acknowledges: "We know Scotland's culture of drinking to get drunk will not be changed overnight."