This study was commissioned by the Govt. of Kerala in light of growing concerns about excessive consumption about alcohol in the state. The study was aimed at providing an overview of the nature and pattern of alcohol use to understand the pathways of harmful use, the extent of harm associated with families and the community. It was concluded by exploring policy options and their feasibility for the reduction of harmful use of alcohol in the local context. It was carried out extensively across over 3000 households in three districts of the state- Kasargod, Kottayam and Thiruvananthapuram.The study involved detailed analysis, including both quantitative and qualitative aspects. The study found that there were significant secondary and tertiary effects of alcohol consumption, in addition to negative individual effects. The study also brings forth a number of recommendations, primary among which is generating awareness, youth-based interventions for prevention and implementation of a stringent legal and monitoring mechanism as long-term solutions. The study also delves into the current Alcohol Policy in Kerala and asserts the need of a detailed, critical analysis of the same.