This paper examines recent developments in Canada and the United States and the role of commercial interests in alcohol-related policies bearing on taxes, outlet density, advertising, counter-advertising, health messages and prevention. Case-study material is drawn from published papers, project reports, government documents and newspaper accounts. The main focus is at the federal level, with some reference to provincial, state and local experience. Alcohol industries have as their primary agenda that of maintaining and expanding their markets and maximizing profits. In order to achieve this they typically oppose restrictions on access to alcohol, tax increases, controls on marketing and some counter-advertising campaigns. They are powerful in influencing policy in both countries, at national and regional levels, and their efforts impact policy agenda and outcome of government deliberations. Their prevention efforts, which tend to be oriented to information and education, are mainly individualistic in focus and typically not supportive of environmentally based policy reforms. Governments appear to have a declining interest in policy issues, due partly to resistance by the industries to alcohol control policies. Governments are encouraged to apply an evidence-based orientation to funding prevention, and facilitate evaluation of industry-sponsored prevention efforts. Greatest attention and resources should be directed to interventions that are most likely to have the greatest impact in reducing drinking-related problems, and funding for prevention from alcohol industries should involve arms-length arrangements. Alcohol industries are encouraged to consider strategies that do not increase access to alcohol but rather reduce drinking-related risks.