Arse! and feck!, but no drink! in Father Ted. Homer Simpson and Barney Gumble guzzling skinny lattes in Moe's cafe. Liverpool FC's players with no Carlsberg logos on the front of their shirts. Carrot and papaya as the official juice of the England football team. Doctor Feelgood's remastered Milk and No Alcohol blaring out from your parents' stereo. The lyrics of Arctic Monkeys' Riot Van subtly altered so that the answer to: "Have you been drinking son?/ You don't look old enough to me" change from the lippy: "I'm sorry officer/ Is there a certain age you're supposed to be" to a simple: "No."

These are a few of the strategies that might be worth putting on the table in the endless discussions about how to convince the young not to drink a lot of alcohol. They may be no more effective than any of the others, but they may at least have the virtue of acknowledging, contrary to the latest round in the blame game, that what drives kids to drink isn't just their parents.

In both Britain and Ireland %u2013 and the two countries are much more alike in this than either likes to admit %u2013 life is steeped in alcohol. Parents can't change that on their own and, until it changes, they face an awkward dilemma. Do they try to protect their kids from the demon drink or do they, rather, teach them how to drink?

For our societies as a whole, there is a larger version of this question. Do we go on pretending, like every deluded boozer, that alcohol is a habit we'll kick someday soon? Or do we accept that it's as much a part of our culture as wearing clothes or driving cars? If we do decide that we have to live with alcohol, then we need to figure out how, collectively, we can best handle it. Before we start teaching our kids how drink can be accompanied with most pleasure and least damage, we need to know those things ourselves.

Real discussion about alcohol tends to get lost between two competing %u2013 and equally unrealistic %u2013 kinds of discourse, one utopian, the other dystopian. The first is medical. Doctors believe that alcohol is a public health problem, equivalent to a disease, and they are trained to believe that all diseases are, in principle, eradicable. They tend to see drink as a social illness that will one day be cured. Even when they're saying sensible things, this attitude makes it hard for them to connect with the majority of people for whom a few pints or a bottle of wine represent, not an illness, but a temporary relief from the symptoms of modern life.

The other discourse is legal. Governments don't want to hear what public health officials have to say. Alcohol consumption can be reduced by raising the price and banning advertising. Since one upsets voters and the other annoys powerful industries, governments prefer to talk about the law %u2013 better regulation, punishment for drink-fuelled rowdyism, the enforcement of the rules aimed at stopping young people doing what young people have always done. While the doctors dream of a perfect future, the politicians see themselves as soldiers in a low-level but eternal war.

But what if drinking is neither primarily a medical nor a legal issue? What if it's actually, at heart, a cultural question? In a striking piece in the current issue of the New Yorker, Malcolm Gladwell suggests that the evidence from anthropology, sociology and psychology is that what matters most is not how much people drink but how they drink it. The social context %u2013 the rules a particular culture imposes and the rituals through which it reinforces them %u2013 determines the way we behave as drinkers.

This is not a new thought. In their classic 1969 study, Drunken Comportment, Craig McAndrew and Robert B Edgerton blew apart the assumptions most of us make about what happens when we get drunk. We think of alcohol as the bolt-cutter that snaps the chains of our inhibitions. It sends our ego to sleep and leaves the id free to go on the razzle. All our normally controlled impulses %u2013 sex, violence, undying love for our mates, the desire to tell the boss what we really think of him %u2013 are let loose. It is the drink that determines our behaviour.

In fact, this is not what happens. People in different cultures behave very differently when they're drunk and the same drunks behave in different ways on various occasions. As one writer has snappily summarised the findings of Drunken Comportment: "A single species (Homo sapiens), a single drug substance (ethanol) and a great diversity of behavioural outcomes." Depending on the context, boozers can feel elated or depressed, slobberingly sentimental or savagely violent. It is not, after all, the drink that does it. What matters is the culture around drinking. McAndrew and Edgerton concluded: "Since societies, like individuals, get the sorts of drunken comportment that they allow, they deserve what they get."

Gladwell suggests that "culture is a more powerful tool in dealing with drinking than medicine, economics or the law" and that what young people need is not more admonition but "a positive and constructive example of how to drink". In Britain and Ireland, it is glaringly obvious that our cultures don't provide this.

At an individual level, it is easy enough to understand why we are reluctant to teach the young how to drink. As a parent of teenage boys, I've faced the dilemma myself. We all like to think that our kids wouldn't dream of desecrating the temples that are their precious bodies with unhealthy and illegal substances. Introducing them to drink in a safe and normal environment is an admission of defeat, an ending not so much of their innocence as of our own. But not teaching them how to drink is as irresponsible and as self-indulgent as not telling them about sex.

Britain's chief medical officer, Sir Liam Donaldson, seems to have been hovering around such an approach in his recent pronouncements on alcohol and the family. He has spoken, on the one side, about the absolute undesirability of any child under 15 being given drink and on the other about parents setting a good example for older teenage children.

Both of these are fine principles, but it is the bit in the middle that needs to be spelled out. Assuming that we get kids to 15 or 16 without drinking (a big achievement in itself), we owe them more than the courtesy of not getting pissed in their presence. Most of us know from experience that there are other societies where alcohol is associated with eating and with intergenerational social life. We also know that in those cultures, drinking does less harm. If we were a little less pious and a lot more honest, we may eventually learn to pass those lessons on to our children.