Methods An environmental scan was conducted which involved a literature review and key informant interviews. The literature review included academic and grey literature (1998-present). Key informant interviews were conducted with 18 individuals throughout Atlantic Canada. The data was coded using the qualitative software package NVivo (version 7).

Results Atlantic Canadians have rates of hazardous drinking higher than the Canadian average. Results indicated that Atlantic Canadian culture accepts and expects alcohol consumption and is highly tolerant of over-consumption and intoxication. Alcohol consumption increases risk of injury, injury severity and number of body regions injured. The results demonstrated that injuries sustained while under the influence of alcohol are in many cases viewed as humorous or as badges of honour. The culture of alcohol and injury in Atlantic Canada was seen to be a product of heritage and industry, marketing strategies by alcohol companies and policies regarding alcohol pricing, sales, and outlet density.

Conclusion The results have demonstrated a need for a comprehensive approach to de-normalising hazardous use of alcohol in Atlantic Canada. Recommendations were developed to address policy, create a supportive cultural environment and to create individual awareness and understanding of the issue.