Alcohol is a drug that Canadians consume regularly. More than 80 per cent of us have at least one drink a year. And 20 per cent of us drink more than is healthy for us.

Alcohol is such a part of our society that our provincial government encourages us to drink through newspaper inserts, ads on billboards and liquor store magazines. As well, alcohol ads from private industry are everywhere.

Yet most of us would balk at ads from the government promoting cigarette smoking. Or for that matter, cocaine use. Imagine a billboard depicting a table covered in lines of white powder surrounded by smiling people with the tagline: "Available at your local government-run Cocaine Control Board of Ontario store."

Drawing a comparison between these three drugs-- alcohol, tobacco and cocaine-- may seem like a stretch, but it isn't. When they use an objective rating scale, experts consistently rate these drugs as having similar degree of harm to the drug user.

Harm from alcohol is clearly evident in Canada. Alcohol causes 9% of disability and disease, and 7% of all premature deaths and it costs the public health care system billions of dollars per year.

In addition to harming the drinker, alcohol harms families, communities and society through violence, drinking and driving, damage to property and missed days at work. When we factor these things in, alcohol surpasses all other drugs on the scale of harm. If 100 people have heavy alcohol use and 100 people have heavy cocaine use, the heavy drinkers would cause more harm to others.

This degree of harm led organizations and large numbers of people to push for alcohol prohibition in the early 20th century.

But prohibition has its problems, too. Alcohol prohibition in North America led to a dramatic reduction in rates of drinking, but only for a short time. Alcohol use began to climb as cartels established illegal markets and as people started to produce their own. Prohibition also had many other unintended consequences -- the rise of organized crime, deaths from consuming toxic alcohol substitutes such as methanol, mass imprisonment, and high court and policing costs. We see similar consequences with the prohibition of cannabis and other drugs in Canada today.

Alcohol is therefore a risk that our society has decided to embrace. For many of us, alcohol is part of our lives, part of our rituals and celebrations. As well, alcohol use in moderation poses little risk of harm to the drinker and perhaps provides some minimal health benefits.

Instead of prohibition, we should acknowledge that alcohol, like cocaine, like tobacco, has substantial risks.

This means, while we permit drinking, governments and private industry should not be promoting alcohol use.

Promoting alcohol use through advertising leads teens to start drinking at an earlier age and leads young people who already drink to drink more. Although the evidence is less clear, it likely also leads to an overall increase in drinking for adults as well. Since such a large number of teens and young adults drink, even a small increase in drinking would lead to substantial increases in deaths, disability and healthcare costs for Canadians.

We should stop the double standard and apply the same rules around advertising alcohol as we apply to tobacco -- a similarly harmful legal substance.

If we followed the same standard, the government would ban all advertising including print, television, radio and Internet ads (with the exception of ads in publications mailed to adults and ads on signs in adult-only places). As well, the government would not allow alcohol producers to get publicity from sponsoring sports and cultural events.

We made these changes with tobacco and saw many positive health effects. Canada now has one of the lowest rates of smoking among young people in the developed world. Banning alcohol advertising could have a similar impact.

Sheryl Spithoff is an addiction medicine and family physician at Women's College Hospital and the University of Toronto