Everyone seems to have an opinion on how to stop the appalling toll of alcohol-related violence. The police, nurses and ambulance unions want early lockouts. The usual suspects in the law-and-order brigade want tougher sentences for 'coward punches' and the alcohol industry wants people to take more responsibility for their own consumption.

The human tragedy, the unacceptable toll on young people and the impact on emergency services and health workers will continue unabated unless governments are prepared to shake off their close relationships with the alcohol industry. Too many licensed venue and bottle shop owners will continue to profit from dangerous sales of alcohol until there is a change in the political culture that then drives new policies.

This seems unlikely in a state like NSW where there is a well-trodden part from government parties to the alcohol industry.

The current head of the Australian Hotels Association in NSW is the former chief fundraiser for the Liberal party in this state, Paul Nicolaou. The Premier's former chief of staff, Peter McConnell, left his job to take up the Director of Corporate Affairs role with a supermarket corporation that runs lucrative bottle shop chains.

The most visible part of the problem centres on the late night entertainment districts created by governments as a deliberate policy of 'bringing life back into the city at night' and building reputations as 'international destinations'.

These are nice sounding phrases that warm the hearts of the alcohol, tourism and entertainment industries, yet the thinking that created them was not properly tested against the impact they might have on drinking culture.

There is another, equally tragic toll of the alcohol-industry's drive for greater profits. Domestic violence is never reported with the same media flourish yet it is just as much a social problem that stems from alcohol policy failures.

The evidence suggests that high densities of licensed venues and bottle shops drive alcohol-related violence. Studies show that the more outlets in an area, the greater the number of assaults.

While venues are more related to street assaults, increasing the number of bottle shops correlates to more domestic violence.

The liquor industry has been on a binge of applying for new outlets, both packaged liquor and venues, and, in NSW, largely getting what they want.

The Daily Telegraph reported that there have been 770 new licences granted last year compared with 228 in 2008. Questions asked by the Greens in last year’s budget estimates also revealed that the City of Sydney had 34 dormant liquor licences activated, 3 of which were within the liquor freeze precincts.

While the independent regulator is making appropriate noises, NSW will have to live with the legacy of violence-causing density from past decisions. Only a genuine commitment to slashing the toll would see a government tackle the difficult task of reducing the number of venues and bottle shops. This seems unlikely.

The recent review of the NSW Liquor Act conducted by Mr Michael Foggo called for pre-existing outlet density to be a factor in determining liquor licence applications. This is a positive step towards breaking the deliberate government silence on the cumulative effects of alcohol ease of accessibility and increased alcohol-related violence.

The evidence also points the finger at marketing. Promoting alcohol by glamorising it with associations to sporting stars, actors and other youth role models is in part responsible for the alcohol abuse culture.

Deep discounting, two-for-one offers and shopper docket deals play a key role in domestic violence, where consumers purchase more than they would have at the normal price. The packaged liquor stores lobby has worked hard to discredit the science around the link between dangerous consumption and marketing but they are up against it.

In documents obtained by the Greens in the pursuit of the shopper docket issue, one supermarket chain claimed that buying large quantities of alcohol on sale "would be akin to a claim that a promotional offer on Corn Flakes would cause purchasers to consume two bowls for breakfast rather than their normal one". However, the purveyors of cheap alcohol are denying the addictive and habit forming nature of alcohol and the pleasure reward that encourages abuse.

In NSW, the O'Farrell government effectively allowed the liquor industry to write its own guidelines with appalling consequences. Under the new guidelines, bottle shops are able to offer dangerous discounts of over 50 per cent under the argument that it cannot be proved the alcohol will be consumed in a short time period. A single letter from AHA CEO Paul Nicolaou led to the drop in the ban on using celebrities and role models that appeal to minors.

Governments, under pressure from the extreme cases that appear with tragic frequency in the media, have taken some steps. However all too often they are ineffective or fail to get to the fundamental causes. In NSW liquor freeze zones are temporary and limited, and fail to deal with the legacy of approvals. The previous Labor government's violent venues list did little to stop the problem and the Coalition's three-strikes-and-you're-out has yet to get beyond second base.

Increased penalties for alcohol-related violent behaviour are likely to be the next step and they too will be spectacularly ineffective. There is strong evidence to suggest that offenders about to punch someone do not stop and give thought to the likely length of jail term they would serve. While toughening up the sentences might play well in some parts of the electorate, it will do almost nothing to cut the frequency of violence.

To be fair, governments are dealing with a cultural problem that manifests as a minority attitude to alcohol consumption. Telling every seeker of late night entertainment to go home and go to bed at midnight, for example, would be neither effective nor sensible.

Governments can however influence culture by policy settings designed to stop the massive exploitation by the liquor industry and by placing increased pressure on venues and bottle shops that do the wrong thing.

There are ways to make licensed venues more responsive to their obligations to serve alcohol responsibly. These include annual licensing, rather than the in-perpetuity approach that allows owners to think they have an ongoing right to sell alcohol.

Risk-based licensing would impose the cost burden of enforcement and cleaning up the street onto the venues and bottle shops that are profiting from dangerous sales of alcohol. Along with holding licensees accountable for infringements, it would create a strong financial incentive for a change in industry practice.

New rules on marketing, discounting and promotions should be written with full public consultation and based on the advice of independent experts, not just the liquor industry.

The availability of alcohol needs to be tackled.

While early lockouts might be effective in some areas, it is hard to see how they would be applicable across the state.

There is a valid argument that it is not the role of the state to tell individuals when they can and cannot engage in their social lives. There is an equally valid argument that the state should protect its community from violence.

A better approach would be to learn from the Newcastle experience where the early closures appear to have some benefits and engage with local communities that might want to impose a similar set of measures in their own areas.

Reducing outlet density, particularly, in areas where there are high levels of street and domestic violence, will be hard but critical. Moving to renewable licenses is an important first step that also puts the industry on notice that it should get very serious about not serving alcohol to people who are already intoxicated.

However, in the end the real cultural change that is needed is not just in the community. It is in the political behaviour of governing parties. Breaking the close links with the alcohol industry will allow for policies that are informed by evidence and hard analysis, not pressure from mates whose eyes are fixed on the profitability of the venues and outlets.

In NSW this will be challenging given the long tradition of influence peddling. An important first step was taken in a 2010 debate on the state's election laws when the parliament agreed to a Greens' amendment that prohibited donations to political parties from the alcohol industry.

While this has been a promising beginning, it is now up to the Premier and his Ministers to show that they can be truly independent of the alcohol industry.

Dr John Kaye is a NSW Greens MP.