In Switzerland, 20% adults drove under the influence of alcohol over the last 12 month, 30% motor vehicle crashes are related to alcohol and over 18,000 people were sentenced for driving under the influence in 2001, 15-25% for repeated offence. This article reviews the scientific literature about the current prevention measures in Europe and North America, assessing the effectiveness of prevention measures. On average, prevention programs reduce repeated offence of 40%. The effectiveness of such programs appears superior for programs combining various measures, educational and behavioral, matched with repression measures, i.e., probation and driving license suspension. Efforts should be undertaken to pursue research and development in this major domain of public health concern.