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Abstract ᅟ Youth drinking is linked with acute harms and Emergency Departments (ED) are places where some of these harms become apparent. This commentary argues that there is a clear case for routinely monitoring alcohol harm at ED and delivering brief interventions to engage with people at a time when they may be more likely to consider lifestyle behaviour change. Based on insights from the UK, it is suggested that young people may not always easily be engaged through messages that focus directly on alcohol harm, and efforts to engage them through issues that matter to them (such as sexual harassment) might add to the effectiveness.