Alcohol problems have long been especially associated with city life, although this perception is not always supported empirically in comparisons of urban and rural rates. Potential explanations of higher urban rates include: more complete reporting of problems in the city; that problems may occur in the city, but involve non-inhabitants; that migrants to the city may be especially attracted by or vulnerable to heavy drinking; and characteristics of city lifestyles that are conducive to heavy drinking, and to heavy drinking being defined as problematic. On the other hand, there are also potential explanations of higher rural rates, such as the ready availability associated with home production. Collective efforts to reduce rates of alcohol problems have often focused on the city or its neighborhoods; these local communities bear many of the costs of the problems, while alcohol tax revenues tend to go to national governments. Three forms of urban alcohol problems prevention are briefly discussed: local alcohol control through municipal public-houses or sales license controls; community action movements to reduce rates of alcohol-related problems; and AA and other mutual-help movements, which are particularly attuned to counteracting characteristically urban problems.