NHS Health Scotland found that a ban on multi-buy drinks promotions was among a number of successful initiatives.
However, it warned that more needed to be done to ensure the improvements continued, including the introduction of a minimum price for alcohol.
The report is the final review of the Scottish government's alcohol strategy, which was introduced in 2009.
Before then, high and increasing levels of alcohol consumption were closely linked to increasing alcohol harm.
Studies had shown that alcohol may have caused the deaths of one in 20 of the Scots who died in 2003.
And half of Scotland's prisoners said they were drunk when they committed their offence.
The government's "framework for action" outlined 41 steps to reduce alcohol consumption, and support families and communities.
A key policy - a minimum price for alcohol - has not been introduced because it is subject to a legal challenge by the Scotch Whisky Association.
Clare Beeston, from NHS Health Scotland, said the country continued to "pay a heavy price" for high levels of alcohol consumption.
She added: "The picture has improved but levels of alcohol-related harm remain high - on average 22 people in Scotland die every week because of alcohol."
She warned that the decline in alcohol consumption and harm may have slowed or stalled recently.
"We need to continue to push for the most effective ways to reduce the amount of alcohol Scotland drinks," she said.
"These are to reduce the affordability, availability and promotion of alcohol.
"A minimum unit price for alcohol is one of the best ways to reduce drinking in the heaviest drinkers and tackle the alcohol related health inequalities."
The report highlighted the success of several parts of the strategy:
It also found that external factors, such as a fall in disposable income, were likely to have had an impact on alcohol trends.
Public Health Minister Maureen Watt said:  "We have seen reductions in alcohol-related harm and this is of course welcome.
"However, harm rates are still higher than they were 20 years ago and higher than in England and Wales, so now is not the time to be complacent."
She added: "The report also recognises that a key element of the alcohol framework - minimum unit pricing - has yet to be implemented due to a legal challenge from parts of the alcohol industry and this has impacted on the progress made.
"Given the link between consumption and harm, and evidence that affordability is a key driver of increased consumption, addressing price is an important element of any long-term strategy to tackle alcohol misuse and, as such, we remain committed to introducing minimum unit pricing."
A new report has found that government policies have had a positive impact on alcohol consumption in Scotland.