The study, commissioned by the Australian National Council on Drugs (ANCD), found peaks in domestic violence in Fiji, Papua New Guinea, Samoa, the Marshall Islands and Vanuatu could be linked to alcohol abuse.
ANCD executive officer, Gino Vumbaca, said Australian and New Zealand alcohol industries had "significant commercial interest" in the region.
"Addressing these alcohol problems imposes an obligation on them and our countries," he said.
Compiled by the Burnet Institute, the report revealed alcohol triggered a rise in violence across the Pacific nations of Samoa, Fiji, Papau New Guinea, Vanuatu and the Marshall Islands.
ANCD chairman John Herron said alcohol abuse was likely to peak even further if no action was taken.
"The rise of alcohol-related problems and the potential for it to escalate further in the Pacific is quite ominous, especially if we don't act now," Dr Herron said.
"Alcohol and other drugs are significantly contributing to risky behaviour, particularly risky sexual behaviour amongst young people in our region.
"The potential harm from this behaviour is great."
The report, released on Thursday, also found cannabis use had increased in Tonga and the Cook Islands, while marijuana crops were "well established" in Fiji, where police reported schoolchildren had been used for trafficking.
