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Hatchard J, Buykx P, Brennan A, Gillespie D. Options for modifying UK alcohol and tobacco tax: A rapid scoping review of the evidence over the period 1997-2018. NIHR OPEN RESEARCH 2023; 3:26. [PMID: 37881457 PMCID: PMC10593339 DOI: 10.3310/nihropenres.13379.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/27/2023]
Abstract
Background Increased taxation is recognised worldwide as one of the most effective interventions for decreasing tobacco and harmful alcohol use, with many variations of policy options available. This rapid scoping review was part of a NIHR-funded project ('SYNTAX' 16/105/26) and was undertaken during 2018 to inform interviews to be conducted with UK public health stakeholders with expertise in alcohol and tobacco pricing policy. Methods Objectives: To synthesise evidence and debates on current and potential alcohol and tobacco taxation options for the UK, and report on the underlying objectives, evidence of effects and mediating factors.Eligibility criteria: Peer-reviewed and grey literature; published 1997-2018; English language; UK-focused; include taxation interventions for alcohol, tobacco, or both. Sources of evidence: PubMed, Scopus, Cochrane Library, Google, stakeholder and colleague recommendations.Charting methods: Excel spreadsheet structured using PICO framework, recording source characteristics and content. Results Ninety-one sources qualified for inclusion: 49 alcohol, 36 tobacco, 6 both. Analysis identified four policy themes: changes to excise duty within existing tax structures, structural reforms, industry measures, and hypothecation of tax revenue for public benefits. For alcohol, policy options focused on raising the price of cheap, high-strength alcohol. For tobacco, policy options focused on raising the price of all tobacco products, especially the cheapest products, which are hand-rolling tobacco. For alcohol and tobacco, there were options such as levies that take money from the industries to help reduce the societal costs of their products. Due to the perceived social and economic importance of alcohol in contrast to tobacco, policy options also discussed supporting pubs and small breweries. Conclusions This review has identified a set of tax policy options for tobacco and alcohol, their objectives, evidence of effects and related mediating factors. The differences between alcohol and tobacco tax policy options and debates suggest an opportunity for cross-substance policy learning.
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Affiliation(s)
- Jenny Hatchard
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Penny Buykx
- School of Humanities and Social Science, University of Newcastle, Australia, New South Wales, Australia
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Duncan Gillespie
- Sheffield Centre for Health and Related Research (SCHARR), Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
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2
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Müller V, Jarl J, Gerdham UG. A measure of alcohol affordability for Sweden: Capturing trends among different demographic groups. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:250-269. [PMID: 37255612 PMCID: PMC10225966 DOI: 10.1177/14550725221143171] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/18/2022] [Indexed: 09/30/2023] Open
Abstract
The World Health Organization has rated alcohol abuse as one of the leading risk factors for population health worldwide and emphasises the relevance of alcohol affordability (AA) measures as important instruments to monitor alcohol control policy. The present study suggests an AA index that is suitable for measuring AA in Sweden, where off-premises alcohol is exclusively distributed by Systembolaget, the government-owned chain of liquor stores. Sweden provides uniform off-premises prices for alcohol and extensive register data, which profits the accuracy of this index. By allowing for AA comparisons across types of alcoholic beverages (beer, wine, spirits) and price categories, as well as across population groups (age, sex and family composition), and by being transferable to other Nordic countries with uniform off-premises prices, this study will facilitate governmental monitoring and supervision of the alcohol policy in Nordic countries. The suggested AA index is defined as the ratio of the median equivalised disposable income and the price per litre of 100% ethanol for alcohol, scaled to equal 100% in the base year. The income can be measured for the reviewed population or a subgroup, and the price measure can include all sold alcoholic beverages or separate them by beverage type and/or price category. Thereby, the index measures the number of litres of 100% ethanol that are affordable with the median income. Applying the index to the publicly available data for 2011-2019 from Statistics Sweden and Systembolaget reveals that alcohol in Sweden generally became more affordable, with high-priced alcoholic beverages becoming comparably more affordable than low-priced alcohol. However, low-priced beer became less affordable over the last decade. Future studies may validate the AA index against alcohol consumption.
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Affiliation(s)
- Vibeke Müller
- Health Economics Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Johan Jarl
- Health Economics Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden
| | - Ulf-Göran Gerdham
- Health Economics Unit, Department of Clinical Sciences, Malmö, Lund University, Sweden; and Department of Economics, Lund University, Sweden
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3
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Taylor N. Three years of minimum unit pricing in the Northern Territory, what does the evidence say? Drug Alcohol Rev 2023; 42:912-914. [PMID: 36917512 DOI: 10.1111/dar.13641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/16/2023]
Affiliation(s)
- Nicholas Taylor
- National Drug Research Institute, Curtin University, Melbourne, Australia.,School of Psychology, Deakin University, Geelong, Australia.,The Burnet Institute, Melbourne, Australia
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Maharaj T, Angus C, Fitzgerald N, Allen K, Stewart S, MacHale S, Ryan JD. Impact of minimum unit pricing on alcohol-related hospital outcomes: systematic review. BMJ Open 2023; 13:e065220. [PMID: 36737089 PMCID: PMC9900069 DOI: 10.1136/bmjopen-2022-065220] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To determine the impact of minimum unit pricing (MUP) on the primary outcome of alcohol-related hospitalisation, and secondary outcomes of length of stay, hospital mortality and alcohol-related liver disease in hospital. DESIGN Databases MEDLINE, Embase, Scopus, APA Psycinfo, CINAHL Plus and Cochrane Reviews were searched from 1 January 2011 to 11 November 2022. Inclusion criteria were studies evaluating the impact of minimum pricing policies, and we excluded non-minimum pricing policies or studies without alcohol-related hospital outcomes. The Effective Public Health Practice Project tool was used to assess risk of bias, and the Bradford Hill Criteria were used to infer causality for outcome measures. SETTING MUP sets a legally required floor price per unit of alcohol and is estimated to reduce alcohol-attributable healthcare burden. PARTICIPANT All studies meeting inclusion criteria from any country INTERVENTION: Minimum pricing policy of alcohol PRIMARY AND SECONDARY OUTCOME MEASURES: RESULTS: 22 studies met inclusion criteria; 6 natural experiments and 16 modelling studies. Countries included Australia, Canada, England, Northern Ireland, Ireland, Scotland, South Africa and Wales. Modelling studies estimated that MUP could reduce alcohol-related admissions by 3%-10% annually and the majority of real-world studies demonstrated that acute alcohol-related admissions responded immediately and reduced by 2%-9%, and chronic alcohol-related admissions lagged by 2-3 years and reduced by 4%-9% annually. Minimum pricing could target the heaviest consumers from the most deprived groups who tend to be at greatest risk of alcohol harms, and in so doing has the potential to reduce health inequalities. Using the Bradford Hill Criteria, we inferred a 'moderate-to-strong' causal link that MUP could reduce alcohol-related hospitalisation. CONCLUSIONS Natural studies were consistent with minimum pricing modelling studies and showed that this policy could reduce alcohol-related hospitalisation and health inequalities. PROSPERO REGISTRATION NUMBER CRD42021274023.
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Affiliation(s)
- Tobias Maharaj
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Hepatology Unit, Beaumont Hospital, Dublin, Ireland
| | - Colin Angus
- Sheffield Alcohol Research Group, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Niamh Fitzgerald
- Institute for Social Marketing, UK Centre for Tobacco and Alcohol Studies, School of Health Sciences, University of Stirling, Stirling, UK
| | | | - Stephen Stewart
- Centre for Liver Disease, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Siobhan MacHale
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Liaison Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - John D Ryan
- Royal College of Surgeons in Ireland, Dublin, Ireland
- Hepatology Unit, Beaumont Hospital, Dublin, Ireland
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5
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LoParco CR, Walker A, Livingston MD, Khoshhal B, Gonzalez-Pons KM, Soule E, Treffers R, Rossheim ME. A national assessment of on-premise drinking establishments near public universities: Drink prices, drink specials, indoor tobacco use, and state-level alcohol laws. Alcohol Clin Exp Res 2022; 46:2068-2076. [PMID: 36098371 PMCID: PMC9743012 DOI: 10.1111/acer.14937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Inexpensive drinks and price promotions increase alcohol consumption and have been observed at on-premise drinking establishments near large colleges. Some bars may sell tobacco products and allow indoor tobacco use to encourage patrons to stay and drink more. This study examined drink prices/specials and associated practices of on-premise drinking establishments including tobacco sales and policies regarding tobacco use. METHODS In 2018, telephone calls about prices/practices were made to 403 randomly selected bars/nightclubs within 2 miles of large residential universities in each U.S. state. The Alcohol Policy Information System provided data on state-level alcohol laws. Multivariable linear and logistic regression models examined associations between alcohol prices/specials, state laws, and establishment practices. RESULTS The average price for the least expensive draft beer and a vodka shot at each location were $3.62 (SD = $1.15) and $4.77 (SD = $1.16), respectively. Most establishments (65%) had happy hour specials, 6% had 2-for-1 specials, 91% sold food, 9% sold cigarettes, 8% allowed smoking indoors, and 18% permitted electronic cigarette (e-cigarette) use indoors. Allowing e-cigarette use indoors (b = -0.54) and selling cigarettes (b = -0.79) were associated with lower vodka prices; allowing cigarette smoking indoors (b = -0.46) was associated with lower beer prices. Lower beer prices (OR = 1.38), selling food (OR = 2.97), and no state law banning happy hour specials altogether (OR = 4.24) or with full-day price reduction exemptions (OR = 12.74) were associated with higher odds of having happy hour specials. Allowing e-cigarette use indoors was associated with having 2-for-1 specials (OR = 6.38). CONCLUSION In bars near large public universities, beers and shots were often available for less than $5 and drink specials were prevalent. Further, some establishments allowed tobacco use indoors and/or sold cigarettes. Laws that increase alcohol taxes, set minimum drink prices, and ban the sale and indoor use of tobacco products at on-premise drinking locations are important harm reduction tools.
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Affiliation(s)
- Cassidy R LoParco
- School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | | | | | - Bita Khoshhal
- College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | | | - Eric Soule
- College of Health and Human Performance, East Carolina University, Greenville, North Carolina, USA
| | - Ryan Treffers
- Pacific Institute for Research and Evaluation, Beltsville, Maryland, USA
| | - Matthew E Rossheim
- School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas, USA
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Sasso A, Hernández-Alava M, Holmes J, Field M, Angus C, Meier P. Strategies to cut down drinking, alcohol consumption, and usual drinking frequency: Evidence from a British online market research survey. Soc Sci Med 2022; 310:115280. [PMID: 35994876 DOI: 10.1016/j.socscimed.2022.115280] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/30/2022] [Accepted: 08/09/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Relatively little is known about how risky drinkers attempt to moderate their drinking in the absence of specialist support. The broader literature has identified multiple potential strategies that people use to cope with temptation when trying to control health-risk behaviours. This study aims to identify types of alcohol moderation strategies used by British adults, and to explore how concurrent alcohol consumption differs across moderation strategies, focusing on the important role of usual drinking frequency. METHODS We use a continuous repeat cross-sectional survey and one-week drinking diary collected by the market research company Kantar; these provide detailed information on alcohol consumption during a diary week and on how individuals try to moderate alcohol use for 49,204 British adults trying to reduce their drinking from 2013 to 2019. We use Latent Class Analysis (LCA) to identify predominant types of moderation strategies. With a three-step method, we also analyse the associations between adopting different moderation strategies, measures of frequency and intensity of drinking events, and usual drinking frequency. RESULTS We found evidence of four alcohol moderation strategies: 29% of individuals use a pre-commitment-focused strategy (having fewer drinking occasions), two set of individuals adopt self-control strategies within drinking occasions (specifically 28% select smaller drinks and 5% have fewer drinks), while 38% adopt a mixed strategy that involves all three. Those using commitment tend to have a higher average consumption per drinking occasion but lower overall weekly consumption compared to those using self-control. Weekly alcohol consumption is particularly high among individuals who are usual everyday drinkers and use self-control to cut down drinking. CONCLUSION This analysis provides a useful platform for further work, using prospective or intervention designs, to test the relative effectiveness of different moderation strategies for alcohol consumers who want to reduce their alcohol consumption.
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Affiliation(s)
- Alessandro Sasso
- Sheffield Alcohol Research Group (SARG), School of Health and Related Research, University of Sheffield, UK; Health Economics and Decision Science (HEDS), School of Health and Related Research, University of Sheffield, UK.
| | - Mónica Hernández-Alava
- Health Economics and Decision Science (HEDS), School of Health and Related Research, University of Sheffield, UK
| | - John Holmes
- Sheffield Alcohol Research Group (SARG), School of Health and Related Research, University of Sheffield, UK
| | - Matt Field
- Department of Psychology, University of Sheffield, UK
| | - Colin Angus
- Sheffield Alcohol Research Group (SARG), School of Health and Related Research, University of Sheffield, UK
| | - Petra Meier
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, UK
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Hu X, Cao H, Dong W, Tang J. Ratiometric fluorescent sensing of ethanol based on copper nanoclusters with tunable dual emission. Talanta 2021; 233:122480. [PMID: 34215108 DOI: 10.1016/j.talanta.2021.122480] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 12/13/2022]
Abstract
Copper nanoclusters (Cu NCs) have attracted a surge of interest in fluorescent sensors as their outstanding physicochemical and optical properties. However, most of the reports have focused on single-signal fluorescent sensors, which are susceptible to background interferences and affect accuracy of the results. Herein, we constructed a facile ratiometric fluorescent sensor for monitoring ethanol based on Cu NCs with tunable dual emission. Polyvinylpyrrolidone (PVP)-modified Cu NCs were simply prepared in water, which exhibit ratiometric dual emission, including a strong green emission at 520 nm and a weak blue emission at 450 nm. The PVP-Cu NCs in water with strong green emission display monodisperse state due to the formation of hydration shell around Cu NCs. In ethanol where the hydration shell is destructed, Cu NCs tend to aggregate and show strong blue emission. This emission shift might attribute to the enhancement of Cu-Cu metallophilic interaction with the aggregation of Cu NCs, which induces the excited-state level increasing. Thus, a ratiometric fluorescent probe for ethanol based on the PVP-Cu NCs is fabricated, which possesses rapid response (<1 min), and realize full-range detection from 0 to 100%. In addition, this ratiometric probe is successfully applied to determine the alcohol strength of alcohol beverages, demonstrating the great potential in practical application.
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Affiliation(s)
- Xue Hu
- The Key Laboratory of Water Pollution Control and Wastewater Reuse of Anhui Province, School of Environment and Energy Engineering, Anhui Jianzhu University, Hefei, 230601, China.
| | - Haiyan Cao
- The Key Laboratory of Chongqing Inorganic Special Functional Materials, College of Chemistry and Chemical Engineering, Yangtze Normal University, Chongqing, 408100, China
| | - Wenfei Dong
- The Key Laboratory of Chongqing Inorganic Special Functional Materials, College of Chemistry and Chemical Engineering, Yangtze Normal University, Chongqing, 408100, China
| | - Jianshe Tang
- The Key Laboratory of Water Pollution Control and Wastewater Reuse of Anhui Province, School of Environment and Energy Engineering, Anhui Jianzhu University, Hefei, 230601, China
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8
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Taylor N, Miller P, Coomber K, Livingston M, Scott D, Buykx P, Chikritzhs T. The impact of a minimum unit price on wholesale alcohol supply trends in the Northern Territory, Australia. Aust N Z J Public Health 2021; 45:26-33. [PMID: 33559964 DOI: 10.1111/1753-6405.13055] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/01/2020] [Accepted: 10/01/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The Northern Territory (NT) Government introduced a minimum unit price (MUP) of $1.30 per standard drink (10g pure alcohol) explicitly aimed at reducing the consumption of cheap wine products from October 2018. We aimed to assess the impact of the NT MUP on estimates of beverage-specific population-adjusted alcohol consumption using wholesale alcohol supply data. METHODS Interrupted time series analyses were conducted to examine MUP effects on trends in estimated per capita alcohol consumption (PCAC) for cask wine, total wine and total alcohol, across the NT and in the Darwin/Palmerston region. RESULTS Significant step decreases were found for cask wine and total wine PCAC in Darwin/Palmerston and across the Northern Territory. PCAC of cask wine decreased by 50.6% in the NT, and by 48.8% in Darwin/Palmerston compared to the prior year. PCAC for other beverages (e.g. beer) were largely unaffected by MUP. Overall, PCAC across the Territory declined, but not in Darwin/Palmerston. CONCLUSION With minimal implementation costs, the Northern Territory Government's MUP policy successfully targeted and reduced cask wine and total wine consumption. Cask wine, in particular, almost halved in Darwin/Palmerston where the impact of the MUP was able to be determined and considering other interventions. Implications for public health: Implementation of a minimum unit price for retail alcohol sales is a cost-effective way to reduce the consumption of high alcohol content and high-risk products, such as cheap cask wine.
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Affiliation(s)
| | - Peter Miller
- School of Psychology, Deakin University, Victoria
| | | | | | - Debbie Scott
- Monash University; Turning Point Alcohol and Drug Centre, Victoria
| | - Penny Buykx
- School of Humanities and Social Science, The University of Newcastle, New South Wales
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Western Australia
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Chikritzhs TN, Weeramanthri TS. The swinging pendulum of alcohol policy in the Northern Territory. Anaesth Intensive Care 2021; 49:8-11. [PMID: 33461304 DOI: 10.1177/0310057x20986309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Tarun S Weeramanthri
- School of Population and Global Health, University of Western Australia, Perth, Australia.,Public Health Association of Australia, Canberra, Australia
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10
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The use of financial incentives to prevent unhealthy behaviors: A review. Soc Sci Med 2020; 261:113236. [PMID: 32781370 DOI: 10.1016/j.socscimed.2020.113236] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/10/2020] [Accepted: 07/17/2020] [Indexed: 11/22/2022]
Abstract
Behaviors that are putting people's health at risk are widespread and some of them are on the rise. Some of these behaviors can be prohibited or prevented by taxation. But financial incentives such as conditional cash transfers are also increasingly proposed and tested to discourage such behaviors, in domains as varied as HIV/AIDS, drugs, alcohol, smoking, and obesity. This paper presents the theoretical justification for using such incentives, distinguishing between the price, income effects, and the nudge effects. The growing literature about the effectiveness of financial incentives to prevent undesirable behaviors is reviewed in detail for each type of harmful behavior. Finally, the paper discusses the long-term sustainability of such incentives, a key issue if they are to be scaled up beyond pilot programs and research projects. The current evidence on whether such incentives have an impact after they are discontinued is mixed. Some design features, like lotteries or commitment devices, could induce savings as well as increase effectiveness, therefore improving sustainability.
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Trangenstein PJ, Subbaraman MS, Greenfield TK, Mulia N, Kerr WC, Karriker-Jaffe KJ. Association between state-level alcohol availability and taxation policies on the prevalence of alcohol-related harms to persons other than the drinker in the USA, 2000-2015. Drug Alcohol Rev 2020; 39:255-266. [PMID: 32202007 DOI: 10.1111/dar.13041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 01/31/2020] [Accepted: 02/02/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS Alcohol-related harms to others (AHTO) are consequences of alcohol use borne by persons other than the drinker. This study assessed whether the odds of experiencing AHTO are associated with alcohol availability and taxation policies. DESIGN AND METHODS This study pooled data from four waves of the National Alcohol Survey (n = 20656 adults). We measured past-year AHTO exposure using three binary variables: physical (pushed/hit/assaulted or property damage by someone who had been drinking), family or financial (family/marital problems or financial harms by someone who had been drinking) and driving AHTO (riding in a vehicle with a drink-driver or being in a drink-driving crash). Policies included bar and off-premise alcohol outlet density (separately), alcohol retail hours, beer and spirits taxes (separately) and monopoly on retail/wholesale alcohol purchases. RESULTS Monopolies were associated with 41.2% lower odds of physical harms [adjusted odds ratio (aOR) = 0.59, 95% confidence interval (CI) 0.45, 0.77, q < 0.001 correcting for multiple analyses], and a 10% increase in bar density was associated with a 1.2% increase in odds of driving-related harms ( e ln(1.1) * β =1.01, 95% CI 1.00, 1.02, q = 0.03). Among men, beer taxes were associated with lower odds of physical harms ( eln(1.1) * β =0.93, 95% CI 0.88, 0.98 q = 0.03) and monopolies were associated with lower odds of physical (aOR = 0.45, 95% CI 0.35, 0.59, q < 0.001) and driving harms (aOR = 0.66, 95% CI 1.00, 1.02, q = 0.03). DISCUSSION AND CONCLUSIONS Monopolies, taxes and outlet density are associated with odds of some AHTO. Future longitudinal research should test whether physical availability and taxation policies may be protective for bystanders as well as drinkers.
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Affiliation(s)
| | | | | | - Nina Mulia
- Alcohol Research Group, Public Health Institute, Emeryville, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, USA
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12
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O'Donnell A, Anderson P, Jané-Llopis E, Manthey J, Kaner E, Rehm J. Immediate impact of minimum unit pricing on alcohol purchases in Scotland: controlled interrupted time series analysis for 2015-18. BMJ 2019; 366:l5274. [PMID: 31554617 PMCID: PMC6759563 DOI: 10.1136/bmj.l5274] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess the immediate impact of the introduction of minimum unit pricing in Scotland on household alcohol purchases. DESIGN Controlled interrupted time series analysis. SETTING Purchase data from Kantar Worldpanel's household shopping panel for 2015-18. PARTICIPANTS 5325 Scottish households, 54 807 English households as controls, and 10 040 households in northern England to control for potential cross border effects. INTERVENTIONS Introduction of a minimum price of 50p (€0.55; $0.61) per UK unit (6.25p per gram) for the sale of alcohol in Scotland on 1 May 2018. MAIN OUTCOME MEASURES Price per gram of alcohol, number of grams of alcohol purchased from off-trade by households, and weekly household expenditure on alcohol. RESULTS The introduction of minimum unit pricing in Scotland was associated with an increase in purchase price of 0.64p per gram of alcohol (95% confidence interval 0.54 to 0.75), a reduction in weekly purchases of 9.5 g of alcohol per adult per household (5.1 to 13.9), and a non-significant increase in weekly expenditure on alcohol per household of 61p (-5 to 127). The increase in purchase price was higher in lower income households and in households that purchased the largest amount of alcohol. The reduction in purchased grams of alcohol was greater in lower income households and only occurred in the top fifth of households by income that purchased the greatest amount of alcohol, where the reduction was 15 g of alcohol per week (6 to 24). Changes in weekly expenditure were not systematically related to household income but increased with increasing household purchases. CONCLUSIONS In terms of immediate impact, the introduction of minimum unit pricing appears to have been successful in reducing the amount of alcohol purchased by households in Scotland. The action was targeted, in that reductions of purchased alcohol only occurred in the households that bought the most alcohol.
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Affiliation(s)
- Amy O'Donnell
- Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK
| | - Peter Anderson
- Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Eva Jané-Llopis
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- ESADE Business School, Ramon Llull University, Barcelona, Spain
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eileen Kaner
- Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, IM Sechenov First Moscow State Medical University, Moscow, Russian Federation
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13
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Kerr WC, Ye Y, Greenfield TK. Changes in spirits purchasing behaviours after privatisation of government-controlled sales in Washington, USA. Drug Alcohol Rev 2019; 38:294-301. [PMID: 30860305 DOI: 10.1111/dar.12915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/24/2019] [Accepted: 01/28/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND AIMS The privatisation of the Washington Liquor Monopoly in 2012 offered a unique opportunity to study spirits purchasing behaviour changes from a government to licensed system. DESIGN AND METHODS Four representative cross-sectional surveys of adults aged 18 and older in Washington state were recruited between January 2014 and October 2015 (Wave 1, N = 1202; W2, N = 804; W3, N = 823; W4, N = 662). Analyses compared spirits purchasing behaviours before privatisation from retrospective reports to current reports in the areas of travel distance, spirits quality, purchase frequency and size of bottle. Respondents also directly reported on changes in convenience, selection and prices. RESULTS No significant changes were found in these aspects of purchasing. However, subgroup analyses found that younger drinkers 18-29 reduced travel distance and increased purchase frequency while drinkers aged 50 and older travelled further. Reduced travel distances were associated with grocery and drug stores while increased travel distances were associated with liquor superstores, wholesale stores and government stores in bordering states. Respondents reported that liquor purchasing was more convenient after privatisation but that the selection of spirits was better and prices were lower in the government-controlled stores. DISCUSSION AND CONCLUSIONS The government monopoly stores were viewed as offering a wider selection of products and as having lower prices than those in the privatised system. The variety of store types in the licensed system allowed drinkers to select stores based on convenience, selection or prices, so that travel times increased for some buyers, presumably those seeking lower prices or a wider selection.
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Public Health Institute, Emeryville, USA
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, Emeryville, USA
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Calcott P. Minimum unit prices for alcohol. JOURNAL OF HEALTH ECONOMICS 2019; 66:18-26. [PMID: 31078015 DOI: 10.1016/j.jhealeco.2019.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 04/23/2019] [Accepted: 04/26/2019] [Indexed: 06/09/2023]
Abstract
Minimum unit prices (MUPs) have been proposed on the grounds that they can reduce alcohol consumption of the heaviest drinkers, without significantly burdening moderate drinkers. This paper examines the case for MUPs in an optimal tax framework. Such a policy can improve welfare when two conditions are both satisfied. First, beverage quality and quantity should be substitutes. Second, there should be more distortion to consumption of cheaper alcohol than to more expensive varieties. The consequences of a MUP for the optimal corrective tax are explored with a calibrated numerical example. This example illustrates how the optimal tax rate might be higher when used in isolation, than when a MUP is also being used.
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15
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Fontes Marx M, London L, Harker N, Ataguba JE. Equity in household spending on alcoholic beverages in South Africa: assessing changes between 1995 and 2011. Int J Equity Health 2019; 18:78. [PMID: 31138225 PMCID: PMC6540469 DOI: 10.1186/s12939-019-0985-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 05/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally, alcohol consumption accounts for a substantial burden of disease, which translates into high social and economic costs. To address this burden, several policies (e.g. age and trading hour restrictions, increasing alcohol taxation) were implemented. Despite the existence of these policies evidence shows that alcohol misuse and alcohol-related harms have increased in South Africa over recent years. The objective of this paper is to assess progressivity and the changes in progressivity of alcohol expenditure at the household level in South Africa using datasets that span 15 years. METHODS Data come from the 1995, 2000, 2005/06 and 2010/11 South Africa Income Expenditure Survey. Distribution of spending on alcoholic beverages were analyzed using standard methodologies. Changes in progressivity between 1995 and 2000, and between 2005/06 and 2010/11 were also assessed using the Kakwani index. RESULTS Alcohol spending was regressive between 1995 and 2011 as the fraction of poorer households' expenditure spent on alcohol beverage exceeds that for the richest households. Also, the difference in Kakwani indexes of progressivity indicates that spending on alcoholic beverages has become less regressive between the same time periods. CONCLUSION The results show no evidence that alcohol policy including taxation increased regressivity. Thus, there is an opportunity to further reduce the regressivity using coherent alcohol policies. This paper concludes that there is a need for further research to unpack why alcohol spending became less regressive over the years that goes beyond just looking at changes in the distribution of alcohol expenditure.
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Affiliation(s)
- Mayara Fontes Marx
- Health Economics Department, School of Public Health and Family Medicine, Health Science Faculty, University of Cape Town, Observatory, Cape Town, 7925, South Africa.
| | - Leslie London
- Health and Human Rights Programme, School of Public Health and Family Medicine, Health Science Faculty, University of Cape Town, Observatory, Cape Town, 7925, South Africa
| | - Nadine Harker
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Cape Town, South Africa
| | - John E Ataguba
- Health Economics Department, School of Public Health and Family Medicine, Health Science Faculty, University of Cape Town, Observatory, Cape Town, 7925, South Africa
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16
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Kerr WC, Ye Y, Greenfield TK. Spirits purchasing and marijuana use behaviors of risky drinkers in the state of Washington from 2014 to 2016. Drug Alcohol Depend 2019; 198:7-12. [PMID: 30856371 PMCID: PMC6467746 DOI: 10.1016/j.drugalcdep.2018.12.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 12/17/2018] [Accepted: 12/19/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Few studies have evaluated alcoholic beverage purchasing behaviors, which are relevant to the design and effectiveness of alcoholic beverage control policies. Focusing on spirits purchasing among spirits drinkers, this study compares purchasing behaviors between risky and non-risky drinkers and across drinking patterns among those observed drinking at both levels. METHODS A rolling panel of 794 spirits drinkers in the state of Washington were surveyed between two and five times at 6-month intervals during 2014, 2015 and 2016 regarding their alcohol use, spirits purchasing and marijuana use frequency. Purchasing behaviors assessed for spirits were the frequency of purchasing and the travel time, unit cost, bottle size and store type from the respondents most recent purchase. Alcohol use was categorized at each measurement as risky or not using US NIAAA guidelines. RESULTS Risky drinkers were more likely to purchase spirits, purchase spirits more frequently, purchase larger spirits containers and use marijuana occasionally, but not frequently. Among drinkers who were risky only in some survey waves, during risky waves they were more likely to purchase more frequently, pay less per liter for spirits purchased, buy larger sized containers of spirits and use marijuana occasionally. CONCLUSIONS Drinkers chose to purchase lower cost spirits in larger containers when they were drinking more heavily compared to times when they were drinking within US low-risk guidelines. Findings also support complementarity between heavier drinking and marijuana use among spirits drinkers in a state with legal recreational marijuana sales.
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Affiliation(s)
- William C Kerr
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St, Suite 450, Emeryville, CA 94608, USA.
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St, Suite 450, Emeryville, CA 94608, USA
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St, Suite 450, Emeryville, CA 94608, USA
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Pryce R, Hollingsworth B, Walker I. Alcohol quantity and quality price elasticities: quantile regression estimates. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2019; 20:439-454. [PMID: 30276497 PMCID: PMC6438945 DOI: 10.1007/s10198-018-1009-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 09/25/2018] [Indexed: 06/02/2023]
Abstract
Many people drink more than the recommended level of alcohol, with some drinking substantially more. There is evidence that suggests that this leads to large health and social costs, and price is often proposed as a tool for reducing consumption. This paper uses quantile regression methods to estimate the differential price (and income) elasticities across the drinking distribution. This is also done for on-premise (pubs, bars and clubs) and off-premise (supermarkets and shops) alcohol separately. In addition, we examine the extent to which drinkers respond to price changes by varying the 'quality' of the alcohol that they consume. We find that heavy drinkers are much less responsive to price in terms of quantity, but that they are more likely to substitute with cheaper products when the price of alcohol increases. The implication is that price-based policies may have little effect in reducing consumption amongst the heaviest drinkers, provided they can switch to lower quality alternatives.
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Affiliation(s)
- Robert Pryce
- School of Health and Related Research, University of Sheffield, 30 Regent Street, Sheffield, S1 4DA, UK.
| | | | - Ian Walker
- Economics Department, Lancaster University, Lancaster, LA1 4YG, UK
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Ludbrook A. Fiscal measures to promote healthier choices: an economic perspective on price-based interventions. Public Health 2019; 169:180-187. [PMID: 30904321 DOI: 10.1016/j.puhe.2019.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 11/21/2018] [Accepted: 02/04/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Non-communicable diseases strongly linked to lifestyle factors create an increasing burden of disease. Fiscal interventions (tax and subsidy) are one approach to improving lifestyles, but their effective design might be improved. ECONOMIC FRAMEWORK Conventional economic theory suggests that fiscal interventions are only used to correct prices for externalities (costs or benefits imposed on others). These can be difficult to calculate accurately. Fiscal interventions operate by altering the prices that consumers face. Price increases are predicted to reduce demand, and the size of the effect is measured by the price elasticity. Tax changes may not translate directly into price changes, however. EVIDENCE FOR THE EFFECT OF TAXES, SUBSIDIES AND PRICES There is strong evidence for the effectiveness of taxation in relation to reducing tobacco and alcohol consumption and resulting harms. There has been less evaluation of taxation in relation to other unhealthy behaviors or of subsidies to promote healthy behaviors. DISCUSSION Fiscal levers have been used as interventions to improve health rather than for market correction. Taking account of behavioral insights may improve the design of fiscal interventions and combining interventions may increase effectiveness. CONCLUSION Both types of intervention have a role in improving health, but there may be challenges in promoting uptake of healthy behaviors.
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Affiliation(s)
- A Ludbrook
- Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK.
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Zahnow R, Miller P, Coomber K, de Andrade D, Ferris J. Lessons from Queensland's last-drinks legislation: The use of extended trading permits. Drug Alcohol Rev 2018; 37:537-545. [DOI: 10.1111/dar.12701] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 03/11/2018] [Accepted: 03/18/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Renee Zahnow
- School of Social Science; The University of Queensland; Brisbane Australia
| | - Peter Miller
- School of Psychology; Deakin University; Geelong Australia
| | - Kerri Coomber
- School of Psychology; Deakin University; Geelong Australia
| | - Dominique de Andrade
- School of Psychology and Counselling; Queensland University of Technology; Brisbane Australia
| | - Jason Ferris
- The Institute for Social Science Research; The University of Queensland; Brisbane Australia
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20
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Herttua K, Östergren O, Lundberg O, Martikainen P. Influence of affordability of alcohol on educational disparities in alcohol-related mortality in Finland and Sweden: a time series analysis. J Epidemiol Community Health 2017; 71:1168-1176. [PMID: 29061845 DOI: 10.1136/jech-2017-209636] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/19/2017] [Accepted: 09/20/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Prices of alcohol and income tend to influence how much people buy and consume alcohol. Price and income may be combined into one measure, affordability of alcohol. Research on the association between affordability of alcohol and alcohol-related harm is scarce. Furthermore, no research exists on how this association varies across different subpopulations. We estimated the effects of affordability of alcohol on alcohol-related mortality according to gender and education in Finland and Sweden. METHODS Vector-autoregressive time series modelling was applied to the quarter-annual aggregations of alcohol-related deaths and affordability of alcohol in Finland in 1988-2007 and in Sweden in 1991-2008. Alcohol-related mortality was defined using information on both underlying and contributory causes of death. We calculated affordability of alcohol index using information on personal taxable income and prices of various types of alcohol. RESULTS Among Finnish men with secondary education, an increase of 1% in the affordability of total alcohol was associated with an increase of 0.028% (95% CI 0.004 to 0.053) in alcohol-related mortality. Similar associations were also found for affordability for various types of alcohol and for beer only in the lowest education group. We found few other significant positive associations for other subpopulations in Finland or Sweden. However, reverse associations were found among secondary-educated Swedish women. CONCLUSIONS Overall, the associations between affordability of alcohol and alcohol-related mortality were relatively weak. Increased affordability of total alcoholic beverages was associated with higher rates of alcohol-related mortality only among Finnish men with secondary education.
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Affiliation(s)
- Kimmo Herttua
- Department of Public Health, Centre of Maritime Health and Society, University of Southern Denmark, Esbjerg, Denmark.,Department of Social Research, Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Olof Östergren
- Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden
| | - Olle Lundberg
- Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden
| | - Pekka Martikainen
- Department of Social Research, Population Research Unit, University of Helsinki, Helsinki, Finland.,Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden.,The Max Planck Institute for Demographic Research, Rostock, Germany
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21
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Stockwell T. Minimum unit pricing for alcohol: the most cost-effective of cancer prevention strategies? Expert Rev Anticancer Ther 2017; 17:981-983. [PMID: 28929817 DOI: 10.1080/14737140.2017.1381565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Timothy Stockwell
- a Centre for Addictions Research of British Columbia , University of Victoria , Victoria , BC , Canada
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22
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Effect of Maryland's 2011 Alcohol Sales Tax Increase on Alcohol-Positive Driving. Am J Prev Med 2017; 53:17-24. [PMID: 28343854 PMCID: PMC5497300 DOI: 10.1016/j.amepre.2016.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 11/03/2016] [Accepted: 12/12/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The 2011 Maryland alcohol sales tax increase from 6% to 9% provided an opportunity to evaluate the impact on rates of alcohol-positive drivers involved in injury crashes. METHODS Maryland police crash reports from 2001 to 2013 were analyzed using an interrupted time series design and a multivariable analysis employing generalized estimating equations models with a negative binomial distribution. Data were analyzed in 2014-2015. RESULTS There was a significant gradual annual reduction of 6% in the population-based rate of all alcohol-positive drivers (p<0.03), and a 12% reduction for drivers aged 15-20 years (p<0.007), and 21-34 years (p<0.001) following the alcohol sales tax increase. There were no significant changes in rates of alcohol-positive drivers aged 35-54 years (rate ratio, 0.98; 95% CI=0.89, 1.09). Drivers aged ≥55 years had a significant immediate 10% increase in the rate of alcohol-positive drivers (rate ratio, 1.10; 95% CI=1.04, 1.16) and a gradual increase of 4.8% per year after the intervention. Models using different denominators and controlling for multiple factors including a proxy for unmeasured factors found similar results overall. CONCLUSIONS The 2011 Maryland alcohol sales tax increase led to a significant reduction in the rate of all alcohol-positive drivers involved in injury crashes especially among drivers aged 15-34 years. This is the first study to examine the impact of alcohol sales taxes on crashes; previous research focused on excise tax. Increasing alcohol taxes is an important but often neglected intervention to reduce alcohol-impaired driving.
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Boniface S, Scannell JW, Marlow S. Evidence for the effectiveness of minimum pricing of alcohol: a systematic review and assessment using the Bradford Hill criteria for causality. BMJ Open 2017; 7:e013497. [PMID: 28588106 PMCID: PMC5777460 DOI: 10.1136/bmjopen-2016-013497] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES To assess the evidence for price-based alcohol policy interventions to determine whether minimum unit pricing (MUP) is likely to be effective. DESIGN Systematic review and assessment of studies according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, against the Bradford Hill criteria for causality. Three electronic databases were searched from inception to February 2017. Additional articles were found through hand searching and grey literature searches. CRITERIA FOR SELECTING STUDIES We included any study design that reported on the effect of price-based interventions on alcohol consumption or alcohol-related morbidity, mortality and wider harms. Studies reporting on the effects of taxation or affordability and studies that only investigated price elasticity of demand were beyond the scope of this review. Studies with any conflict of interest were excluded. All studies were appraised for methodological quality. RESULTS Of 517 studies assessed, 33 studies were included: 26 peer-reviewed research studies and seven from the grey literature. All nine of the Bradford Hill criteria were met, although different types of study satisfied different criteria. For example, modelling studies complied with the consistency and specificity criteria, time series analyses demonstrated the temporality and experiment criteria, and the analogy criterion was fulfilled by comparing the findings with the wider literature on taxation and affordability. CONCLUSIONS Overall, the Bradford Hill criteria for causality were satisfied. There was very little evidence that minimum alcohol prices are not associated with consumption or subsequent harms. However the overall quality of the evidence was variable, a large proportion of the evidence base has been produced by a small number of research teams, and the quantitative uncertainty in many estimates or forecasts is often poorly communicated outside the academic literature. Nonetheless, price-based alcohol policy interventions such as MUP are likely to reduce alcohol consumption, alcohol-related morbidity and mortality.
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Affiliation(s)
- Sadie Boniface
- Department of Psychology and Neuroscience, National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
| | - Jack W Scannell
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Sally Marlow
- Department of Psychology and Neuroscience, National Addiction Centre, Institute of Psychiatry, King's College London, London, UK
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24
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Jakovljevic M, Varavikova EA, Walter H, Wascher A, Pejcic AV, Lesch OM. Alcohol Beverage Household Expenditure, Taxation and Government Revenues in Broader European WHO Region. Front Pharmacol 2017; 8:303. [PMID: 28603498 PMCID: PMC5445193 DOI: 10.3389/fphar.2017.00303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/10/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Mihajlo Jakovljevic
- Health Economics and Pharmacoeconomics, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Elena A. Varavikova
- Federal Research Institute for Public Health Organization and Information (CNIIOIZ), Ministry of HealthMoscow, Russia
| | - Henriette Walter
- Department of Psychiatry and Psychotherapy, Medical University of ViennaVienna, Austria
| | | | - Ana V. Pejcic
- Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Otto M. Lesch
- Department of Psychiatry and Psychotherapy, Medical University of ViennaVienna, Austria
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Beer, wine and distilled spirits in Ontario: A comparison of recent policies, regulations and practices. NORDIC STUDIES ON ALCOHOL AND DRUGS 2017. [DOI: 10.2478/v10199-012-0006-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Aims There is a long-standing discussion about whether some beverages are more likely to be linked with high-risk drinking and damage than others, and implications for beverage specific alcohol policies. While the evidence is inconclusive, when controlling for individual consumption, some studies have shown elevated risks by beverage type. This paper examines the situation in Ontario, Canada, from 1995 to present (2011) on several dimensions in order to assess the differences by beverage and their rationale with a specific focus on the most recent policie. Methods This paper draws on archival consumption statistics, taxation and pricing arrangements, and retailing and marketing practices. Results Off-premise sales, which represent an estimated 75% of ethanol, involve several channels: stores controlled by the Liquor Control Board (LCBO) – which sell all spirits, imported and domestic wines, and beer products; the Beer Store network which sell all beers; and Ontario winery stores – which sell Ontario wines. In LCBO stores Ontario wines are more prominently displayed than other beverages, and extensive print advertising tends to feature wine over beer and spirits. There are also differences by beverage in terms of taxation and price. The taxes on higher alcohol content beverage types account for a higher portion of the retail price than taxes on lower alcohol content beverage types. Furthermore, minimum price regulations allow for differential minimum pricing per standard drink [17.05 ml ethanol] across beverage types. Conclusions The apparent rationale for these arrangements is not primarily that of favouring lighter-strength beverages in order to reduce harm, but rather to accommodate long-standing vested interests which are primarily financially based.
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Minimum alcohol pricing policies in practice: A critical examination of implementation in Canada. J Public Health Policy 2016; 38:39-57. [DOI: 10.1057/s41271-016-0051-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Changes in living arrangement, daily smoking, and risky drinking initiation among young Swiss men: a longitudinal cohort study. Public Health 2016; 140:119-127. [PMID: 27558957 DOI: 10.1016/j.puhe.2016.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 07/15/2016] [Accepted: 07/22/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The aim of this study was to assess the association between changes in living arrangement and the initiation of daily smoking and monthly risky single-occasion drinking (RSOD) in a cohort of young Swiss men. STUDY DESIGN Longitudinal cohort study. METHODS The sample consisted of 4662 young men drawn from the Cohort Study on Substance Use Risk Factors who lived with their family at baseline. Follow-up assessments occurred 15 months later. Multiple regression models were adjusted for individual and family factors (family model), as well as for individual and peer-related factors (peer model). RESULTS Relative to those still living with their parents at follow-up (n = 3845), those who had moved out (n = 817) were considerably more likely to have taken up smoking or RSOD after adjusting for several individual, family, and peer-related variables: OR (daily smoking) = 1.67 (95% CI 1.15-2.41) (P = 0.007) and OR (monthly RSOD) = 1.42 (95% CI 1.08-1.88) (P = 0.012). The strongest family-related predictors of smoking initiation were family structure and the lack of parental regulation and the strongest peer-related factors alcohol/drug problems in peers. Meanwhile, the strongest peer-related predictors of RSOD initiation were peer pressure (misconduct), perceived social support from friends, and perceived social support from a significant other, whereas family factors were not associated with RSOD initiation. Further subanalyses were conducted to examine the impact of different living arrangement changes on substance use initiation and revealed that living with peers at follow-up was associated with the greatest risk. CONCLUSIONS We identified a strong association between moving out of one's parents' home and daily smoking and monthly RSOD initiation in young Swiss men. Moving out to live with peers was an especially strong predictor of substance use initiation. Campaigns that aim to prevent heavy smoking and drinking should be intensified at the end of obligatory school.
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Abstract
Alcohol consumption is a global phenomenon, as is the resultant health, social and economic harm. The nature of these harms varies with different drinking patterns and with the societal and political responses to the burden of harm; nevertheless, alcohol-related chronic diseases have a major effect on health. Strong evidence exists for the effectiveness of different strategies to minimize this damage and those policies that target price, availability and marketing of alcohol come out best, whereas those using education and information are much less effective. However, these policies can be portrayed as anti-libertarian and so viewing them in the context of alcohol-related harm to those other than the drinker, such as the most vulnerable in society, is important. When this strategy is successful, as in Scotland, it has been possible to pass strong and effective legislation, such as for a minimum unit price for alcohol.
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Stockwell T, Zhao J, Marzell M, Gruenewald PJ, Macdonald S, Ponicki WR, Martin G. Relationships Between Minimum Alcohol Pricing and Crime During the Partial Privatization of a Canadian Government Alcohol Monopoly. J Stud Alcohol Drugs 2015; 76:628-34. [PMID: 26098040 DOI: 10.15288/jsad.2015.76.628] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The purpose of this study was to estimate the independent effects of increases in minimum alcohol prices and densities of private liquor stores on crime outcomes in British Columbia, Canada, during a partial privatization of off-premise liquor sales. METHOD A time-series cross-sectional panel study was conducted using mixed model regression analysis to explore associations between minimum alcohol prices, densities of liquor outlets, and crime outcomes across 89 local health areas of British Columbia between 2002 and 2010. Archival data on minimum alcohol prices, per capita alcohol outlet densities, and ecological demographic characteristics were related to measures of crimes against persons, alcohol-related traffic violations, and non-alcohol-related traffic violations. Analyses were adjusted for temporal and regional autocorrelation. RESULTS A 10% increase in provincial minimum alcohol prices was associated with an 18.81% (95% CI: ±17.99%, p < .05) reduction in alcohol-related traffic violations, a 9.17% (95% CI: ±5.95%, p < .01) reduction in crimes against persons, and a 9.39% (95% CI: ±3.80%, p < .001) reduction in total rates of crime outcomes examined. There was no significant association between minimum alcohol prices and non-alcohol-related traffic violations (p > .05). Densities of private liquor stores were not significantly associated with alcohol-involved traffic violations or crimes against persons, though they were with non-alcohol-related traffic violations. CONCLUSIONS Reductions in crime events associated with minimum-alcohol-price changes were more substantial and specific to alcohol-related events than the countervailing increases in densities of private liquor stores. The findings lend further support to the application of minimum alcohol prices for public health and safety objectives.
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Affiliation(s)
- Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, British Columbia, Canada.,Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Jinhui Zhao
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, British Columbia, Canada
| | - Miesha Marzell
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Paul J Gruenewald
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California
| | - Scott Macdonald
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, British Columbia, Canada.,School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
| | - William R Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, Oakland, California
| | - Gina Martin
- School of Medicine, University of St. Andrews, St. Andrews, Scotland
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Knai C, Petticrew M, Durand MA, Eastmure E, Mays N. Are the Public Health Responsibility Deal alcohol pledges likely to improve public health? An evidence synthesis. Addiction 2015; 110:1232-46. [PMID: 25807862 DOI: 10.1111/add.12855] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 11/17/2014] [Accepted: 01/08/2015] [Indexed: 01/08/2023]
Abstract
AIMS The English Public Health Responsibility Deal (RD) is a public-private partnership involving voluntary pledges between industry, government and other actors in various areas including alcohol, and designed to improve public health. This paper reviews systematically the evidence underpinning four RD alcohol pledges. METHODS We conducted a systematic review of reviews of the evidence underpinning interventions proposed in four RD alcohol pledges, namely alcohol labelling, tackling underage alcohol sales, advertising and marketing alcohol, and alcohol unit reduction. In addition, we included relevant studies of interventions where these had not been covered by a recent review. RESULTS We synthesized the evidence from 14 reviews published between 2002 and 2013. Overall, alcohol labelling is likely to be of limited effect on consumption: alcohol unit content labels can help consumers assess the alcohol content of drinks; however, labels promoting drinking guidelines and pregnancy warning labels are unlikely to influence drinking behaviour. Responsible drinking messages are found to be ambiguous, and industry-funded alcohol prevention campaigns can promote drinking instead of dissuading consumption. Removing advertising near schools can contribute to reducing underage drinking; however, community mobilization and law enforcement are most effective. Finally, reducing alcohol consumption is more likely to occur if there are incentives such as making lower-strength alcohol products cheaper. CONCLUSIONS The most effective evidence-based strategies to reduce alcohol-related harm are not reflected consistently in the RD alcohol pledges. The evidence is clear that an alcohol control strategy should support effective interventions to make alcohol less available and more expensive.
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Affiliation(s)
- Cécile Knai
- Policy Innovation Research Unit, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Petticrew
- Policy Innovation Research Unit, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Mary Alison Durand
- Policy Innovation Research Unit, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Elizabeth Eastmure
- Policy Innovation Research Unit, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Nicholas Mays
- Policy Innovation Research Unit, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
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Jiang H, Livingston M. The Dynamic Effects of Changes in Prices and Affordability on Alcohol Consumption: An Impulse Response Analysis. Alcohol Alcohol 2015; 50:631-8. [PMID: 26071563 DOI: 10.1093/alcalc/agv064] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 04/28/2015] [Indexed: 11/13/2022] Open
Abstract
AIMS To investigate how changes in alcohol price and affordability are related to aggregate level alcohol consumption in Australia to help to inform effective price and tax policy to influence consumption. MATERIAL AND METHODS Annual time series data between 1974 and 2012 on price and per-capita consumption for beer, wine and spirits and average weekly income were collected from the Australian Bureau of Statistics. Using a Vector Autoregressive model and impulse response analysis, the dynamic responses of alcohol consumption to changes in alcohol prices and affordability were estimated. RESULTS Alcohol consumption in Australia was negatively associated with alcohol price and positively associated with the affordability of alcohol. The results of the impulse response analysis suggest that a 10% increase in the alcohol price was associated with a 2% decrease in the population-level alcohol consumption in the following year, with further, diminishing, effects up to year 8, leading to an overall 6% reduction in total consumption. In contrast, when alcohol affordability increased, per-capita alcohol consumption increased over the following 6 years. CONCLUSIONS Our findings suggest that increasing alcohol prices or taxes can help to reduce alcohol consumption at the population level in Australia. However, the impact of affordability in our findings highlights that pricing policies need to consider increases in income to ensure effectiveness. Alcohol price policy should only cautiously focus on individual beverage types, because increasing the price of one beverage generally leads to an increase in consumption of substitutes.
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Affiliation(s)
- Heng Jiang
- Centre for Alcohol Policy Research, Turning Point, Melbourne, VIC, Australia Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, Turning Point, Melbourne, VIC, Australia Drug Policy Modelling Program, National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, NSW, Australia
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Deng J, Ma W, Yu P, Mao L. Colorimetric and Fluorescent Dual Mode Sensing of Alcoholic Strength in Spirit Samples with Stimuli-Responsive Infinite Coordination Polymers. Anal Chem 2015; 87:6958-65. [DOI: 10.1021/acs.analchem.5b01617] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Jingjing Deng
- Beijing National Laboratory
for Molecular Sciences, Key Laboratory of Analytical Chemistry for
Living Biosystems, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
| | - Wenjie Ma
- Beijing National Laboratory
for Molecular Sciences, Key Laboratory of Analytical Chemistry for
Living Biosystems, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
| | - Ping Yu
- Beijing National Laboratory
for Molecular Sciences, Key Laboratory of Analytical Chemistry for
Living Biosystems, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
| | - Lanqun Mao
- Beijing National Laboratory
for Molecular Sciences, Key Laboratory of Analytical Chemistry for
Living Biosystems, Institute of Chemistry, Chinese Academy of Sciences, Beijing 100190, China
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Xuan Z, Chaloupka FJ, Blanchette JG, Nguyen TH, Heeren TC, Nelson TF, Naimi TS. The relationship between alcohol taxes and binge drinking: evaluating new tax measures incorporating multiple tax and beverage types. Addiction 2015; 110:441-50. [PMID: 25428795 PMCID: PMC4441276 DOI: 10.1111/add.12818] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/24/2014] [Accepted: 11/17/2014] [Indexed: 11/29/2022]
Abstract
AIMS U.S. studies contribute heavily to the literature about the tax elasticity of demand for alcohol, and most U.S. studies have relied upon specific excise (volume-based) taxes for beer as a proxy for alcohol taxes. The purpose of this paper was to compare this conventional alcohol tax measure with more comprehensive tax measures (incorporating multiple tax and beverage types) in analyses of the relationship between alcohol taxes and adult binge drinking prevalence in U.S. states. DESIGN Data on U.S. state excise, ad valorem and sales taxes from 2001 to 2010 were obtained from the Alcohol Policy Information System and other sources. For 510 state-year strata, we developed a series of weighted tax-per-drink measures that incorporated various combinations of tax and beverage types, and related these measures to state-level adult binge drinking prevalence data from the Behavioral Risk Factor Surveillance System surveys. FINDINGS In analyses pooled across all years, models using the combined tax measure explained approximately 20% of state binge drinking prevalence, and documented more negative tax elasticity (-0.09, P = 0.02 versus -0.005, P = 0.63) and price elasticity (-1.40, P < 0.01 versus -0.76, P = 0.15) compared with models using only the volume-based tax. In analyses stratified by year, the R-squares for models using the beer combined tax measure were stable across the study period (P = 0.11), while the R-squares for models rely only on volume-based tax declined (P < 0.0). CONCLUSIONS Compared with volume-based tax measures, combined tax measures (i.e. those incorporating volume-based tax and value-based taxes) yield substantial improvement in model fit and find more negative tax elasticity and price elasticity predicting adult binge drinking prevalence in U.S. states.
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Affiliation(s)
- Ziming Xuan
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Frank J. Chaloupka
- Department of Economics and Institute for Health Research and Policy, University of Illinois, Chicago, IL, USA
| | - Jason G. Blanchette
- Section of General Internal Medicine, Boston Medical Center, Boston, MA, USA
| | - Thien H. Nguyen
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Timothy C. Heeren
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Toben F. Nelson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Timothy S. Naimi
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA,Section of General Internal Medicine, Boston Medical Center, Boston, MA, USA
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Nelson JP. Binge drinking and alcohol prices: a systematic review of age-related results from econometric studies, natural experiments and field studies. HEALTH ECONOMICS REVIEW 2015; 5:6. [PMID: 25853004 PMCID: PMC4384974 DOI: 10.1186/s13561-014-0040-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 12/23/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND Heavy episodic ("binge") drinking of alcohol has serious public health implications, especially for youth and young adults. Previous summaries and surveys have failed to address in a comprehensive manner the effects of alcohol prices on binge drinking by gender or age group. METHODS A qualitative systematic review is performed for effects of alcohol prices (or tax surrogates) on binge drinking for three age groups: youth, young adults, and adults. Outcomes examined include binge participation, intensity and frequency. Criteria for data collection and potential sources of bias are discussed, including adequacy of price data. Price-binge relationships are judged using a 95% confidence interval (p ≤ 0.05) for statistical significance. RESULTS Fifty-six relevant econometric studies were found, with studies and results distributed equally among three age groups. Also found were five natural experiments for tax reductions and six field studies. Null results or mixed results are found in more than half of the studies. The body of evidence indicates that binge drinkers are not highly-responsive to increased prices. Non-responsiveness holds generally for younger and older drinkers and for male and female binge drinkers alike. A limitation of the current literature is that results are only available for higher-income countries. CONCLUSIONS Increased alcohol taxes or prices are unlikely to be effective as a means to reduce binge drinking, regardless of gender or age group.
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Affiliation(s)
- Jon P Nelson
- Department of Economics, Pennsylvania State University, University Park, PA, 16802 USA
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Albers AB, DeJong W, Naimi TS, Siegel M, Jernigan DH. The relationship between alcohol price and brand choice among underage drinkers: are the most popular alcoholic brands consumed by youth the cheapest? Subst Use Misuse 2014; 49:1833-43. [PMID: 25183436 PMCID: PMC4192130 DOI: 10.3109/10826084.2014.935790] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We examined the influence of price on alcohol brand choice among underage youth. Using a national sample of 1,032 youth, ages 13-20, recruited from a national Internet panel in 2011-2012, we compared differences in mean prices between popular and unpopular brands, examined the association of price and brand popularity using logistic regression, and rank ordered the average price of top brands. Lower brand-specific prices were significantly associated with higher levels of past 30-day consumption prevalence. However, youth did not preferentially consume the cheapest brands. These findings indicate that youth have preferences for certain brands, even if those brands cost more than competing brands. Our study highlights the need for research on the impact of brand-specific alcohol marketing on underage drinking.
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Affiliation(s)
- Alison B Albers
- 1Department of Community Health Sciences, Boston University School of Public Health , Boston, Massachusetts , USA
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Holmes J, Meier PS, Booth A, Brennan A. Reporting the characteristics of the policy context for population-level alcohol interventions: a proposed 'Transparent Reporting of Alcohol Intervention ContExts' (TRAICE) checklist. Drug Alcohol Rev 2014; 33:596-603. [PMID: 25271563 PMCID: PMC4278551 DOI: 10.1111/dar.12201] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Accepted: 08/10/2014] [Indexed: 11/26/2022]
Abstract
ISSUES Effectiveness of alcohol policy interventions varies across times and places. The circumstances under which effective polices can be successfully transferred between contexts are typically unexplored with little attention given to developing reporting requirements that would facilitate systematic investigation. APPROACH Using purposive sampling and expert elicitation methods, we identified context-related factors impacting on the effectiveness of population-level alcohol policies. We then drew on previous characterisations of alcohol policy contexts and methodological-reporting checklists to design a new checklist for reporting contextual information in evaluation studies. KEY FINDINGS Six context factor domains were identified: (i) baseline alcohol consumption, norms and harm rates; (ii) baseline affordability and availability; (iii) social, microeconomic and demographic contexts; (iv) macroeconomic context; (v) market context; and (vi) wider policy, political and media context. The checklist specifies information, typically available in national or international reports, to be reported in each domain. IMPLICATIONS The checklist can facilitate evidence synthesis by providing: (i) a mechanism for systematic and more consistent reporting of contextual data for meta-regression and realist evaluations; (ii) information for policy-makers on differences between their context and contexts of evaluations; and (iii) an evidence base for adjusting prospective policy simulation models to account for policy context. CONCLUSIONS Our proposed checklist provides a tool for gaining better understanding of the influence of policy context on intervention effectiveness. Further work is required to rationalise and aggregate checklists across interventions types to make such checklists practical for use by journals and to improve reporting of important qualitative contextual data.
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Affiliation(s)
- John Holmes
- School of Health and Related Research, University of SheffieldSheffield, UK
| | - Petra S Meier
- School of Health and Related Research, University of SheffieldSheffield, UK
| | - Andrew Booth
- School of Health and Related Research, University of SheffieldSheffield, UK
| | - Alan Brennan
- School of Health and Related Research, University of SheffieldSheffield, UK
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Sunderland M, Chalmers J, McKetin R, Bright D. Typologies of Alcohol Consumption on a Saturday Night Among Young Adults. Alcohol Clin Exp Res 2014; 38:1745-52. [DOI: 10.1111/acer.12400] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 02/04/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Matthew Sunderland
- Drug Policy Modelling Program ; National Drug and Alcohol Research Centre; UNSW Australia; Sydney NSW Australia
| | - Jenny Chalmers
- Drug Policy Modelling Program ; National Drug and Alcohol Research Centre; UNSW Australia; Sydney NSW Australia
| | - Rebecca McKetin
- Centre for Research on Ageing, Health and Well-being ; the Australian National University; Canberra ACT Australia
| | - David Bright
- Faculty of Arts and Social Science ; School of Social Sciences; UNSW Australia; Sydney NSW Australia
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Meng Y, Brennan A, Purshouse R, Hill-McManus D, Angus C, Holmes J, Meier PS. Estimation of own and cross price elasticities of alcohol demand in the UK--A pseudo-panel approach using the Living Costs and Food Survey 2001-2009. JOURNAL OF HEALTH ECONOMICS 2014; 34:96-103. [PMID: 24508846 PMCID: PMC3991422 DOI: 10.1016/j.jhealeco.2013.12.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 12/09/2013] [Accepted: 12/24/2013] [Indexed: 06/01/2023]
Abstract
The estimation of price elasticities of alcohol demand is valuable for the appraisal of price-based policy interventions such as minimum unit pricing and taxation. This study applies a pseudo-panel approach to the cross-sectional Living Cost and Food Survey 2001/2-2009 to estimate the own- and cross-price elasticities of off- and on-trade beer, cider, wine, spirits and ready-to-drinks in the UK. A pseudo-panel with 72 subgroups defined by birth year, gender and socioeconomic status is constructed. Estimated own-price elasticities from the base case fixed effect models are all negative and mostly statically significant (p<0.05). Off-trade cider and beer are most elastic (-1.27 and -0.98) and off-trade spirits and on-trade ready-to-drinks are least elastic (-0.08 and -0.19). Estimated cross-price elasticities are smaller in magnitude with a mix of positive and negative signs. The results appear plausible and robust and could be used for appraising the estimated impact of price-based interventions in the UK.
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Affiliation(s)
- Yang Meng
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
| | - Alan Brennan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Robin Purshouse
- Department of Automatic Control and Systems Engineering, University of Sheffield, Sheffield, UK
| | - Daniel Hill-McManus
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Colin Angus
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - John Holmes
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Petra Sylvia Meier
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Sharma A, Vandenberg B, Hollingsworth B. Minimum pricing of alcohol versus volumetric taxation: which policy will reduce heavy consumption without adversely affecting light and moderate consumers? PLoS One 2014; 9:e80936. [PMID: 24465368 PMCID: PMC3898955 DOI: 10.1371/journal.pone.0080936] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 10/07/2013] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND We estimate the effect on light, moderate and heavy consumers of alcohol from implementing a minimum unit price for alcohol (MUP) compared with a uniform volumetric tax. METHODS We analyse scanner data from a panel survey of demographically representative households (n = 885) collected over a one-year period (24 Jan 2010-22 Jan 2011) in the state of Victoria, Australia, which includes detailed records of each household's off-trade alcohol purchasing. FINDINGS The heaviest consumers (3% of the sample) currently purchase 20% of the total litres of alcohol (LALs), are more likely to purchase cask wine and full strength beer, and pay significantly less on average per standard drink compared to the lightest consumers (A$1.31 [95% CI 1.20-1.41] compared to $2.21 [95% CI 2.10-2.31]). Applying a MUP of A$1 per standard drink has a greater effect on reducing the mean annual volume of alcohol purchased by the heaviest consumers of wine (15.78 LALs [95% CI 14.86-16.69]) and beer (1.85 LALs [95% CI 1.64-2.05]) compared to a uniform volumetric tax (9.56 LALs [95% CI 9.10-10.01] and 0.49 LALs [95% CI 0.46-0.41], respectively). A MUP results in smaller increases in the annual cost for the heaviest consumers of wine ($393.60 [95% CI 374.19-413.00]) and beer ($108.26 [95% CI 94.76-121.75]), compared to a uniform volumetric tax ($552.46 [95% CI 530.55-574.36] and $163.92 [95% CI 152.79-175.03], respectively). Both a MUP and uniform volumetric tax have little effect on changing the annual cost of wine and beer for light and moderate consumers, and likewise little effect upon their purchasing. CONCLUSIONS While both a MUP and a uniform volumetric tax have potential to reduce heavy consumption of wine and beer without adversely affecting light and moderate consumers, a MUP offers the potential to achieve greater reductions in heavy consumption at a lower overall annual cost to consumers.
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Affiliation(s)
- Anurag Sharma
- Centre for Health Economics, Monash University, Melbourne, Australia
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MacLean S, Callinan S. “Fourteen Dollars for One Beer!” Pre-drinking is associated with high-risk drinking among Victorian young adults. Aust N Z J Public Health 2013; 37:579-85. [DOI: 10.1111/1753-6405.12138] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 04/01/2013] [Accepted: 08/01/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sarah MacLean
- Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, Victoria; Centre for Heath and Society; University of Melbourne; Victoria
| | - Sarah Callinan
- Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, Victoria; Eastern Health Clinical School; Monash University; Victoria
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Chalmers J, Carragher N, Davoren S, O’Brien P. Real or perceived impediments to minimum pricing of alcohol in Australia: Public opinion, the industry and the law. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 24:517-23. [DOI: 10.1016/j.drugpo.2013.05.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 04/09/2013] [Accepted: 05/06/2013] [Indexed: 10/26/2022]
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Stockwell T, Zhao J, Martin G, Macdonald S, Vallance K, Treno A, Ponicki W, Tu A, Buxton J. Minimum alcohol prices and outlet densities in British Columbia, Canada: estimated impacts on alcohol-attributable hospital admissions. Am J Public Health 2013; 103:2014-20. [PMID: 23597383 DOI: 10.2105/ajph.2013.301289] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES We investigated whether periodic increases in minimum alcohol prices were associated with reduced alcohol-attributable hospital admissions in British Columbia. METHODS The longitudinal panel study (2002-2009) incorporated minimum alcohol prices, density of alcohol outlets, and age- and gender-standardized rates of acute, chronic, and 100% alcohol-attributable admissions. We applied mixed-method regression models to data from 89 geographic areas of British Columbia across 32 time periods, adjusting for spatial and temporal autocorrelation, moving average effects, season, and a range of economic and social variables. RESULTS A 10% increase in the average minimum price of all alcoholic beverages was associated with an 8.95% decrease in acute alcohol-attributable admissions and a 9.22% reduction in chronic alcohol-attributable admissions 2 years later. A Can$ 0.10 increase in average minimum price would prevent 166 acute admissions in the 1st year and 275 chronic admissions 2 years later. We also estimated significant, though smaller, adverse impacts of increased private liquor store density on hospital admission rates for all types of alcohol-attributable admissions. CONCLUSIONS Significant health benefits were observed when minimum alcohol prices in British Columbia were increased. By contrast, adverse health outcomes were associated with an expansion of private liquor stores.
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Affiliation(s)
- Tim Stockwell
- Tim Stockwell, Jinhui Zhao, Gina Martin, Scott Macdonald, and Kate Vallance are with the Centre for Addictions Research of British Columbia, University of Victoria, British Columbia. Tim Stockwell is also with the Department of Psychology, University of Victoria. Andrew Treno and William Ponicki are with the Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, California. Andrew Tu and Jane Buxton are with the British Columbia Centre for Disease Control, Vancouver, British Columbia
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Treno AJ, Ponicki WR, Stockwell T, Macdonald S, Gruenewald PJ, Zhao J, Martin G, Greer A. Alcohol outlet densities and alcohol price: the British Columbia experiment in the partial privatization of alcohol sales off-premise. Alcohol Clin Exp Res 2013; 37:854-9. [PMID: 23316802 DOI: 10.1111/acer.12065] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 09/22/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol beverage prices or taxes have been shown to be related to alcohol sales and use and related problems. What is not clear are the mechanisms underlying these relationships. METHODS This study examines the relationship between alcohol outlet density under conditions of the partial privatization of off-premise consumption in British Columbia (BC) occurring over the past decade. Two hypotheses are tested. First, reflecting basic supply-demand principles, greater geographic densities of alcohol outlets will be directly related to reductions in beverage prices in response to greater competition. Second, reflecting the effects of niche marketing and resulting market stratification, increased densities of private liquor stores will be especially related to reductions in beverage prices within this outlet category. Data were collected from: (i) a survey of BC private store prices and practices, (ii) alcohol outlet location information, and (iii) data on demographic characteristics. Multilevel models examine the relationships between prices at individual private liquor stores and the densities of government liquor stores, private liquor stores, bars, and restaurants, controlling for background demographics and geographic unit level effects. Spatial dependencies were also examined. RESULTS Increased densities of private liquor stores were associated with lower mean prices of beer and all alcohol aggregated across brands at the store level. There appeared to be no outlet level effect on discounting patterns, however, with the mean price differences apparently reflecting differences in the quality of brands carried rather than unequal prices for any given brand. CONCLUSIONS Increased densities of private off-sale alcohol outlets appear to result in lower prices charged at said establishments independently of other types of alcohol outlets suggesting that they represent an emerging marketing niche in the context of off-sale outlet privatization.
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Affiliation(s)
- Andrew J Treno
- Pacific Institute for Research and Evaluation, Berkeley, CA 94704, USA.
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45
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Stockwell T, Zhao J, Giesbrecht N, Macdonald S, Thomas G, Wettlaufer A. The raising of minimum alcohol prices in Saskatchewan, Canada: impacts on consumption and implications for public health. Am J Public Health 2012; 102:e103-10. [PMID: 23078488 PMCID: PMC3519328 DOI: 10.2105/ajph.2012.301094] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2012] [Indexed: 01/17/2023]
Abstract
OBJECTIVES We report impacts on alcohol consumption following new and increased minimum alcohol prices in Saskatchewan, Canada. METHODS We conducted autoregressive integrated moving average time series analyses of alcohol sales and price data from the Saskatchewan government alcohol monopoly for 26 periods before and 26 periods after the intervention. RESULTS A 10% increase in minimum prices significantly reduced consumption of beer by 10.06%, spirits by 5.87%, wine by 4.58%, and all beverages combined by 8.43%. Consumption of coolers decreased significantly by 13.2%, cocktails by 21.3%, and liqueurs by 5.3%. There were larger effects for purely off-premise sales (e.g., liquor stores) than for primarily on-premise sales (e.g., bars, restaurants). Consumption of higher strength beer and wine declined the most. A 10% increase in minimum price was associated with a 22.0% decrease in consumption of higher strength beer (> 6.5% alcohol/volume) versus 8.17% for lower strength beers. The neighboring province of Alberta showed no change in per capita alcohol consumption before and after the intervention. CONCLUSIONS Minimum pricing is a promising strategy for reducing the public health burden associated with hazardous alcohol consumption. Pricing to reflect percentage alcohol content of drinks can shift consumption toward lower alcohol content beverage types.
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Affiliation(s)
- Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, Canada.
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Lachenmeier DW, Rehm J. Is There a Relationship Between Alcohol Quality and Health? Alcohol Alcohol 2012; 48:127-9. [DOI: 10.1093/alcalc/ags101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rice P, Drummond C. The price of a drink: the potential of alcohol minimum unit pricing as a public health measure in the UK. Br J Psychiatry 2012; 201:169-71. [PMID: 22945922 DOI: 10.1192/bjp.bp.111.105601] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The UK has seen a dramatic increase in alcohol consumption and alcohol-related harm over the past 30 years. Alcohol taxation has long been considered a key method of controlling alcohol-related harm but a combination of factors has recently led to consideration of methods which affect the price of the cheapest alcohol as a means of improved targeting of alcohol control measures to curb the consumption of the heaviest drinkers. Although much of the evidence in favour of setting a minimum price of a unit of alcohol is based on complex econometric models rather than empirical data, all jurisdictions within the UK now intend to make selling alcohol below a set price illegal, which will provide a naturalistic experiment allowing assessment of the impact of minimum pricing.
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Kan MY, Lau M. Comparing alcohol affordability in 65 cities worldwide. Drug Alcohol Rev 2012; 32:19-26. [DOI: 10.1111/j.1465-3362.2012.00476.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2011] [Accepted: 05/09/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Ming-Yue Kan
- Centre for Greater China Studies; The Hong Kong Institute of Education; Hong Kong; China
| | - Maggie Lau
- Department of Social Sciences; The Hong Kong Institute of Education; Hong Kong; China
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Cohen D, Rabinovich L. Addressing the proximal causes of obesity: the relevance of alcohol control policies. Prev Chronic Dis 2012; 9:E94. [PMID: 22554409 PMCID: PMC3431955 DOI: 10.5888/pcd9.110274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Many policy measures to control the obesity epidemic assume that people consciously and rationally choose what and how much they eat and therefore focus on providing information and more access to healthier foods. In contrast, many regulations that do not assume people make rational choices have been successfully applied to control alcohol, a substance — like food — of which immoderate consumption leads to serious health problems. Alcohol-use control policies restrict where, when, and by whom alcohol can be purchased and used. Access, salience, and impulsive drinking behaviors are addressed with regulations including alcohol outlet density limits, constraints on retail displays of alcoholic beverages, and restrictions on drink “specials.” We discuss 5 regulations that are effective in reducing drinking and why they may be promising if applied to the obesity epidemic.
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Stockwell T, Auld MC, Zhao J, Martin G. Does minimum pricing reduce alcohol consumption? The experience of a Canadian province. Addiction 2012; 107:912-20. [PMID: 22168350 DOI: 10.1111/j.1360-0443.2011.03763.x] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Minimum alcohol prices in British Columbia have been adjusted intermittently over the past 20 years. The present study estimates impacts of these adjustments on alcohol consumption. DESIGN Time-series and longitudinal models of aggregate alcohol consumption with price and other economic data as independent variables. SETTING British Columbia (BC), Canada. PARTICIPANTS The population of British Columbia, Canada, aged 15 years and over. MEASUREMENTS Data on alcohol prices and sales for different beverages were provided by the BC Liquor Distribution Branch for 1989-2010. Data on household income were sourced from Statistics Canada. FINDINGS Longitudinal estimates suggest that a 10% increase in the minimum price of an alcoholic beverage reduced its consumption relative to other beverages by 16.1% (P < 0.001). Time-series estimates indicate that a 10% increase in minimum prices reduced consumption of spirits and liqueurs by 6.8% (P = 0.004), wine by 8.9% (P = 0.033), alcoholic sodas and ciders by 13.9% (P = 0.067), beer by 1.5% (P = 0.043) and all alcoholic drinks by 3.4% (P = 0.007). CONCLUSIONS Increases in minimum prices of alcoholic beverages can substantially reduce alcohol consumption.
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Affiliation(s)
- Tim Stockwell
- Centre for Addictions Research of British Columbia, University of Victoria, Victoria, BC, Canada.
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