DENVER – Doubling the currently low alcohol tax would result in roughly a 35% reduction in direct alcohol-related mortality as well as substantial benefits across a range of other important public health outcomes, a meta-analysis has shown.
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Researchers found that the doubling of current alcohol taxes would result in an up to 35% reduction in direct alcohol mortality and would help improve other public health outcomes.
"We have a lot of literature. This is probably the most studied preventive health policy issue. The magnitude of the observed effects is larger and more consistent than for most other preventive efforts that’ve been studied," Alexander C. Wagenaar, Ph.D., said at the annual meeting of the American Public Health Association.
He presented a meta-analysis based on what he described as "an exhaustive search" of the past 50 years of published studies on the effects of alcohol tax pricing policies on a whole range of public health outcomes.
In summary, a 10% increase in the alcohol tax and a commensurate price increase would result in an across-the-board 5% reduction in drinking across all groups: underage teens as well as adults, moderate as well as heavy drinkers. The meta-analysis of 50 studies showed that doubling the alcohol tax would be associated on average with a 35% reduction in deaths due to cirrhosis, some cancers, and other directly alcohol-related causes; an 11% drop in traffic crash morbidity and mortality; a 6% decrease in sexually transmitted infections; a 2% reduction in violence; and a 1% decrease in crime and delinquent misbehavior. All of these effects were statistically significant, according to Dr. Wagenaar, professor of epidemiology and health policy at the University of Florida, Gainesville.
Alex Wagenaar
"This is a policy that applies at the population level. It’s not just for the high-risk group, it’s not only for the people that get into treatment. When a tax change is implemented, it changes the environment slightly across the entire population such that there’s a reduction in drinking, and that effect ripples across these whole sets of alcohol-related outcomes," explained the researcher, whose prior health policy studies have been credited as playing a key role in establishing the uniform nationwide drinking age of 21.
Suicide was the only outcome the investigators studied that didn’t show a significant decrease in response to an increased tax on alcohol. Most of the 11 relevant studies have been conducted by only two research groups.
"There’s not enough evidence yet to determine conclusively whether change in alcohol taxes influences suicide rates," Dr. Wagenaar said.
He pointed out several practical advantages to raising the alcohol tax, beyond the striking public health benefits. An alcohol tax increase would generate additional revenues that could be used to fund other public health objectives or to bolster the general fund. No costly new bureaucratic infrastructure is required to implement an alcohol tax increase; the tax structures are already present. And alcohol tax rates are now at historic lows because they’re volume-based and aren’t adjusted for inflation.
"That’s how we’ve gotten into this situation where the tax rates now are only a fraction of what they were in the 1950s, ’60s, and ’70s. If we were to simply return the tax rates in most jurisdictions to the rates that were in place in the ’60s and ’70s, we would see the kinds of effects that we’re seeing in the meta-analysis, because in many areas that would involve a doubling of the tax rates," Dr. Wagenaar said.
In response to an audience question, he said the available evidence indicates there is no threshold effect for the relationship between alcohol tax increases and public health benefits. In other words, if the alcohol tax is increased by, say, one-quarter, public health benefits will accrue, albeit not with the same large effect sizes as with a doubling of the tax.
Dr. Wagenaar’s study was funded by the Robert Wood Johnson Foundation. He said he has no relevant financial conflicts of interest.