Effects of Alcohol Tax and Price Policies on Morbidity and Mortality: A Systematic Review
Research article
Abstract
Objectives
The researchers systematically reviewed the effects of alcohol taxes and prices on alcohol-related morbidity and mortality to assess their public health impact.
Methods
The researchers searched 12 databases, along with articles’ reference lists, for studies providing estimates of the relationship between alcohol taxes and prices and measures of risky behavior or morbidity and mortality, then coded for effect sizes and numerous population and study characteristics. The researchers combined independent estimates in random-effects models to obtain aggregate effect estimates.
Results
The researchers identified 50 articles, containing 340 estimates.
Meta-estimates were r = −0.347 for alcohol-related disease and injury outcomes, −0.022 for violence, −0.048 for suicide, −0.112 for traffic crash outcomes, −0.055 for sexually transmitted diseases, −0.022 for other drug use, and −0.014 for crime and other misbehavior measures. All except suicide were statistically significant.
Conclusions
Public policies affecting the price of alcoholic beverages have significant effects on alcohol-related disease and injury rates.
The systematic review results suggest that doubling the alcohol tax would reduce
- alcohol-related mortality by an average of 35%,
- traffic crash deaths by 11%,
- sexually transmitted disease by 6%,
- violence by 2%, and
- crime by 1.4%.
Public Health Significance
The results establish beyond any reasonable doubt that alcohol taxes and prices are inversely associated with population health outcomes.
But how significant is this apparent effect to public health? Two approaches can be taken to evaluate the substantive significance of these findings.
In the data the researchers analyzed, the effect on alcohol morbidity and mortality indicators showed a large effect. The effect on traffic crash outcomes showed a medium effect. Effects on crime, violence, and STDs, although still statistically significant, were smaller. In the context of individual-level interventions, some of these effects might be deemed as medium-sized effects, but in the researchers’ analysis they were population-level effects. Modest effects on individuals are substantively larger and more significant when the effects apply across the entire population of alcohol users in a region or country.
A second way to assess the public health significance of the findings of this systematic review is to estimate the percentage reduction in these important population health outcomes associated with a given change in alcohol tax.
According to the data the researchers analyzed, doubling alcohol taxes would be associated with an average reduction of 35% in alcohol-related mortality, an 11% reduction in traffic crash deaths, a 6% reduction in STDs, a 2% reduction in violence, and a 1.2% reduction in crime.
