Fewer Cancer Cases in 4 Countries of the WHO European Region in 2018 through Increased Alcohol Excise Taxation: A Modelling Study
Research Article
Abstract
Introduction
Prevention of cancer has been identified as a major public health priority for Europe, and alcohol is a leading risk factor for various types of cancer. This contribution estimates the number of cancer cases that could have potentially been averted in 2018 in 4 European countries if an increase in alcohol excise taxation had been applied.
Methods
Current country and beverage-specific excise taxation of 4 member states of the WHO European Region (Germany, Italy, Kazakhstan, and Sweden) was used as a baseline, and the potential impacts of increases of 20, 50, and 100% to current excise duties were modelled.
A sensitivity analysis was performed, replacing the current tax rates in the 4 countries by those levied in Finland. The resulting increase in tax was assumed to be fully incorporated into the consumer price, and beverage-specific price elasticities of demand were obtained from meta-analyses, assuming less elasticity for heavy drinkers. Model estimates were applied to cancer incidence rates for the year 2018.
Results
In the 4 countries, >35,000 cancer cases in 2018 were caused by alcohol consumption, with the highest rate of alcohol-attributable cancers recorded in Germany and the lowest in Sweden.
An increase in excise duties on alcohol would have significantly reduced these numbers, with between 3 and 7% of all alcohol-attributable cancer cases being averted if taxation had been increased by 100%.
If the 4 countries were to adopt an excise taxation level equivalent to the one currently imposed in Finland, an even higher proportion of alcohol-attributable cancers could be avoided, with Germany alone experiencing 1,600 fewer cancer cases in 1 year.
Discussion/Conclusion
Increasing alcohol excise taxes can markedly prevent cancer incidence and reduce the cancer burden in European countries.
More detailed findings
Alcohol-attributable cancer cases were estimated
- Germany: 21,980,
- Italy: 10,006,
- Kazakhstan: 1,655, and
- Sweden: 1,416.
In the scenario with highest increase in alcohol excise duties modelled, between 3 and 7% of all alcohol-attributable cancer cases were averted, which translated for Germany, the country with the lowest taxation rates at baseline, into 673 cancer cases averted in 2018.
In case of a 100% increase in the alcohol excise taxes, 673 (in Germany), 480 (in Italy), 59 (in Kazakhstan), and 100 (in Sweden) new cancer cases would be avoided.
Obviously, the number of incident cancer cases averted depends substantially on the population size of the country, on the prevalence of alcohol use, and on the level of taxation before the increase.
However, in a single country like Germany, if the current very low alcohol excise duties were increased, a substantial number of new cancer cases could potentially be averted.
