Prices, taxes and alcohol use: a systematic umbrella review

Abstract

Aim To measure the impact of taxes and prices on alcohol use with particular attention to the different context of rising alcohol consumption in low‐ and middle‐income countries. Methods Systematic review: we searched MEDLINE, Embase, EconLit and LILACS, grey literature, hand‐searched five specialty journals and examined references of relevant studies. We considered all reviews that included studies that quantitatively examined the relationship between alcohol prices or taxes and alcohol use. At least two reviewers independently screened the articles and extracted the characteristics, methods and main results and assessed the quality of each included study. We identified 30 reviews. Results There was overwhelming evidence that higher alcohol prices and taxes were associated with lower total alcohol consumption and that price responsiveness varied by beverage type. Total own‐price elasticities of alcohol demand were consistently negative and substantial enough to be policy meaningful; total own‐price elasticities for beer, wine and spirits were found to be approximately −0.3, −0.6 and −0.65. Reviews generally concluded that higher taxes and prices were associated with lower heavy episodic drinking and heavy drinking, although the magnitude of these associations was generally unclear. Reviews provided no evidence that alcohol price responsiveness differed by socioeconomic status, mixed and contradictory evidence with respect to age and sex and limited evidence that price responsiveness in low‐ and middle‐income countries was approximately the same as in high‐income countries. Conclusions Taxes are effective in reducing alcohol use. Moreover, increasing the price of alcohol by increasing taxes can also be expected to increase tax revenue, because the demand for alcohol is most certainly inelastic.

Reduction of Alcoholic Strength: Does It Matter for Public Health?

“…Recent analyses (e.g., [ 32 ]) showed marked underestimation of the beneficial effects of taxation using the standard elasticities from meta-analyses conducted a decade ago [ 23 , 24 , 25 , 27 ] when compared with direct estimates of interrupted time-series analyses. However, more recent meta-analyses showed similar values [ 33 ]. Finally, all models were based on relative risks derived from meta-analyses for dose–response relationships [ 34 ], and these could pose challenges when applied to reductions in drinking and its consequences.…”

Alcoholic beverage types consumed by population subgroups in the United States: Implications for alcohol policy to address health disparities

“…Importantly, we found that high‐level and very‐high‐level drinkers, who constituted less than 10% of all drinkers, were likely to drink over half of total volume of beer, coolers and liquor consumed by all adult drinkers. A large body of literature has demonstrated the effectiveness of alcohol price and tax increases in reducing alcohol consumption [33] and alcohol‐related morbidity and mortality [34]. Heavy drinkers are more likely to purchase cheaper alcohol than other drinkers [35] and to show the steepest decline in consumption levels when prices increase given their high baseline consumption [36].…”

A public health perspective on mitigating the global burden of chronic liver disease

“…Excise taxes for alcohol are a powerful tool to do so. Increased tax has been shown to be associated with reductions in consumption, 47 attributable harm, 48 and marked reductions in cirrhosis mortality 49 . The impact of taxation ultimately depends on the degree of price increase, with a 3% to 7% reduction in consumption expected with every 10% increase in the price of alcohol-associated beverages, and are similar across low-income, middle-income, and high-income countries 47 .…”

“…Increased tax has been shown to be associated with reductions in consumption, 47 attributable harm, 48 and marked reductions in cirrhosis mortality 49 . The impact of taxation ultimately depends on the degree of price increase, with a 3% to 7% reduction in consumption expected with every 10% increase in the price of alcohol-associated beverages, and are similar across low-income, middle-income, and high-income countries 47 . A WHO study 50 on the potential of increasing taxation in 16 countries spanning low-income, middle-income, and high-income settings indicated that increasing current alcohol taxes by 50% had low costs (< International $0.10 per capita) and a highly favorable cost-to-effect ratio (< International $100 per healthy life year gained in both low-income and high-income settings).…”