Deaths Fall When Alcohol Price Increases

Drop in alcohol related deaths by nearly a third follows minimum alcohol price increase of 10%

A new study made available online today in ‘Addiction’ shows that, between 2002 and 2009, the percentage of deaths caused by alcohol in British Columbia, Canada dropped more than expected when minimum alcohol price was increased, while alcohol-related deaths increased when more private alcohol stores were opened. The paper has significant implications for international alcohol policy.

The study was carried out by researchers from British Columbia, the westernmost province in Canada, using three categories of death associated with alcohol – wholly alcohol attributable (AA), acute, and chronic*, analysing death rates across the time period against increases in government set minimum prices of alcohol drinks.

The study was complicated by another provincial policy which allowed partial privatisation of alcohol retail sales, resulting in a substantial expansion of alcohol stores.  Previously, alcohol could only be sold directly to the public in government owned stores, unlike in Europe where it is widely available in supermarkets, off-licences and petrol stations.  The researchers therefore had to both control for the effects of the wider availability of alcohol, and assess what effect this measure had on mortality rates.

The major finding was that increased minimum alcohol prices were associated with immediate, substantial and significant reductions in wholly AA deaths:

A 10% increase in the average minimum price for all alcoholic beverages was associated with a 32% reduction in wholly AA deaths

Some of the effect was also detected up to a year after minimum price increases

Significant reductions in chronic and total AA deaths were detected between two and three years after minimum price increases

A 10% increase in private liquor stores was associated with a 2% increase in acute, chronic, and total AA mortality rates

This overall drop in deaths was more than expected, and disproportionate to the size of the minimum price increase – a minimum price increase of 1% was associated with a mortality decline of more than 3%.

The authors suggest that the reason for the reduction in mortality is that increasing the price of cheaper drinks reduces the consumption of heavier drinkers who prefer these drinks. They note that other research has also suggested that impacts on some types of mortality may be delayed by one or two years after price increases.

Dr Tim Stockwell, director of the University of Victoria’s Centre for Addictions Research of British Columbia and a lead author, said “This study adds to the scientific evidence that, despite popular opinion to the contrary, even the heaviest drinkers reduce their consumption when minimum alcohol prices increase. It is hard otherwise to explain the significant changes in alcohol-related deaths observed in British Columbia.”

Zhao J, Stockwell T, Martin G, Macdonald S, Vallance K, Treno A, Ponicki W, Tu A, and Buxton J. (2013) The relationship between changes to minimum alcohol prices, outlet densities and alcohol attributable deaths in British Columbia in 2002-2009. Addiction, 108: doi:  10.1111/add.12139

* Wholly alcohol attributable deaths included the following: poisonings due to alcohol, alcoholic psychoses, alcohol dependence, alcohol abuse, alcoholic cardiomyopathy, alcoholic gastritis, chronic pancreatitis (alcohol induced), fetal alcohol syndrome and excess alcohol blood level; acute alcohol attributable deaths comprised mainly injuries whether caused intentionally or unintentionally while chronic alcohol attributable deaths were those caused by alcohol-related illnesses such as liver cirrhosis and various cancers (e.g. cancers of the mouth, oesophagus, stomach, colon and breast). These types of diagnosis were determined from the underlying cause of death identified on the death certificates.

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