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Alcohol taxes protective against binge drinking, study shows

Boston University Medical Center

Higher alcohol taxes strongly protect against binge drinking, according to a new study by Boston University School of Public Health (BUSPH) researchers.

The study, published in the journal Addiction, found that a one-percent increase in alcohol beverage prices from taxes was associated with a 1.4 percent decrease in the proportion of adults who binge drink. Most previous studies have examined the effect of taxes on average consumption, while the effect of taxes on high-level drinking has been controversial.

"This is really significant for public health," said lead author Ziming Xuan, assistant professor of community health sciences at BUSPH, explaining that binge drinking causes more than half of nearly 90,000 alcohol-attributable deaths in the U.S. each year, and accounts for three-quarters of the $224 billion in annual economic costs.

The study shows that as combined alcohol taxes rise, binge drinking rates fall. Taxes accounted for approximately 20 percent of the difference in binge drinking prevalence rates across U.S. states.

The state with the highest beer combined taxes - Tennessee--had the lowest binge drinking rate (6.6 percent) in 2010, while states with low alcohol taxes, such as Montana, Wisconsin and Delaware, had relatively high binge drinking rates.

Binge drinking was defined as consuming five or more drinks for men, or four or more drinks for women, per occasion. The percentage of adults who reported binge drinking in U.S. states was based on data from the Behavioral Risk Factor Surveillance System surveys from 2000-2010.

The study also found that a new measure that combines both volume-based and value-based taxes on alcohol was associated with a stronger preventive effect on binge drinking and produced more precise statistical results, compared to the conventional use of only volume-based excise taxes. Using the comprehensive measure, taxes had about twice the impact on binge drinking, compared to using only excise taxes.

Xuan and co-author Dr. Timothy Naimi, associate professor of the BU Schools of Medicine and Public Health and senior author of the study, said many previous U.S. studies might be underestimating the effect of higher taxes on reducing alcohol consumption. They said their study demonstrates a key vulnerability of volume-based taxes: their erosion over time due to inflation. Such taxes are levied as a fixed dollar amount per unit volume, rather than as a percentage of price.

"This study emphasizes the importance of assessing multiple co-existing tax types -- and possibly tax structure -- for characterizing the relationship between tax and related outcomes, evaluating the effects of tax policy interventions, and for planning tax policy interventions," the researchers said.

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The study was supported by a grant from the National Institutes of Health. Researchers from the Department of Economics and Institute for Health Research and Policy, University of Illinois, and the Division of Epidemiology and Community Health, University of Minnesota School of Public Health contributed to the study.

The full study is available at: http://onlinelibrary.wiley.com/doi/10.1111/add.12818/full

The Boston University School of Public Health, founded in 1976, offers master's and doctoral-level education in eight public health concentrations including biostatistics, environmental health, epidemiology, health law, bioethics & human rights; health policy & management, international health, and social & behavioral sciences. The faculty conducts policy-changing public health research around the world with the mission of improving the health of populations, especially the disadvantaged, underserved and vulnerable, locally, nationally and internationally.

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