title: Decreased taxation, spirits consumption and alcohol-related problems in Switzerland.
abstract: OBJECTIVE
  The spirits market in Switzerland was reformed in 1999 in accordance with the World Trade Organization agreement. The resulting tax reform and increased competition have resulted in markedly reduced prices for foreign spirits, and a previous study showed that spirits consumption increased significantly after the tax reform. The present study examined whether alcohol-related problems also increased at follow-up and if they did, whether the increase was the result of increased spirits consumption. Further correlates of alcohol-related problems were also explored.
  
  
  METHODS
  Data were obtained from a longitudinal study on changes in alcohol consumption in Switzerland. The baseline survey was conducted 3 months before the tax reform, and the follow-up was conducted 28 months after the tax reform. A randomly selected sample of 4,007 residents aged 15 years or older participated in the baseline survey, and 73% of this sample participated in the follow-up survey. Alcohol consumption was measured on the basis of a graduated frequency, and alcohol-related problems were measured by items taken from the Alcohol Use Disorder Identification Test (AUDIT).
  
  
  RESULTS
  Findings indicate that alcohol-related problems increased significantly at follow-up. The significance disappeared, however, after controlling for spirits consumption, indicating that the increase of alcohol-related problems at follow-up was mainly mediated through increased consumption of spirits. The multiple regression models showed that spirits, beer and wine consumption, gender, Age*Spirits Consumption interaction, region, smoking status, heavy-drinking frequency and average number of drinks were significant correlates of alcohol-related problems.
  
  
  CONCLUSIONS
  Alcohol-related problems increased at the follow-up, particularly among younger age groups who consumed more spirits. Prevention programs on alcohol-related problems should target young people.
authors.affiliation: Addiction Research Institute (ISF), Konradstrasse 32, Postfach 8031 Zürich, Switzerland. mmohler@isf.unizh.ch
authors.forename: Meichun
authors.initials: M
authors.lastname: Mohler-Kuo
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rehm
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Heeb
authors.forename: Gerhard
authors.initials: G
authors.lastname: Gmel
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D019973:Alcohol-Related Disorders / Q000453:epidemiology*; D003710:Demography; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013557:Switzerland / Q000453:epidemiology; D013660:Taxes / Q000706:statistics & numerical data*