title: Effects of alcohol retail privatization on excessive alcohol consumption and related harms: a community guide systematic review.
abstract: BACKGROUND
  Excessive alcohol consumption is the third-leading cause of preventable death in the U.S. This systematic review is one in a series exploring effectiveness of interventions to reduce alcohol-related harms.
  
  
  METHODS
  The focus of this review was on studies evaluating the effects of the privatization of alcohol retail sales on excessive alcohol consumption and related harms. Using Community Guide methods for conducting systematic reviews, a systematic search was conducted in multiple databases up to December 2010. Reference lists of acquired articles and review papers were also scanned for additional studies.
  
  
  RESULTS
  A total of 17 studies assessed the impact of privatizing retail alcohol sales on the per capita alcohol consumption, a well-established proxy for excessive alcohol consumption; 9 of these studies also examined the effects of privatization on the per capita consumption of alcoholic beverages that were not privatized. One cohort study in Finland assessed the impact of privatizing the sales of medium-strength beer (MSB) on self-reported alcohol consumption. One study in Sweden assessed the impact of re-monopolizing the sale of MSB on alcohol-related harms. Across the 17 studies, there was a 44.4% median increase in the per capita sales of privatized beverages in locations that privatized retail alcohol sales (interquartile interval: 4.5% to 122.5%). During the same time period, sales of nonprivatized alcoholic beverages decreased by a median of 2.2% (interquartile interval: -6.6% to -0.1%). Privatizing the sale of MSB in Finland was associated with a mean increase in alcohol consumption of 1.7 liters of pure alcohol per person per year. Re-monopolization of the sale of MSB in Sweden was associated with a general reduction in alcohol-related harms.
  
  
  CONCLUSIONS
  According to Community Guide rules of evidence, there is strong evidence that privatization of retail alcohol sales leads to increases in excessive alcohol consumption.
authors.affiliation: Community Guide Branch, Epidemiology and Analysis Program Office, CDC, Atlanta, Georgia 30333, USA. rhahn@cdc.gov
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hahn
authors.forename: Jennifer Cook
authors.initials: JC
authors.lastname: Middleton
authors.forename: Randy
authors.initials: R
authors.lastname: Elder
authors.forename: Robert
authors.initials: R
authors.lastname: Brewer
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fielding
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Naimi
authors.forename: Traci L
authors.initials: TL
authors.lastname: Toomey
authors.forename: Sajal
authors.initials: S
authors.lastname: Chattopadhyay
authors.forename: Briana
authors.initials: B
authors.lastname: Lawrence
authors.forename: Carla Alexia
authors.initials: CA
authors.lastname: Campbell
mesh_terms: D000428:Alcohol Drinking / Q000191:economics / Q000453:epidemiology* / Q000331:legislation & jurisprudence; D019973:Alcohol-Related Disorders / Q000453:epidemiology / Q000517:prevention & control*; D000434:Alcoholic Beverages / Q000191:economics / Q000600:supply & distribution*; D003132:Commerce / Q000331:legislation & jurisprudence; D005387:Finland / Q000453:epidemiology; D006801:Humans; D011332:Privatization; D013548:Sweden / Q000453:epidemiology