title: Mortality from traumatic brain injury after reduction of alcohol prices: a population-based study from northern Finland.
abstract: OBJECTIVE
  Traumatic brain injury (TBI) is the leading cause of death after trauma, and alcohol is a major risk factor for TBI. In Finland, alcohol taxes were cut by one third in 2004. This resulted in a marked increase of alcohol consumption. We investigated whether increased alcohol consumption influenced the number of fatal TBIs.
  
  
  METHODS
  All (n = 318) fatal TBIs were identified from medico-legal reports during the years 1999, 2006 and 2007 among the residents of Oulu Province, Finland. Mortality rates were compared before and after alcohol price reduction. Alcohol involvement based on the presence of alcohol in body fluids and/or alcohol-related diseases recorded in death certificates.
  
  
  RESULTS
  The proportion of alcohol-related TBI deaths of all TBI deaths increased (from 1999 to 2007) among middle-aged people from 48% to 91% (p = 0.001) but decreased among young adults from 74% to 41% (p = 0.015). The overall TBI mortality rate did not increase. Fatal TBIs due to falls were significantly more commonly alcohol-related in 2006-2007 than in 1999 (p = 0.003) and accumulated among middle-aged people.
  
  
  CONCLUSIONS
  After the price reduction, alcohol-related fatal TBIs increased most among middle-aged people, and they were frequently caused by fall accidents. The reduction of alcohol prices did not increase the total number of fatal TBIs. Middle-aged and elderly subjects with TBI should be routinely asked for alcohol drinking and those with hazardous drinking habits should be guided for alcohol intervention.
authors.affiliation: Department of Neurology, Oulu University Hospital, Finland. jpuljula@paju.oulu.fi
authors.forename: Jussi
authors.initials: J
authors.lastname: Puljula
authors.forename: Saara
authors.initials: S
authors.lastname: Lesonen
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Kortelainen
authors.forename: Seppo
authors.initials: S
authors.lastname: Juvela
authors.forename: Matti
authors.initials: M
authors.lastname: Hillbom
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D019973:Alcohol-Related Disorders / Q000401:mortality*; D000434:Alcoholic Beverages / Q000191:economics*; D001930:Brain Injuries / Q000401:mortality*; D003132:Commerce / Q000706:statistics & numerical data*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: alcohol consumption; alcohol prices; cause of death; mortality; traumatic brain injury