title: Alcopops, taxation and harm: a segmented time series analysis of emergency department presentations.
abstract: BACKGROUND
  In Australia, a Goods and Services Tax (GST) introduced in 2000 led to a decline in the price of ready-to-drink (RTD) beverages relative to other alcohol products. The 2008 RTD ("alcopops") tax increased RTD prices. The objective of this study was to estimate the change in incidence of Emergency Department (ED) presentations for acute alcohol problems associated with each tax.
  
  
  METHODS
  Segmented regression analyses were performed on age and sex-specific time series of monthly presentation rates for acute alcohol problems to 39 hospital emergency departments across New South Wales, Australia over 15 years, 1997 to 2011. Indicator variables represented the introduction of each tax. Retail liquor turnover controlled for large-scale economic factors such as the global financial crisis that may have influenced demand. Under-age (15-17 years) and legal age (18 years and over) drinkers were included.
  
  
  RESULTS
  The GST was associated with a statistically significant increase in ED presentations for acute alcohol problems among 18-24 year old females (0 · 14/100,000/month, 95% CI 0 · 05-0 · 22). The subsequent alcopops tax was associated with a statistically significant decrease in males 15-50 years, and females 15-65 years, particularly in 18-24 year old females (-0 · 37/100,000/month, 95% CI -0 · 45 to -0 · 29). An increase in retail turnover of liquor was positively and statistically significantly associated with ED presentations for acute alcohol problems across all age and sex strata.
  
  
  CONCLUSIONS
  Reduced tax on RTDs was associated with increasing ED presentations for acute alcohol problems among young women. The alcopops tax was associated with declining presentations in young to middle-aged persons of both sexes, including under-age drinkers.
authors.affiliation: Public Health Officer Training Program, New South Wales Ministry of Health and School of Public Health and Community Medicine, University of New South Wales, 73 Miller Street, North Sydney, NSW, 2060, Australia. mgale@doh.health.nsw.gov.au.
authors.forename: Marianne
authors.initials: M
authors.lastname: Gale
authors.affiliation: New South Wales Ministry of Health and School of Public Health and Community Medicine, University of New South Wales, 73 Miller Street, North Sydney, NSW, 2060, Australia. dmusc@doh.health.nsw.gov.au.
authors.forename: David J
authors.initials: DJ
authors.lastname: Muscatello
authors.affiliation: Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Missenden Road, Camperdown, NSW, 2050, Australia. dinh.mm@gmail.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Dinh
authors.affiliation: Centre for Applied Health Economics School of Medicine, Griffith University, Meadowbrook, QLD, 4131, Australia. j.byrnes@griffith.edu.au.
authors.forename: Joshua
authors.initials: J
authors.lastname: Byrnes
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia. a.shakeshaft@unsw.edu.au.
authors.forename: Anthony
authors.initials: A
authors.lastname: Shakeshaft
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, 2052, Australia. a.hayen@unsw.edu.au.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hayen
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, 2052, Australia. r.macintyre@unsw.edu.au.
authors.forename: Chandini Raina
authors.initials: CR
authors.lastname: MacIntyre
authors.affiliation: Royal Prince Alfred Hospital and Sydney Medical School, University of Sydney, Missenden Road, Camperdown, NSW, 2050, Australia. paul.haber@sydney.edu.au.
authors.forename: Paul
authors.initials: P
authors.lastname: Haber
authors.affiliation: New South Wales Ministry of Health, 73 Miller Street, North Sydney, NSW, 2060, Australia. mcret@doh.health.nsw.gov.au.
authors.forename: Michelle
authors.initials: M
authors.lastname: Cretikos
authors.affiliation: New South Wales Ministry of Health, 73 Miller Street, North Sydney, NSW, 2060, Australia. pmort@doh.health.nsw.gov.au.
authors.forename: Patricia
authors.initials: P
authors.lastname: Morton
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000331:legislation & jurisprudence* / Q000517:prevention & control; D019973:Alcohol-Related Disorders / Q000453:epidemiology* / Q000628:therapy; D000434:Alcoholic Beverages / Q000191:economics* / Q000706:statistics & numerical data; D001315:Australia / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013660:Taxes / Q000191:economics*; D055815:Young Adult