title: What happens to drinking when alcohol policy changes? A review of five natural experiments for alcohol taxes, prices, and availability.
abstract: Natural experiments are an important alternative to observational and econometric studies. This paper provides a review of results from empirical studies of alcohol policy interventions in five countries: Denmark, Finland, Hong Kong, Sweden, and Switzerland. Major policy changes were removal of quotas on travelers' tax-free imports and reductions in alcohol taxes. A total of 29 primary articles are reviewed, which contain 35 sets of results for alcohol consumption by various subpopulations and time periods. For each country, the review summarizes and examines: (1) history of tax/quota policy interventions and price changes; (2) graphical trends for alcohol consumption and liver disease mortality; and (3) empirical results for policy effects on alcohol consumption and drinking patterns. We also compare cross-country results for three select outcomes-binge drinking, alcohol consumption by youth and young adults, and heavy consumption by older adults. Overall, we find a lack of consistent results for consumption both within- and across-countries, with a general finding that alcohol tax interventions had selective, rather than broad, impacts on subpopulations and drinking patterns. Policy implications of these findings are discussed.
authors.affiliation: Pennsylvania State University, 609 Kern Building, University Park, PA, 16802-3306, USA. jpn@psu.edu.
authors.forename: Jon P
authors.initials: JP
authors.lastname: Nelson
authors.affiliation: , Centre Hall, PA, 16828, USA.
authors.forename: Amy D
authors.initials: AD
authors.lastname: McNall
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000009:adverse effects / Q000191:economics* / Q000453:epidemiology*; D003132:Commerce / Q000191:economics; D003431:Cross-Cultural Comparison; D005260:Female; D019649:Food Industry / Q000191:economics*; D006291:Health Policy / Q000191:economics; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D017678:Sex Distribution; D013557:Switzerland / Q000453:epidemiology; D013660:Taxes; D055815:Young Adult
keywords: Alcohol policy; Alcohol taxes; Determinants of drinking; Drinking patterns