Effect of Maryland's 2011 Alcohol Sales Tax Increase on Alcohol-Positive Driving.
BACKGROUND
The 2011 Maryland alcohol sales tax increase from 6% to 9% provided an opportunity to evaluate the impact on rates of alcohol-positive drivers involved in injury crashes.


METHODS
Maryland police crash reports from 2001 to 2013 were analyzed using an interrupted time series design and a multivariable analysis employing generalized estimating equations models with a negative binomial distribution. Data were analyzed in 2014-2015.


RESULTS
There was a significant gradual annual reduction of 6% in the population-based rate of all alcohol-positive drivers (p<0.03), and a 12% reduction for drivers aged 15-20 years (p<0.007), and 21-34 years (p<0.001) following the alcohol sales tax increase. There were no significant changes in rates of alcohol-positive drivers aged 35-54 years (rate ratio, 0.98; 95% CI=0.89, 1.09). Drivers aged ≥55 years had a significant immediate 10% increase in the rate of alcohol-positive drivers (rate ratio, 1.10; 95% CI=1.04, 1.16) and a gradual increase of 4.8% per year after the intervention. Models using different denominators and controlling for multiple factors including a proxy for unmeasured factors found similar results overall.


CONCLUSIONS
The 2011 Maryland alcohol sales tax increase led to a significant reduction in the rate of all alcohol-positive drivers involved in injury crashes especially among drivers aged 15-34 years. This is the first study to examine the impact of alcohol sales taxes on crashes; previous research focused on excise tax. Increasing alcohol taxes is an important but often neglected intervention to reduce alcohol-impaired driving.
Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland; National Study Center for Trauma and EMS, University of Maryland, Baltimore, Maryland. Electronic address: marieclavoie@gmail.com.
Marie-Claude
MC
Lavoie
Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland.
Patricia
P
Langenberg
Social, Urban, Rural & Resilience Global Practice, World Bank, Washington, District of Columbia; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina.
Andres
A
Villaveces
Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland; National Study Center for Trauma and EMS, University of Maryland, Baltimore, Maryland.
Patricia C
PC
Dischinger
School of Pharmacy, University of Maryland, Baltimore, Maryland.
Linda
L
Simoni-Wastila
Francis King Carey School of Law, University of Maryland, Baltimore, Maryland.
Kathleen
K
Hoke
Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland; National Study Center for Trauma and EMS, University of Maryland, Baltimore, Maryland; School of Public Health, West Virginia University, Morgantown, West Virginia.
Gordon S
GS
Smith
D000063:Accidents, Traffic / Q000706:statistics & numerical data* / Q000639:trends; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000066448:Driving Under the Influence / Q000517:prevention & control / Q000706:statistics & numerical data* / Q000639:trends; D000431:Ethanol / Q000009:adverse effects / Q000191:economics*; D005260:Female; D006801:Humans; D065186:Interrupted Time Series Analysis; D008297:Male; D008396:Maryland; D008875:Middle Aged; D015999:Multivariate Analysis; D013660:Taxes; D055815:Young Adult
D000431:Ethanol