{"id":673,"date":"2015-04-15T11:00:52","date_gmt":"2015-04-15T11:00:52","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/?p=673"},"modified":"2017-08-21T09:51:14","modified_gmt":"2017-08-21T09:51:14","slug":"primary-care-corner-with-geoffrey-modest-md-raise-the-alcohol-tax","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmjebmspotlight\/2015\/04\/15\/primary-care-corner-with-geoffrey-modest-md-raise-the-alcohol-tax\/","title":{"rendered":"Primary Care Corner with Geoffrey Modest MD: Raise the alcohol tax!"},"content":{"rendered":"

By: Dr. Geoffrey Modest<\/strong><\/p>\n

An article was just published in the Washington\u00a0Post\u00a0arguing for an increase in the alcohol tax (see here\u200b<\/a>).<\/p>\n

\"Untitled\"<\/a><\/p>\n

They make the following points:<\/p>\n

–There has been a remarkable\u00a0cheapening of alcohol: a 10-drink\/day drinker in 1950 had to spend 45% of their disposable income on the alcohol. today it is 3%.<\/p>\n

–Taxes have fallen dramatically: in today’s dollars, the federal tax on\u00a0a shot of 80-proof whiskey was 90 cents\u00a0in 1951, now it’s 13 cents (7-fold decrease). Beer tax has decreased 5-fold.<\/p>\n

–Cigarettes, in contrast, have less political support and have had record high taxes (and significantly\u00a0decreasing consumption)<\/p>\n

There is a voluminous\u00a0literature finding that increased alcohol prices through state\/national taxes decrease\u00a0alcohol consumption, alcohol-related morbidity and mortality, and alcohol-related harmful social interactions (violent assaults, drunk-driving, sexually-transmitted\u00a0infections). A\u00a0few studies have been\u00a0published looking at the effects of a small\u00a0alcohol tax increase in Illinois in 2009, where\u00a0the tax\u00a0on beer was increased\u00a0by 4.6 cents\/gallon, wine by 66 cents\/gallon, and distilled spirits by $4.05\/gallon.\u00a0\u00a0In one study\u00a0researchers\u00a0looked at the relationship between this\u00a0tax increase\u00a0and sexually transmitted infection (STI)\u00a0morbidity, finding that state-wide rates of gonorrhea decreased 21%\u00a0(3506 fewer infections)\u00a0and chlamydia decreased 11%\u00a0(5844\u00a0fewer infections); these decreases were (not surprisingly)\u00a0highest among 25-29 year olds (see\u00a0Addiction\u00a02014;\u00a0109:\u00a0904\u2013912).\u00a0In a study\u00a0just published\u00a0on-line in the Am J Public Health\u00a0this group also looked at fatal car crashes, finding that the tax increase was associated with a 26% decrease in fatal alcohol-related car crashes (decreased 9.9\/month), with a striking 37% decrease in those <30 yo. Similar reductions were found\u00a0in those with alcohol levels <0.15 grams\/dl (-22%) vs higher (-25%), and there was no significant gend\u200ber or race differences. They controlled for weather, traffic law enforcement, safety policies, and compared their results to those of neighboring Wisconsin where there was no\u00a0tax increase.\u00a0Of note, alcohol-related car crashes account for 10K deaths and 500K injuries per year in the US.<\/p>\n

So,\u00a0there have been lots of studies in the public health journals showing that taxes lead to lower levels of\u00a0harmful-substance use and fewer medical and social consequences. Even with the seemingly paltry tax increase in Illinois, there were pretty dramatic decreases in alcohol-related fatal car crashes and\u00a0STIs. None of this is surprising. There have been very old observations (eg Prohibition in the US, German seizure of alcohol in France in World War II, Gorbachev’s anti-alcohol campaign in Russia) leading to major decreases in liver cirrhosis mortality, typically within 6-12 months. This all\u00a0highlights the major health improvement attributable to\u00a0decreasing alcohol consumption. Seems pretty clear that the current trend in effectively decreasing alcohol taxes\/cost is wrong-headed, though unfortunately\u00a0there are powerful political lobbies in the US which\u00a0will make it difficult to change this…. (oh, wouldn’t it\u00a0be great if public health concerns had a bit more of a role in determining policy??).\u200b<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

By: Dr. Geoffrey Modest An article was just published in the Washington\u00a0Post\u00a0arguing for an increase in the alcohol tax (see here\u200b). They make the following points: –There has been a remarkable\u00a0cheapening of alcohol: a 10-drink\/day drinker in 1950 had to spend 45% of their disposable income on the alcohol. today it is 3%. –Taxes have […]<\/p>\n

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