Stern alcohol policies fail to improve public health
New research found that the severity of alcohol policy had no association with the number of disability-adjusted life years (DALYs) lost due to alcohol in 30 OECD countries in 2005 nor with alcohol consumption (Table, Figure). DALYs are the most comprehensive measure of public health. DALYs are composites of the number of years lost due to ill-health, disability and premature death. The rate of excise tax on alcoholic beverages was not related to alcohol-related DALYs (25 countries with tax rate data).
The severity of a country’s alcohol control policies was gauged by Alcohol Policy Index, a composite indicator comprising regulations from five policy domains: availability (restrictions to access) of alcohol, drinking context, alcohol prices, alcohol advertising, and motor vehicle driving restrictions. These policies have been sponsored by the World Health Organization in the hope of decreasing the adverse effects of alcohol.
The new findings strongly disagree with the prevailing theory, called the total consumption model. The latter forecasts that alcohol-related harms will diminish if the population total alcohol consumption is reduced by increasing the price, lessening availability and controlling the marketing of the beverages. A stern alcohol policy is defined by a high price level and restricted availability of alcohol beverages. Current policy recommendations are often based on this model. Some evidence suggests that stern alcohol policies really can decrease the total alcohol consumption. The weakness of the total consumption model is, however, that all drinkers are assumed to decrease both their consumption and health risks approximately in proportion of the amount of alcohol consumed. Drinking patterns are ignored. In fact, when policy becomes more stringent moderate drinkers are likely to decrease their drinking. Heavy drinkers and alcoholics are less sensitive to severe control measures. Therefore, strict policies may bring about fewer health benefits to moderate drinkers but make little change in the health of alcoholics. In the worst case, stringent alcohol policies can lead to counterproductive effects, such as illicit trade and moon-shining as well as consuming industrial alcohol products that have high toxicity, thus killing more alcoholics. More efforts is called for to reduce alcohol dependence and promote moderate drinking.
Department of Public Health, University of Helsinki, Finland
The Weakness of Stern Alcohol Control Policies.
Alcohol Alcohol. 2015 Jul 6