Choosing between different alcohol pricing and taxation strategies: a comparative policy appraisal using the Sheffield Alcohol Policy Model

BackgroundPolicies that increase alcohol prices effectively reduce alcohol consumption, one of the top three risk factors for global disease burden. Our aim was to appraise how different alcohol pricing policies balance competing priorities.MethodsWe built an econometric dynamic epidemiological model for England, combining survey and register data on alcohol purchasing, consumption, and 43 harms, and published price elasticities, relative risk, and alcohol attribution. We model five hypothetical taxation options each estimated to give a 10% reduction in average consumption: P1, a uniform 85% increase in existing duty; P2, a 22% sales tax based on product price; P3, a £0·35 per unit volumetric tax; P4, a £0·80 minimum unit price (MUP); P5, a £0·75 MUP with a volumetric tax of £0·30. Outcomes were consumption, annual alcohol-related deaths, hospital admissions, health-care costs, consumer spending, and government revenue. Uncertainty was assessed through sensitivity analyses.FindingsPopulation level health harm-reductions would be highest for increases in the present tax system (P1: deaths ?3026, hospital admissions ?179 000, health-care costs ?£583 million) and for the MUP (P4: ?3081, ?169 000, ?£574 million), and lowest for the sales tax (P2: ?2852, ?168 000, ?£575 million). Harm reductions in high-risk drinkers would be highest for the two MUP options (P4: deaths ?1764, hospital admissions ?84 000, health care ?£218 million; P5: ?1712, ?78 000, ?£205 million), and lowest for sales tax (P2: ?1267, ?64 000, ?£159 million). The overall greatest burden on consumer spending would be from a duty increase under the present system (P1 £3·2 million), and the lowest from a volumetric tax (P3 £2·0 million). The smallest extra annual expenditure for each moderate drinker would be achieved by MUP (P4 £17·80), whereas the largest extra expenditure would be from a tax rise in the present system (P2 £37·20). With the exception of the MUP-only policy, which would have a small negative effect on government revenue from alcohol (P4: 1·3%, ?£121 million), all taxation policies would raise government revenue, by between £1·9 billion and £4·2 billion per year.InterpretationPricing policies can be implemented in ways that balance the priorities of increasing government revenue, maximising harm reductions, and targeting heavy drinkers, while protecting moderate consumers from excessive burden.FundingMedical Research Council and Economic and Social Research Council (grant G1000043).     

Botswana alcohol policy and the presidential levy controversy

Aim To assess the state of alcohol policy in Botswana in the context of a substantial levy imposed on alcohol sales by the President. Design, measurements Analysis of policy documents and media reports to describe the drivers of policy formation. Setting, participants Botswana. Findings Legislation aimed at addressing the problem of excessive consumption of alcohol in the country has been proposed and enacted since independence in 1966 and a draft national alcohol policy is currently being debated. The policy recognizes the need to protect the rights of adult citizens of Botswana to purchase and consume alcohol in a safe and well‐regulated manner and the role of government in ensuring that vulnerable members of the community are protected against the impact of harmful use of alcohol. In 2008, controversy erupted over the proposal by the President of the country to impose a 70% levy on alcohol products, later reduced to 30%. The industry responded by threatening to go to court and has since focused their response on what they claim to be serious economic losses due to reduced consumption of their products. Conclusions The ongoing controversy in Botswana calls attention to the role of the industry in influencing the debate on alcohol and the need to keep in mind overall public health interest in efforts to develop and implement a national alcohol policy.     

DNA microarray and proteomic strategies for understanding alcohol action

This article summarizes the proceedings of a symposium presented at the 2005 annual meeting of the Research Society on Alcoholism in Santa Barbara, California. The organizer was James M. Sikela, and he and Michael F. Miles were chairs. The presentations were (1) Genomewide Surveys of Gene Copy Number Variation in Human and Mouse: Implications for the Genetics of Alcohol Action, by James M. Sikela; (2) Regional Differences in the Regulation of Brain Gene Expression: Relevance to the Detection of Genes Associated with Alcohol-Related Traits, by Robert Hitzemann; (3) Identification of Ethanol Quantitative Trait Loci Candidate Genes by Expression Profiling in Inbred Long Sleep/Inbred Short Sleep Congenic Mice, by Robnet T. Kerns; and (4) Quantitative Proteomic Analysis of AC7-Modified Mice, by Kathleen J. Grant.