Altering alcohol price by ethanol content: results from a Swedish tax policy in 1992

In July 1992, the Swedish alcohol retail monopoly reset the taxes for alcohol sold in state stores according to absolute alcohol content. This provided a unique opportunity to examine the effects on alcohol sales within the three beverage classes (beer, wine and spirits) in a situation where price is purposely linked to alcohol content. The most notable effects of the taxation change were a substantial compression of the range of prices for spirits and wine and a corresponding expansion of the price spectrum for beer. Consumers appear to have responded to these tax changes by shifting away from beverage brands that became relatively more expensive. These results suggest that alcohol policy strategies to reduce total alcohol consumption should consider the entire price/quality spectrum as well as differences in absolute alcohol per volume across the three alcohol beverage types.     

The price of alcohol: a consideration of contextual factors

BACKGROUND: The current study considers the determinants of prices charged for alcoholic beverages by on-premise and off-premise outlets in Alaska. Alcohol outlet densities, a surrogate measure for local retail competition, are expected to be negatively associated with prices while costs associated with distribution are expected to be positively related to prices. Community demographic and economic characteristics may affect observed local prices via the level of demand, retail costs borne by retailers, or the quality of brands offered for sale. METHODS: The core data for these analyses came from a telephone survey of Alaskan retail establishments licensed to serve alcohol. This survey utilized computer-assisted telephone interviewing (CATI) techniques to collect alcohol-pricing information from on-premise (i.e., establishments where alcohol is consumed at the point of purchase such as bars and restaurants) and off-premise (i.e., establishments such as grocery stores and convenience markets where consumption occurs in other locations) alcohol retailers throughout the state of Alaska. Price estimates were developed for each beverage-type based on alcohol content. Separate regression analyses were used to model each of the 8 price indices (on-premise and off-premise measures for beer, spirits, wine, and the average price across beverage types). All regressions also controlled for a set of zip-code level indicators of community economic and demographic characteristics based on census data. RESULTS: Outlet density per roadway mile was unrelated to price for both on- and off-premise establishments, either across or between beverage types. In contrast, overall distribution costs did appear to be related to alcohol price. The demographic and economic variables, as a group, were significantly related to observed prices. CONCLUSIONS: More attention needs to be directed to the manner in which sellers and buyers behave relative to alcoholic beverages. Alcohol demand remains responsive to prices; yet, consumers have considerable latitude in determining the price that they pay for alcohol.     

The Relationship of Outlet Densities to Alcohol Consumption: A Time Series Cross-Sectional Analysis

The implementation of regulations on access to alcoholic beverages, whether through beverage taxes or restrictions on the availability of this commodity through alcohol outlets, has often been proposed as a legitimate and politically feasible approach to the prevention of alcohol-related problems. Empirical studies of the effects of these approaches to regulation on alcohol consumption and problems, however, have not been unanimous in their support of these preventive measures. While support exists for the suggestion that increases in alcohol beverage prices reduce consumption and have preventive effects upon the occurrence of problems, relatively little evidence exists for the supposition that the regulation of alcohol availability will have similar preventive effects. The lack of evidence in support of the latter thesis rests primarily upon the difficulty of obtaining sufficient data to examine comprehensive models of access to alcohol.
The current paper analyzes aggregate time series cross-sectional data from states of the U.S. to evaluate the relationships between alcohol beverage prices, availability, and alcohol sales within one analytic model. The model relates beverage prices and alcohol availability directly to alcohol sales in the context of an assumed simultaneous relationship between sales and availability. The results show that, independent of the effects of beverage prices, and controlling for the endogeneity of sales and availability, physical availability of alcohol was directly related to sales of spirits and wine.     

Effects of beverage alcohol price and tax levels on drinking: a meta-analysis of 1003 estimates from 112 studies

Aims We conducted a systematic review of studies examining relationships between measures of beverage alcohol tax or price levels and alcohol sales or self‐reported drinking. A total of 112 studies of alcohol tax or price effects were found, containing1003 estimates of the tax/price–consumption relationship. Design Studies included analyses of alternative outcome measures, varying subgroups of the population, several statistical models, and using different units of analysis. Multiple estimates were coded from each study, along with numerous study characteristics. Using reported estimates, standard errors, t‐ratios, sample sizes and other statistics, we calculated the partial correlation for the relationship between alcohol price or tax and sales or drinking measures for each major model or subgroup reported within each study. Random‐effects models were used to combine studies for inverse variance weighted overall estimates of the magnitude and significance of the relationship between alcohol tax/price and drinking. Findings Simple means of reported elasticities are ?0.46 for beer, ?0.69 for wine and ?0.80 for spirits. Meta‐analytical results document the highly significant relationships (P < 0.001) between alcohol tax or price measures and indices of sales or consumption of alcohol (aggregate‐level r = ?0.17 for beer, ?0.30 for wine, ?0.29 for spirits and ?0.44 for total alcohol). Price/tax also affects heavy drinking significantly (mean reported elasticity = ?0.28, individual‐level r = ?0.01, P < 0.01), but the magnitude of effect is smaller than effects on overall drinking. Conclusions A large literature establishes that beverage alcohol prices and taxes are related inversely to drinking. Effects are large compared to other prevention policies and programs. Public policies that raise prices of alcohol are an effective means to reduce drinking.     

Does minimum pricing reduce alcohol consumption? The experience of a Canadian province

Aims Minimum alcohol prices in British Columbia have been adjusted intermittently over the past 20 years. The present study estimates impacts of these adjustments on alcohol consumption. Design Time–series and longitudinal models of aggregate alcohol consumption with price and other economic data as independent variables. Setting British Columbia (BC), Canada. Participants The population of British Columbia, Canada, aged 15 years and over. Measurements Data on alcohol prices and sales for different beverages were provided by the BC Liquor Distribution Branch for 1989–2010. Data on household income were sourced from Statistics Canada. Findings Longitudinal estimates suggest that a 10% increase in the minimum price of an alcoholic beverage reduced its consumption relative to other beverages by 16.1% (P < 0.001). Time–series estimates indicate that a 10% increase in minimum prices reduced consumption of spirits and liqueurs by 6.8% (P = 0.004), wine by 8.9% (P = 0.033), alcoholic sodas and ciders by 13.9% (P = 0.067), beer by 1.5% (P = 0.043) and all alcoholic drinks by 3.4% (P = 0.007). Conclusions Increases in minimum prices of alcoholic beverages can substantially reduce alcohol consumption.     

Estimates of the mean alcohol concentration of the spirits, wine, and beer sold in the United States and per capita consumption: 1950 to 2002

BACKGROUND: Estimates of per capita consumption of alcohol in the United States require estimates of the mean alcohol content by volume (%ABV) of the beer, wine, and spirits sold to convert beverage volume to gallons of pure alcohol. METHODS: The mean %ABV of spirits is estimated for each year from 1950 to 2002 and for each state using the %ABV of major brands and sales of sprits types. The mean %ABV of beer and wine is extrapolated to cover this period based on previous estimates. These mean %ABVs are then applied to alcohol sales figures to calculate new yearly estimates of per capita consumption of beer, wine, spirits, and total alcohol for the United States population aged 15 and older. RESULTS: The mean %ABV for spirits is found to be lower than previous estimates and to vary considerably over time and across states. Resultant per capita consumption estimates indicate that more alcohol was consumed from beer and less from wine and spirits than found in previous estimates. CONCLUSIONS: Empirically based calculation of mean %ABV for beer, wine, and spirits sold in the United States results in different and presumably more accurate per capita consumption estimates than heretofore available. Utilization of the new estimates in aggregate time-series and cross-sectional models of alcohol consumption and related outcomes may improve the accuracy and precision of such models.     

Assessing the potential effectiveness of food and beverage taxes and subsidies for improving public health: a systematic review of prices,demand and body weight outcomes

Taxes and subsidies are increasingly being considered as potential policy instruments to incentivize consumers to improve their food and beverage consumption patterns and related health outcomes. This study provided a systematic review of recent U.S. studies on the price elasticity of demand for sugar‐sweetened beverages (SSBs), fast food, and fruits and vegetables, as well as the direct associations of prices/taxes with body weight outcomes. Based on the recent literature, the price elasticity of demand for SSBs, fast food, fruits and vegetables was estimated to be ?1.21, ?0.52, ?0.49 and ?0.48, respectively. The studies that linked soda taxes to weight outcomes showed minimal impacts on weight; however, they were based on existing state‐level sales taxes that were relatively low. Higher fast‐food prices were associated with lower weight outcomes particularly among adolescents, suggesting that raising prices would potentially impact weight outcomes. Lower fruit and vegetable prices were generally found to be associated with lower body weight outcomes among both low‐income children and adults, suggesting that subsidies that would reduce the cost of fruits and vegetables for lower‐socioeconomic populations may be effective in reducing obesity. Pricing instruments should continue to be considered and evaluated as potential policy instruments to address public health risks.     

Alcohol Availability and the Formal Power and Resources of State Alcohol Beverage Control Agencies

The formal powers and resources of state alcohol beverage control agencies place them in a position to regulate access to alcoholic beverages through restrictions on retail distribution and sales. For example, monopoly states restrict access to spirits, and sometimes wine, by allowing retail sales only through state stores. On the other hand, license and monopoly states share in restricting sales through the use of price posting and fixing provisions. The degree to which these powers are realized in restrictions on alcohol outlets (e.g., licenses) and subsequent alcohol consumption (e.g., sales) was investigated in the current study. In a cross-sectional analysis of data available from 44 alcohol beverage control (ABC) jurisdictions in the United States, it was shown that states with greater restrictions on retail sales had greater resources for the conduct of ABC activities and lower densities of spirit outlets. These states, however, had greater densities of wine and beer outlets. States with greater marketplace restrictions had more resources for ABC enforcement activities and lower outlet densities across all beverage types. Further, supporting the suggestion that availability and demand may be simultaneously related, greater outlet densities were related to greater alcohol consumption (for beer) and greater levels of consumption were related to greater outlet densities (for wine).     

Privatizing alcohol sales and alcohol consumption: evidence and implications

Aim. To provide an overview of recent privatization/deregulation experiences in North America and other settings, in order to draw conclusions about the impacts that might be expected from such changes on rates of alcohol consumption and related problems. Methods. Critical review of research evidence on the effect of changes in availability, particularly changes in physical availability and economic availability that typically accompany privatization of alcohol retail monopolies. Findings. Deregulation/privatization experiences commonly involve higher density of outlets, longer hours or more days of sale, changes in price, a strong orientation to commercial aspects of alcohol sales and the introduction of new vested economic interests into alcohol management arrangements in the jurisdiction. In many instances these changes in access to alcohol are accompanied by an increase in the per capita rates of consumption. In the short term changes in prices are likely to either increase or demonstrate opposite patterns for beverages with different base prices. Longer-term patterns point to a decline in real price with privatization, which very probably stimulates per capita alcohol sales. Conclusion. The existing evaluation literature on the subject of privatization has tended to focus on examining the net short-term results in terms of alcohol consumption levels. Overall, there are too few studies employing adequate statistical methodologies to explore the underlying causes of changing alcohol consumption and alcohol-related harm. Finally, seven specific suggestions that may assist future studies are discussed.     

A Ban of Fortified Wine in Northwestern Ontario and its Impact on the Consumption Level and Drinking Patterns*

This paper examines a ‘natural experiment’ where sixty brands of low-priced domestic fortified wines were removed from stock (i.e., delisted). Ten communities where the brands were delisted were compared to a group of 18 where these brands continued to be available. Changes in consumption levels and beverage preference are examined for the ‘delisted’ and ‘available’ outlets in the two groups of communities in the northwestern region. There was little difference between the delisted and non-delisted group in the overall consumption level although the decline was slightly steeper in the former group. Purchasing of domestic red and rose wines, as well as domestic vodka and Liquor Board alcohol increased in the delisted group. In some instances these wines and spirits may have been used in combination to produce a fortified beverage. Geographic adaption to the restriction was a minor phenomenon in that the increase in consumption of the relevant brands in a non-listed community was a fraction of the reduction in the comparable sales in an adjacent delisted community.     

The Prevention of Alcoholism: Epidemiological Studies of the Effects of Government Control Measures *

Widely used control measures such as the monopoly system and restrictions on the number and type of alcoholic beverage outlets, and on hours of sale appear to be muck less powerful determinants of regional and temporal variation in the prevalence of alcoholism than taxation policy. It is found that where or when Ike price of beverage alcohol relative to average disposable (real) income in high, indices of alcohol consumption and alcoholism are usually low, and vice versa. Differential taxation (involving a disproportionately high tax on spirituous liquors) appears to be effective temporarily, but to result ultimately in the substitution of another beverage source with an increase in consumption and alcohol problems. This is consistent with other evidence which indicates that the overall level of alcohol consumption in a population, regardless of beverage source, determines the prevalence of hazardous consumers and of alcohol–related organic pathologies. The nature of a taxation policy which might be expected to prevent increases, and perhaps achieve a reduction in prevalence is outlined. However, an appropriate program of public education would probably be required in most jurisdictions to render the implementation of the policy fully effective and politically feasible.     

Alcohol Price and Intoxication in College Bars

Background:  Many population studies find that alcohol prices are inversely related to alcohol consumption and alcohol-related problems, including among college students and young adults. Yet, little is known about the "micro-level" effects of alcohol price on the behavior of individual consumers in natural drinking settings such as college bars. Therefore, we assessed patron's cost per gram of ethanol consumed at on-premise drinking establishments and its association with intoxication upon leaving an establishment.
Methods:  On 4 consecutive nights during April 2008, data were collected from 804 patrons exiting 7 on-premise establishments in a bar district located adjacent to a large university campus in the southeastern United States. Anonymous interview and survey data were collected as well as breath alcohol concentration (BrAC) readings. We calculated each patron's expenditures per unit of ethanol consumed based on self-reported information regarding the type, size, number, and cost of consumed drinks.
Results:  A multivariable model revealed that a 10-cent increase in cost per gram of ethanol at on-premise establishments was associated with a 30% reduction in the risk of exiting an establishment intoxicated (i.e., BrAC ≥ 0.08 g/210 l).
Conclusions:  The results are consistent with economic theory and population-level research regarding the price elasticity of alcoholic beverages, which show that increases in alcohol prices are accompanied by less alcohol consumption. These findings suggest that stricter regulation of the drink discounting practices of on-premise drinking establishments would be an effective strategy for reducing the intoxication levels of exiting patrons.     

Alcohol consumption and cardiovascular disease: differential effects in France and Northern Ireland. The PRIME study.

BACKGROUND: The effects of wine and other alcoholic beverages on coronary heart disease (CHD) have seldom been studied in several countries using a common methodology. DESIGN: Five-year prospective study conducted among 9750 men (7352 in France and 2398 in Northern Ireland) free of CHD at entry. Outcomes were angina pectoris, myocardial infarction or CHD death. RESULTS: In all, 90% of subjects in France reported drinking at least once per week, versus 61% in Northern Ireland. In France, after adjusting for other CHD risk factors, subjects in the highest quartile of alcohol consumption had a significantly lower risk of developing angina pectoris relative to non-drinkers. For myocardial infarction and all CHD events, the risk also decreased from the first to the fourth quartile (P for trend=0.02). Conversely, in Northern Ireland, no significant relationship was found between alcohol consumption and the incidence of angina pectoris or all CHD events, although alcohol consumption appeared to decrease the risk for myocardial infarction. Similar findings were obtained when the 5% higher alcohol consumers were excluded from the analysis. Finally, splitting the alcohol consumption into wine, beer and spirits did not improve the relationships, the three types of beverage exerting comparable effects on CHD events. CONCLUSIONS: Alcohol consumption patterns exert differential effects on CHD risk in middle-aged men from France and Northern Ireland. Further, the amount of alcohol consumption, rather than the type of alcoholic beverage, is related to both angina pectoris and myocardial infarction in France, whereas no relationship was found in Northern Ireland.     

The Nature and Extent of Flavored Alcoholic Beverage Consumption among Underage Youth: Results of a National Brand-Specific Survey

Background: Flavored alcoholic beverages are popular among underage drinkers. Existing studies that assessed flavored alcoholic beverage use among youth relied upon respondents to correctly classify the beverages they consume, without defining what alcohol brands belong to this category. Objectives: The aim is to demonstrate a new method for analyzing the consumption of flavored alcoholic beverages among youth on a brand-specific basis, without relying upon youth to correctly classify brands they consume. Methods: Using a prerecruited Internet panel developed by Knowledge Networks, we measured the brands of alcohol consumed by a national sample of youth drinkers, aged 16–20 years, in the United States. The sample consisted of 108 youths who had consumed at least one drink of an alcoholic beverage in the past 30 days. We measured the brand-specific consumption of alcoholic beverages within the past 30 days, ascertaining the consumption of 380 alcohol brands, including 14 brands of flavored alcoholic beverages. Results: Measuring the brand-specific consumption of flavored alcoholic beverages was feasible. Based on a brand-specific identification of flavored alcoholic beverages, nearly half of the youth drinkers in the sample reported having consumed such beverages in the past 30 days. Flavored alcoholic beverage preference was concentrated among the top four brands, which accounted for almost all of the consumption volume reported in our study. Conclusions and scientific significance: These findings underscore the need to assess youth alcohol consumption at the brand level and the potential value of such data in better understanding underage youth drinking behavior and the factors that influence it.     

Alcoholic beverage preference, 29-year mortality, and quality of life in men in old age

BACKGROUND: Harms of excessive alcohol consumption are obvious, but moderate wine consumption is frequently advocated for prevention of cardiovascular diseases. We compared 29-year mortality and quality of life in old age by alcoholic beverage preference (beer, wine, or spirits) in a cohort of men whose socioeconomic status was similar in their adult life. METHODS: In 1974, cardiovascular risk factors and beverage preference were assessed in 2468 businessmen and executives aged 40-55 years. Of them, 131 did not use alcohol, 455 did not report a single preference, and 694, 251, and 937 preferred beer, wine, and spirits, respectively. Quality of life with a RAND-36 Short Form (SF)-36 instrument was surveyed in 2000 in survivors. Mortality was retrieved from registers during the 29-year follow-up. RESULTS: Alcoholic beverage preference tracked well during the follow-up. Total alcohol consumption was not significantly different between preference groups. Men with wine preference had the lowest total mortality due to lower cardiovascular mortality. With the spirits group as the reference category and age, cardiovascular risk factors, and total alcohol consumption as covariates, wine drinkers had a 34% lower total mortality (relative risk 0.66; 95% confidence interval, 0.45-0.98); relative risk for beer preferers was 0.91 (95% confidence interval, 0.68-1.14). In 2000, wine preferers had the highest scores in all RAND-36 scales; general health (p =.007) and mental health (p =.01) were also significantly different. CONCLUSION: In this male cohort from the highest social class, wine preference was associated with lower mortality and better quality of life in old age. Mortality advantage was independent of overall alcohol consumption and cardiovascular risk factors, but contributing personal characteristics or early life differences cannot be excluded.     

Per capita alcohol consumption and ischemic heart disease mortality in a panel of US states from 1950 to 2002

Aims To estimate the overall impact of alcohol on ischemic heart disease (IHD) mortality in the United States using aggregate‐level models and to consider beverage‐specific effects that may represent more effectively the changes in drinking patterns over time that are related to both harmful and protective impacts of alcohol consumption on IHD. Design Several model specifications are estimated, including state‐specific autoregressive integrated moving average (ARIMA) models and generalized least squares (GLS) panel models on first‐differenced data. Setting US states from 1950 to 2002. Participants US general population. Measurements Per capita alcohol sales and cigarette sales, age‐standardized IHD and cirrhosis mortality rates. Findings Apparent consumption of total alcohol was associated with a significant overall increase of IHD of about 1% mortality per litre of ethanol. Beverage‐specific models found that spirits consumption was significantly positively related to IHD mortality overall, for both genders and in three regions defined by drinking culture (or ‘wetness’), while beer was found to have a significant protective relationship overall and in the wet region. The results for wine also suggest a protective relationship, but only marginally significant effects were found. Cirrhosis mortality rates were consistently positively related to IHD mortality. Combined results from state‐specific ARIMA models including both cigarette sales and cirrhosis rates were generally consistent with the GLS results. Conclusions Population‐level models confirm individual‐level findings of both harmful and protective relationships between alcohol use patterns and ischemic heart disease mortality. However, an overall harmful impact of per capita alcohol consumption on IHD mortality was found.     

The price of a drink: levels of consumption and price paid per unit of alcohol by Edinburgh's ill drinkers with a comparison to wider alcohol sales in Scotland

Aim To compare alcohol purchasing and consumption by ill drinkers in Edinburgh with wider alcohol sales in Scotland. Design Cross‐sectional. Setting Two hospitals in Edinburgh in 2008/09. Participants A total of 377 patients with serious alcohol problems; two‐thirds were in‐patients with medical, surgical or psychiatric problems due to alcohol; one‐third were out‐patients. Measurements Last week's or typical weekly consumption of alcohol: type, brand, units (1 UK unit 8 g ethanol), purchase place and price. Findings Patients consumed mean 197.7 UK units/week. The mean price paid per unit was £0.43 (lowest £0.09/unit) (£1 = 1.6 US$ or 1.2€), which is below the mean unit price, £0.71 paid in Scotland in 2008. Of units consumed, 70.3% were sold at or below £0.40/unit (mid‐range of price models proposed for minimum pricing legislation by the Scottish Government), and 83% at or below £0.50/unit proposed by the Chief Medical Officer of England. The lower the price paid per unit, the more units a patient consumed. A continuous increase in unit price from lower to higher social status, ranked according to the Scottish Index of Multiple Deprivation (based on postcode), was not seen; patients residing in postcodes in the mid‐quintile paid the highest price per unit. Cheapness was quoted commonly as a reason for beverage choice; ciders, especially ‘white’ cider, and vodka were, at off‐sales, cheapest per unit. Stealing alcohol or drinking alcohol substitutes was only very rarely reported. Conclusions Because patients with serious alcohol problems tend to purchase very cheap alcohol, elimination of the cheapest sales by minimum price or other legislation might reduce their consumption. It is unknown whether proposed price legislation in Scotland will encourage patients with serious alcohol problems to start stealing alcohol or drinking substitutes or will reduce the recruitment of new drinkers with serious alcohol problems and produce predicted longer‐term gains in health and social wellbeing.     

Alcohol consumption, Type 2 diabetes mellitus and impaired glucose tolerance in middle-aged Swedish men.

AIMS: To investigate the association between alcohol consumption and impaired glucose tolerance and Type 2 diabetes mellitus. METHODS: A population-based cross-sectional study consisting of 3,128 Swedish men, aged 35-56 years. Oral glucose tolerance testing identified 55 cases of Type 2 diabetes and 172 cases of impaired glucose tolerance. Information on alcohol consumption, family history of diabetes, smoking and physical activity was obtained by questionnaire. RESULTS: After adjustment for family history, smoking, physical activity and body mass index, the odds ratio of diabetes was 2.1 (95% confidence interval (CI) 1.0-4.5) in men with high consumption of alcohol (corresponding to over 12 drinks per week) and 0.7 (0.3-1.8) in moderate consumers (7-12 drinks), compared to occasional drinkers. For impaired glucose tolerance, the corresponding odds ratios were 0.7 (0.5-1.1) and 0.6 (0.4-1.0), respectively. Separate analyses for type of beverage indicated that high consumers of beer, spirits and wine had an odds ratio for diabetes of 2.9 (1.2-6.9), 3.3 (1.4-7.8) and 1.2 (0.5-2.7), respectively. CONCLUSIONS: The results indicated that high consumption of alcohol increases the occurrence of Type 2 diabetes and that this may primarily concern consumption of beer and spirits. For impaired glucose tolerance, regular alcohol consumption was associated with a reduced prevalence, particularly at moderate levels.     

Advertising, price, income and publicity effects on weekly cigarette sales in New Zealand supermarkets

Total cigarettes (all brands) sold weekly by a panel of 60 New Zealand supermarkets were monitored electronically for 42 weeks, a period when cigarette advertisements were in plain format with strong, varied disease warnings. Real cigarette price, newspaper advertising of old, regular and upmarket brands, and the number of newspaper news items on smoking issues were inversely associated with cigarette sales. Tending to increase total sales (all brands) were: more non-shopping days in the current week, and in the week following; volume of grocery items purchased, to indicate income and store traffic; and real advertising expenditure in newspapers for new downmarket cigarette brands, particularly one heavily-advertised brand (Peter Jackson) which was in late 1989 smoked by 4% of teenage smokers. All factors when interacting, explained 93% of changes in weekly cigarette sales. Most of the change occurred in the same week, and was 90% in place after a further 3 weeks. Newspapers, by doubling news coverage of smoking issues or by banning cigarette advertisements, can lower cigarette consumption as much as can a 10% price increase.     

Policy options for alcohol price regulation: the importance of modelling population heterogeneity

Context and aims Internationally, the repertoire of alcohol pricing policies has expanded to include targeted taxation, inflation‐linked taxation, taxation based on alcohol‐by‐volume (ABV), minimum pricing policies (general or targeted), bans of below‐cost selling and restricting price‐based promotions. Policy makers clearly need to consider how options compare in reducing harms at the population level, but are also required to demonstrate proportionality of their actions, which necessitates a detailed understanding of policy effects on different population subgroups. This paper presents selected findings from a policy appraisal for the UK government and discusses the importance of accounting for population heterogeneity in such analyses. Method We have built a causal, deterministic, epidemiological model which takes account of differential preferences by population subgroups defined by age, gender and level of drinking (moderate, hazardous, harmful). We consider purchasing preferences in terms of the types and volumes of alcoholic beverages, prices paid and the balance between bars, clubs and restaurants as opposed to supermarkets and off‐licenses. Results Age, sex and level of drinking fundamentally affect beverage preferences, drinking location, prices paid, price sensitivity and tendency to substitute for other beverage types. Pricing policies vary in their impact on different product types, price points and venues, thus having distinctly different effects on subgroups. Because population subgroups also have substantially different risk profiles for harms, policies are differentially effective in reducing health, crime, work‐place absence and unemployment harms. Conclusion Policy appraisals must account for population heterogeneity and complexity if resulting interventions are to be well considered, proportionate, effective and cost‐effective.