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Journal of Health Inequalities
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1/2024
vol. 10
 
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abstract:
Original paper

Estimating the impact of availability restrictions and taxation increases on alcohol consumption, 100% alcohol-attributable and all-cause mortality in the Baltic countries and Poland 2001-2020

Jürgen Rehm
1
,
Inese Gobina
2
,
Kinga Janik-Koncewicz
3
,
Huan Jiang
1
,
Laura Miscikiene
4
,
Janina Petkeviciene
4
,
Ricardas Radisauskas
5
,
Rainer Reile
6
,
Mindaugas Stelemekas
4
,
Alexander Tran
1
,
Justina Trisauske
4
,
Witold A. Zatoński
3
,
Shannon Lange
1

  1. Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, Canada
  2. Department of Public Health and Epidemiology, Riga Stradiņš University, Latvia
  3. Institute – European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
  4. Health Research Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania
  5. Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
  6. Department for Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
J Health Inequal 2024; 10 (1): 12–16
DOI: https://doi.org/10.5114/jhi.2024.140837
Online publish date: 2024/07/01
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Introduction:
Major alcohol control policy measures in the Baltic countries and Poland have been shown to reduce alcohol per capita consumption (APC), 100% alcohol-attributable and all-cause mortality. This publication aims to estimate the effects of taxation increases and availability restrictions separately.

Material and methods:
Data were obtained from the statistical offices of the countries included except for alcohol consumption data, which were taken from the WHO for comparability reasons. Various types of regression analyses were conducted on time-series data using generalized additive mixed models.

Results:
On average, taxation increases were associated with decreases in APC (–0.89 litres (l); 95% CI: –1.35 l, –0.43 l) and all-cause mortality (–1.3%; 95% CI: –2.4%, –0.17%) among males. Given the average number of deaths in the four countries, the 1.3% reduction in the male mortality rate corresponds to 93 deaths postponed in Estonia, 166 in Latvia, 239 in Lithuania, and 2,606 in Poland, using the 2019 popu­lations of the respective countries as the reference points. For 100% alcohol-attributable mortality, there were significant associations with availability restrictions for males (–12.1%; 95% CI: –17.8%, –6.4%) and females (–8.5%; 95% CI: –16.3%, –0.7%), as well as with taxation for females (–9.06%; 95% CI: –14.02%, –3.83%). All other associations were in the hypothesized direction but did not reach statistical significance.

Conclusions:
Different effects were found for taxation increases and availability restrictions. The former works via reducing the level of consumption, and thereby reduces all-cause mortality, while the latter seems to work more specifically on reducing heavy drinking occasions and consequently in particular on decreasing 100% alcohol-attributable mortality. Both alcohol control policies important to reduce consumption and alcohol-attributable mortality. However, they produce partly different outcomes, and thus should be implemented depending on the epidemiological profile and the desired effects.

keywords:

alcohol drinking, taxes, availability restrictions, costs and cost analysis: affordability, health policy
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