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Purshouse R.C., Meier P.S., Brennan Alan. et al.
Lancet: 2010, 375(9723), p. 1355–1364.
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Commissioned by the English health department, the first study to model the impacts of alcohol policies by integrating data on pricing, promotion, purchasing, consumption and harm found that price rises or bans on promotions can bring major benefits. Findings informed a Home Office assessment of the impacts of raising the price of alcohol.
Background Although pricing policies for alcohol are known to be effective, little is known about how specific interventions affect health-care costs and health-related quality-of-life outcomes for different types of drinkers. We assessed effects of alcohol pricing and promotion policy options in various population subgroups.
Methods We built an epidemiological mathematical model to appraise 18 pricing policies, with English data from the Expenditure and Food Survey and the General Household Survey for average and peak alcohol consumption. We used results from econometric analyses (256 own-price and cross-price elasticity estimates) to estimate effects of policies on alcohol consumption. We applied risk functions from systemic reviews and meta-analyses, or derived from attributable fractions, to model the effect of consumption changes on mortality and disease prevalence for 47 illnesses.
Findings General price increases were effective for reduction of consumption, health-care costs, and health-related quality of life losses in all population subgroups. Minimum pricing policies can maintain this level of effectiveness for harmful drinkers while reducing effects on consumer spending for moderate drinkers. Total bans on supermarket and off-license discounting are effective, but banning only large discounts has little effect. Young adult drinkers aged 18–24 years are especially affected by policies that raise prices in pubs and bars.
Interpretation Minimum pricing policies and discounting restrictions might warrant further consideration because both strategies are estimated to reduce alcohol consumption and related health harms and costs, with drinker spending increases targeting those who incur most harm.
commentary This article is based on work funded by the UK Department of Health which has been analysed in greater depth in this Findings analysis. These reports were among those which informed a UK Home Office assessment published in January 2011 of the likely impact of a rise in the price of alcohol in Britain.
Last revised 09 February 2011
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