For what seems the first time, this analysis combined results from relevant studies to test whether low tax/price levels on alcohol result in poorer health and higher death rates. It found the expected relationships, but based on only the partial accounting of the harms and benefits of drinking found in most studies.
There are well established links between low tax/price on alcohol and heavier drinking, and in turn between heavier drinking across a population and poorer health and elevated death rates. The implication is that there will also be a relationship between the two ends of this chain, such that lower tax/price levels are associated with poorer health and elevated death rates. The featured analysis tested this expectation by combining the results of relevant studies using meta-analytic techniques. However, variation in the design of the individual studies meant that certain assumptions underlying the ability to combine their results were violated, so the analysts also reported descriptive summaries of the studies such as how many found the expected relationships, and how many of these were statistically significant. Another way the variation in studies was catered for was to group the diverse outcome measures in to eight conceptually distinct categories and to calculate the magnitude of the relationship (effect size) for each outcome in each individual study.
Fifty papers were found documenting 340 observations of the relationship of alcohol taxes or prices to mortality, health or other adverse impacts. Across all studies and all outcomes, there was a statistically significant but small inverse relationship, such that higher prices and taxes were associated with improvements in health, mortality and other adverse impacts.
Among the studies were 13 which recorded alcohol-related disease or injury such as deaths from cirrhosis. Across these there was a relatively (compared to all studies) strong (effect size –0.347) and statistically significant inverse relationship with prices/taxes. Every study found such a relationship and in all but two it was statistically significant. Among the other studies was one which found that US state alcohol taxes were inversely but weakly related to deaths overall to a degree which narrowly missed the conventional cut-off for statistical significance.
The largest group of papers dealt with traffic safety, including drink-driving, alcohol-related deaths, and crash fatalities overall. Across these there was a weak (effect size –0.112) but statistically significant relationship with tax/price in the expected direction. All the studies found at least some inverse relationships and most were statistically significant.
Remaining categories of outcomes were addressed by fewer than ten papers each. In respect of violence, suicide, indicators of crime and misbehaviour, and sexual risk or disease, in each case the pooled relationship across relevant studies was weak but (except for suicide) statistically significant. Two papers documented an inverse relationship between alcohol tax/price and smoking and cannabis use respectively. Though neither alone was statistically significant, the pooled relationship was.