Report Says Alcohol-Related Deaths are Likely to Increase after Cuts by England in Alcohol Taxation; What Can We Learn Here in the States?

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Alcohol related deaths are most likely set to increase in England as incomes outstrip rises in taxation, argue experts in The BMJ (British Medical Journal). This prediction is based on the researchers’ analysis of trends in alcohol-related harm in the context of changes in the alcohol marketplace, in turn driven by changes in fiscal policy.

Meanwhile, the number of alcohol related deaths will likely continue to decrease in Scotland if legislation on minimum unit pricing for alcoholic drinks is implemented, according to Science Daily this April. Leading experts Nick Sheron and Ian Gilmore say that if the legislation is passed, it could result in an “interesting and unusual situation” whereby cheap alcohol is constrained by minimum pricing in Scotland, and this may be swiftly followed by Ireland, Northern Ireland, and Wales.

They say the number of alcohol-related deaths will decrease in these countries as a result. However, they note that the situation in England won’t change for the better as “incomes are likely to outstrip changes in alcohol taxation,” and the “relentless rise” of alcohol-related deaths will likely resume.

There was a threefold increase in the number of alcohol related deaths between 1980 and 2008 in England and Wales, “probably driven by the increased affordability and availability of strong alcohol,” Sheron and Gilmore say. As wages increased and alcohol taxation was reduced, by 2008 it was possible to buy almost four bottles of vodka for the price of one bottle in 1980.

They note that four bottles represents the weekly alcohol consumption of an average patient with alcohol related liver cirrhosis. The authors say that of the various economic factors influencing alcohol consumption, the 2% duty escalator had the greatest effect.

However, following a “fierce campaign of lobbying” by the Wine and Spirits Trade Association, the duty escalator was dropped in 2014. Furthermore, incomes are starting to rise again, and alcohol duty was cut by a further 2% for spirits and cheap cider. Therefore, the authors predict the “relentless rise” of alcohol deaths in England once again, the authors say.

Nick Sheron is an academic clinical hepatologist at University of Southampton and runs the liver unit at Southampton General Hospital. Sir Ian Thomas Gilmore is a professor of hepatology  and previous president of the Royal College of Physicians of London.

Separately, and in a similar finding, the rise and fall of alcohol-related mortality in Scotland is partly due to changes in affordability, according to reports published this May in Public Health. They say new research has found that the rise in alcohol-related mortality during the 1990s and early 2000s in Scotland, and the subsequent decline, were likely to be explained in part by increasing then decreasing alcohol affordability.

The research was undertaken to understand better what the independent impact of the Scottish Government’s alcohol strategy was. Other factors aside from the strategy and the affordability of alcohol were also considered including migration, historical social, economic and political change, the alcohol market, social norms, and health services.

“Alcohol has been suggested to be the most harmful substance misused in societies when wider harms on health and social outcomes such as violence and reduced economic output, are taken into account,” explained lead investigator Dr. Gerry McCartney of NHS Health Scotland, Glasgow, UK. “Our work evaluated the extent to which differing trends in income, demographic change, and the consequences of an earlier period of social, economic, and political change might explain differences in the magnitude and trends in alcohol-related mortality between 1991 and 2011 in Scotland compared to England & Wales. We found that increasing alcohol affordability during the 1990s is likely to have been important in explaining the rise in alcohol-related harms.”

“Given the likely importance of alcohol affordability in driving the downward trend in alcohol-related mortality, any future increase in incomes or decline in prices might be expected to increase alcohol-related harms in Scotland once again, commented Dr. McCartney. “The most recent trends in consumption, harms, and alcohol affordability provide an early indication of this. It is therefore important that a comprehensive range of alcohol control policies is in place to prevent this.”

Steve’s Take: Here in the U.S., the taxation power of the federal government has always been an effective tool for constructive social engineering. Raising taxes on cigarettes, for instance, has done more to lower the rate of smoking, particularly of new smokers, than any other policy.

The same applies to alcohol consumption, and even fuel consumption by increasing taxes on the consumable. Even prices for bullets probably are not elastic. At a certain cost, fewer bullets will be purchased and the cost of stockpiling ammunition will become onerous.

Some would argue that there’s no such thing as “constructive” social engineering. That it’s invariably tyrannical in nature, usually unconstitutional or in some other way an evasion of established limits on the power of government. It’s the fundamental inspiration of the old maxim, “The power to tax is the power to destroy.”

But others say the Constitution assigns to government the responsibility to “promote the general welfare.” There are few more effective ways to perform that essential function other than creating both carrots and sticks to encourage (not coerce, as tyranny does) socially-responsible behavior.

Beyond raising the minimum price of alcohol and increasing excise taxes, there’s another approach some economists and public-policy wonks think might cut back on alcohol-fueled violence, as well: the decriminalization or legalization of marijuana. T

he studies are a little thinner and shakier here, according to a piece in NYmag.com by Annie Lowrey. Nevertheless, there is some evidence that young people, at least, tend to substitute pot for alcohol.

“Alcohol is clearly the drug with the most evidence to support a direct intoxication-violence relationship,” according to one paper in the journal Addictive Behaviors. “Cannabis reduces likelihood of violence during intoxication.”

Utilizing tax policy for alcohol and for cannabis legalization should be two of our top mechanisms used federally and at the state and local levels to reduce violent crime. Cannabis has not been shown to stimulate violence in individuals.

The aforementioned studies from the U.K. have placed the incontrovertible data of the correlation between alcohol and violent crime before us. I could go on about the countless studies correlating alcohol abuse and the thousands upon thousands of rape cases each year on our college campuses, which largely go unnoticed, or if noticed, get shrugged off as part of the “college experience.”

We need to make this a priority for our representatives. When the get back from their seven-week summer vacation, time for them to finally take this matter seriously. It’s up to us to force them to do so.