摘要：Objectives. We systematically reviewed the effects of alcohol taxes and prices on alcohol-related morbidity and mortality to assess their public health impact. Methods. We searched 12 databases, along with articles’ reference lists, for studies providing estimates of the relationship between alcohol taxes and prices and measures of risky behavior or morbidity and mortality, then coded for effect sizes and numerous population and study characteristics. We combined independent estimates in random-effects models to obtain aggregate effect estimates. Results. We identified 50 articles, containing 340 estimates. Meta-estimates were r = −0.347 for alcohol-related disease and injury outcomes, −0.022 for violence, −0.048 for suicide, −0.112 for traffic crash outcomes, −0.055 for sexually transmitted diseases, −0.022 for other drug use, and −0.014 for crime and other misbehavior measures. All except suicide were statistically significant. Conclusions. Public policies affecting the price of alcoholic beverages have significant effects on alcohol-related disease and injury rates. Our results suggest that doubling the alcohol tax would reduce alcohol-related mortality by an average of 35%, traffic crash deaths by 11%, sexually transmitted disease by 6%, violence by 2%, and crime by 1.4%. Alcohol prices and taxes are rising issues on the agenda of state and local health officials and policymakers because of historically low real alcohol tax rates, political opposition to increased income and property taxes, increasing budget shortfalls, and positive experience with tobacco tax increases. Moreover, the knowledge base on alcohol tax effects is much larger than most health officials and policymakers realize. Over the past several decades, 162 papers have been published that evaluate the effects of alcohol tax and price levels on alcohol sales, drinking, and a range of alcohol-related morbidity and mortality outcomes. We recently presented the cumulative evidence from 112 papers containing 1003 estimates of effects of alcohol taxes and prices on alcohol sales and drinking behaviors; we found statistically significant inverse relationships for all 3 major beverages (beer, wine, and spirits). 1 The major conclusion emerging from those 112 studies was that a 10% increase in alcohol prices resulted in an approximately 5% reduction in drinking. A large epidemiological literature covering many decades shows drinking to be a risk factor for a wide range of injuries, diseases, and social disruption, 2 – 4 and considerable consensus has emerged on approximate alcohol-attributable fractions for several leading causes of morbidity and mortality. 5 , 6 Because the link between alcohol tax and price levels and drinking (including heavy drinking) is so well established, along with the association of individual and population drinking levels with several indicators of morbidity and mortality, we hypothesized an effect of alcohol tax and price levels on morbidity and mortality. Therefore, we systematically reviewed the literature and calculated overall estimates of effect between alcohol tax or price changes and the range of alcohol-related morbidity and mortality outcomes reported in the literature.
