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Tackling Harmful Alcohol Use

Economics and Public Health Policy

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Alcoholic beverages, and their harmful use, have been familiar fixtures in human societies since the beginning of recorded history. Worldwide, alcohol is a leading cause of ill health and premature mortality. It accounts for 1 in 17 deaths, and for a significant proportion of disabilities, especially in men. In OECD countries, alcohol consumption is about twice the world average. Its social costs are estimated in excess of 1% of GDP in high- and middle-income countries. When it is not the result of addiction, alcohol use is an individual choice, driven by social norms, with strong cultural connotations. This is reflected in unique patterns of social disparity in drinking, showing the well-to-do in some cases more prone to hazardous use of alcohol, and a polarisation of problem-drinking at the two ends of the social spectrum. Certain patterns of drinking have social impacts, which provide a strong economic rationale for governments to influence the use of alcohol through policies aimed at curbing harms, including those occurring to people other than drinkers. Some policy approaches are more effective and efficient than others, depending on their ability to trigger changes in social norms, and on how well they can target the groups that are most at risk. This book provides a detailed examination of trends and social disparities in alcohol consumption. It offers a wide-ranging assessment of the health, social and economic impacts of key policy options for tackling alcohol-related harms in three OECD countries (Canada, the Czech Republic and Germany), extracting relevant policy messages for a broader set of countries.

 

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Health and economic impacts of key alcohol policy options

Alcohol policies have significant potential to curb alcohol-related harms, improve health, increase productivity, reduce crime and violence, and cut government expenditure. The WHO Global Strategy to reduce the harmful use of alcohol provides a menu of policy options based on international consensus, which the OECD has used as a starting point in identifying a set of policies to be assessed in an economic analysis based on a computer simulation approach. The policies assessed in three country settings – Canada, the Czech Republic and Germany – include price policies, regulation and enforcement policies, education programmes and health care interventions. The results of the OECD analyses show that brief interventions in primary care, typically targeting high-risk drinkers, and tax increases, which affect all drinkers, have the potential to generate large health gains. The impacts of regulation and enforcement policies as well as other health care interventions are more dependent on the setting and mode of implementation, while school-based programmes show less promise. Alcohol policies have the potential to prevent alcohol-related disabilities and injuries in hundreds of thousands of working-age people in the countries examined, with major potential gains in their productivity. Most alcohol policies are estimated to cut health care expenditures to the extent that their implementation costs would be more than offset. Health care interventions and enforcement of drinking-and-driving restrictions are more expensive policies, but they still have very favourable cost-effectiveness profiles.

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