Health Economics Research Unit, University of Aberdeen, Aberdeen, Scotland, UK.
Appl Health Econ Health Policy. 2012 Jan 1;10(1):51-63. doi: 10.2165/11594840-000000000-00000.
Alcohol consumption is associated with a range of health and social harms that increase with the level of consumption. Policy makers are interested in effective and cost-effective interventions to reduce alcohol consumption and associated harms. Economic theory and research evidence demonstrate that increasing price is effective at the population level. Price interventions that target heavier consumers of alcohol may be more effective at reducing alcohol-related harms with less impact on moderate consumers. Minimum pricing per unit of alcohol has been proposed on this basis but concerns have been expressed that 'moderate drinkers of modest means' will be unfairly penalized. If those on low incomes are disproportionately affected by a policy that removes very cheap alcohol from the market, the policy could be regressive. The effect on households' budgets will depend on who currently purchases cheaper products and the extent to which the resulting changes in prices will impact on their demand for alcohol. This paper focuses on the first of these points.
This paper aims to identify patterns of purchasing of cheap off-trade alcohol products, focusing on income and the level of all alcohol purchased.
Three years (2006-08) of UK household survey data were used. The Expenditure and Food Survey provides comprehensive 2-week data on household expenditure. Regression analyses were used to investigate the relationships between the purchase of cheap off-trade alcohol, household income levels and whether the household level of alcohol purchasing is categorized as moderate, hazardous or harmful, while controlling for other household and non-household characteristics. Predicted probabilities and quantities for cheap alcohol purchasing patterns were generated for all households.
The descriptive statistics and regression analyses indicate that low-income households are not the predominant purchasers of any alcohol or even of cheap alcohol. Of those who do purchase off-trade alcohol, the lowest income households are the most likely to purchase cheap alcohol. However, when combined with the fact that the lowest income households are the least likely to purchase any off-trade alcohol, they have the lowest probability of purchasing cheap off-trade alcohol at the population level. Moderate purchasing households in all income quintiles are the group predicted as least likely to purchase cheap alcohol. The predicted average quantity of low-cost off-trade alcohol reveals similar patterns.
The results suggest that heavier household purchasers of alcohol are most likely to be affected by the introduction of a 'minimum price per unit of alcohol' policy. When we focus only on those households that purchase off-trade alcohol, lower income households are the most likely to be affected. However, minimum pricing in the UK is unlikely to be significantly regressive when the effects are considered for the whole population, including those households that do not purchase any off-trade alcohol. Minimum pricing will affect the minority of low-income households that purchase off-trade alcohol and, within this group, those most likely to be affected are households purchasing at a harmful level.
饮酒与一系列健康和社会危害有关,这些危害随着饮酒量的增加而增加。政策制定者对有效且具有成本效益的干预措施感兴趣,以减少饮酒和相关危害。经济理论和研究证据表明,提高价格在人群层面上是有效的。针对饮酒量较大的人群的价格干预措施可能更能有效减少与酒精相关的危害,而对适度饮酒者的影响较小。在此基础上提出了每单位酒精的最低定价,但有人担心“收入微薄的适度饮酒者”将受到不公平的惩罚。如果那些收入较低的人受到一项政策的不成比例的影响,该政策将从市场上取消非常便宜的酒精,那么该政策可能具有倒退性。家庭预算的影响将取决于目前购买较便宜产品的人以及价格变化对他们对酒精需求的影响程度。本文主要关注第一个问题。
本文旨在确定购买廉价非贸易酒类产品的模式,重点关注收入和所有酒类购买水平。
使用了三年(2006-08 年)的英国家庭调查数据。支出和食品调查提供了关于家庭支出的全面两周数据。回归分析用于调查购买廉价非贸易酒类、家庭收入水平以及家庭饮酒水平是否被归类为适度、有害或危险之间的关系,同时控制其他家庭和非家庭特征。为所有家庭生成了购买廉价酒类模式的预测概率和数量。
描述性统计和回归分析表明,低收入家庭并不是所有酒类甚至廉价酒类的主要购买者。在购买非贸易酒类的人中,收入最低的家庭最有可能购买廉价酒类。然而,考虑到收入最低的家庭最不可能购买任何非贸易酒类,他们在人口层面上购买廉价非贸易酒类的可能性最低。所有收入五分位数的适度购买家庭是预测最不可能购买廉价酒类的群体。低价位非贸易酒类的预测平均数量揭示了类似的模式。
结果表明,饮酒量较大的家庭最有可能受到“每单位酒精最低价格”政策的影响。当我们仅关注那些购买非贸易酒类的家庭时,收入较低的家庭最有可能受到影响。然而,当考虑到包括不购买任何非贸易酒类的家庭在内的整个人口时,英国的最低定价不太可能具有明显的倒退性。最低定价将影响少数购买非贸易酒类的低收入家庭,而在这一群体中,最有可能受到影响的是购买有害水平酒类的家庭。