Stanford Prevention Research Center , Stanford University School of Medicine, Stanford, California.
Alcohol Clin Exp Res. 2014 Jan;38(1):241-8. doi: 10.1111/acer.12226. Epub 2013 Aug 9.
Cigarette taxation has been recognized as one of the most significant policy instruments to reduce smoking. Smoking and drinking are highly comorbid behaviors, and the public health benefits of cigarette taxation may extend beyond smoking-related outcomes to impact alcohol consumption. The current study is the first to test whether increases in cigarette taxes are associated with reductions in alcohol consumption among smokers using a large, prospective U.S. sample.
Our sample included 21,473 alcohol consumers from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC). Multiple linear regression analyses were conducted to evaluate whether increases in cigarette taxes between Waves 1 (2001 to 2002) and 2 (2004 to 2005) were associated with reductions in quantity and frequency of alcohol consumption, adjusting for demographics, baseline alcohol consumption, and alcohol price. Stratified analyses were conducted by sex, hazardous drinking status, and age and income group.
Increases in cigarette taxes were associated with modest reductions in typical quantity of alcohol consumption and frequency of binge drinking among smokers. Cigarette taxation was not associated with changes in alcohol consumption among nonsmokers. In analyses stratified by sex, the inverse associations of cigarette taxes with typical quantity and binge drinking frequency were found only for male smokers. Further, the inverse association of cigarette taxation and alcohol consumption was stronger among hazardous drinkers (translating into approximately 1/2 a drink less alcohol consumption per episode), young adult smokers, and smokers in the lowest income category.
Findings from this longitudinal, epidemiological study suggest increases in cigarette taxes are associated with modest to moderate reductions in alcohol consumption among vulnerable groups. Additional research is needed to further quantify the public health benefits of cigarette taxation on alcohol consumption and to evaluate the potential broader crossover effects of cigarette taxation on other health behaviors.
香烟税收已被公认为减少吸烟的最有效政策手段之一。吸烟和饮酒是高度共病的行为,香烟税收的公共卫生效益可能不仅限于与吸烟相关的结果,还会影响到酒精消费。本研究首次使用大型美国前瞻性样本测试了增加香烟税是否与吸烟者的酒精消费减少有关。
我们的样本包括来自国家酒精流行病学调查和相关条件(NESARC)的 21473 名酒精消费者。采用多元线性回归分析评估了在波 1(2001-2002 年)和波 2(2004-2005 年)之间增加香烟税是否与酒精消费数量和频率的减少有关,调整了人口统计学、基线酒精消费和酒精价格等因素。还按性别、危险饮酒状况以及年龄和收入组进行了分层分析。
增加香烟税与吸烟者的典型酒精消费量和狂饮频率适度减少有关。香烟税收的变化与非吸烟者的酒精消费无关。在按性别分层的分析中,只有男性吸烟者才发现香烟税与典型饮酒量和狂饮频率之间存在负相关关系。此外,在危险饮酒者(每次饮酒量减少约半杯)、年轻成年吸烟者和收入最低类别的吸烟者中,香烟税收与酒精消费之间的负相关关系更强。
这项纵向、流行病学研究的结果表明,增加香烟税与脆弱群体的酒精消费适度到中度减少有关。需要进一步研究来量化香烟税收对酒精消费的公共卫生效益,并评估香烟税收对其他健康行为的潜在更广泛的交叉影响。