Ramirez Rebecca L, Jernigan David H
National Liquor Law Enforcement Association, Calverton, Maryland.
Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
J Stud Alcohol Drugs. 2017 Sep;78(5):763-770. doi: 10.15288/jsad.2017.78.763.
The effectiveness of alcohol taxes in reducing excessive alcohol consumption and related problems is well established in research, yet increases in U.S. state alcohol taxes are uncommon. This study examined how alcohol tax increases occurred recently in three U.S. states, what public health's role was, and what can be learned from those experiences.
Review of available documentation and news media content analysis provided context and, along with snowball sampling, helped identify proponents, opponents, and neutral parties in each state. Thirty-five semi-structured key informant interviews (lasting approximately 1 hour) were conducted, transcribed, and analyzed for common themes.
State routes to alcohol tax increases varied, as did the role of public health research. Use of polling data, leveraging existing political champions, coalition building, drawing on past experience with legislative initiatives, deciding revenue allocation strategically, and generating media coverage were universal elements of these initiatives. Tax changes occurred when key policy makers sought new revenue sources or when proponents were able to build coalitions broader than the substance abuse field.
Translation of scientific evidence on the effectiveness of increasing alcohol taxes into public health interventions may occur if legislative leaders seek new revenue sources or if broad-based coalitions can generate support and sustained media coverage. Policy makers are generally unaware of the health impact of alcohol taxes, although public health research may play a valuable role in framing and informing discussions of state alcohol tax increases as a strategy for reducing excessive alcohol use and alcohol-related harms.
酒精税在减少过度饮酒及相关问题方面的有效性在研究中已得到充分证实，但美国各州提高酒精税的情况并不常见。本研究考察了美国三个州近期酒精税是如何提高的、公共卫生发挥了什么作用以及能从这些经历中学到什么。
对现有文献资料的回顾和新闻媒体内容分析提供了背景信息，并与滚雪球抽样法一起，有助于确定每个州的支持者、反对者和中立方。进行了35次半结构化关键信息人访谈（每次约1小时），访谈内容经转录后分析共同主题。
各州提高酒精税的途径各不相同，公共卫生研究的作用也有所不同。利用民意调查数据、借助现有的政治支持者、建立联盟、借鉴过去立法倡议的经验、战略性地决定收入分配以及进行媒体报道是这些倡议的普遍要素。当关键政策制定者寻求新的收入来源，或者支持者能够建立起比药物滥用领域更广泛的联盟时，税收就会发生变化。
如果立法领导人寻求新的收入来源，或者广泛的联盟能够获得支持并持续得到媒体报道，那么关于提高酒精税有效性的科学证据可能会转化为公共卫生干预措施。政策制定者通常没有意识到酒精税对健康的影响，尽管公共卫生研究可能在将提高州酒精税作为减少过度饮酒及与酒精相关危害的策略的讨论中起到框架构建和信息提供的重要作用。
