Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK; SPECTRUM Consortium, Edinburgh, UK.
Sheffield Addictions Research Group, School of Medicine and Population Health, University of Sheffield, Sheffield, UK; SPECTRUM Consortium, Edinburgh, UK.
Lancet Public Health. 2024 Oct;9(10):e719-e728. doi: 10.1016/S2468-2667(24)00191-9. Epub 2024 Sep 16.
Increasing the amount of alcohol taxation is among the most effective measures for addressing the rising global burden of alcohol harm. However, less is known about the effect of changing alcohol tax structures. Substantial reforms to UK alcohol taxation structures enacted in August, 2023, mean that all alcohol is taxed based on its ethanol content, beers and ciders sold in on-trade premises (eg, public houses) are taxed at a reduced rate (hereafter called draught relief), and beer and particularly cider remain taxed at lower rates than other alcohol of equivalent strength. We aimed to model the effect of these reforms on alcohol consumption and health and economic outcomes, and the effects of hypothetical alternative scenarios.
The Sheffield Tobacco and Alcohol Policy Model was used to estimate policy effects on alcohol consumption. The model is an individual-based microsimulation that uses data from the Health Survey for England, Living Costs and Food Survey, Hospital Episode Statistics, and the Office for National Statistics. Spending and revenues to retailers and the Government were estimated cumulatively for a 5-year period post-intervention. Policy effects on all-cause deaths, years of life lost, hospital admissions, and admissions costs were estimated cumulatively for a 20-year period post-intervention.
The reform was estimated to decrease mean weekly alcohol consumption per drinker by less than 0·05 (-0·34%) units (1 unit=8 g/10 mL ethanol), and prevent 2307 deaths and 11 510 hospital admissions during 20 years compared with no policy change. Removing draught relief was estimated to prevent 1441 further deaths and 14 247 further admissions. Hypothetical scenarios showed that removing draught relief would only slightly improve public health outcomes, and increasing tax rates for beer and ciders to match other drinks of equivalent strength would reduce consumption by a further 2·5 units per week (-17%) and deaths by approximately 74 465.
Alcohol tax structures based on alcohol strength enable tax policy to improve public health in a targeted way. However, the UK reforms are unlikely to substantially improve health outcomes as they do not raise taxes overall. Raising tax rates for the lowest taxed beer and ciders, which are favoured by those who consume harmful amounts of alcohol, could achieve substantially greater public health benefits and reduce health inequalities.
National Institute for Health and Care Research and UK Prevention Research Partnership.
提高酒精税收是应对全球不断增加的酒精危害负担的最有效措施之一。然而，关于改变酒精税收结构的影响知之甚少。2023 年 8 月，英国对酒精税收结构进行了重大改革，所有酒精都根据其乙醇含量征税，在贸易场所（如酒吧）销售的啤酒和苹果酒按较低税率征税（以下简称 draft relief），啤酒和苹果酒的税率仍低于同等强度的其他酒精。我们旨在模拟这些改革对酒精消费和健康及经济结果的影响，并模拟假设的替代方案的影响。
谢菲尔德烟草和酒精政策模型用于估计政策对酒精消费的影响。该模型是一种基于个体的微观模拟，使用来自英格兰健康调查、生活成本和食品调查、医院发病统计和国家统计局的数据。在干预后 5 年内，对零售商和政府的累计支出和收入进行了估计。在干预后 20 年内，对所有原因导致的死亡、失去的生命年、住院和住院费用进行了累计估计。
改革估计将使每位饮酒者每周的平均酒精摄入量减少不到 0.05 个单位（1 个单位=8 克/10 毫升乙醇），并在 20 年内预防 2307 人死亡和 11510 人住院。取消 draft relief 估计将预防另外 1441 人死亡和 14247 人进一步住院。假设方案表明，取消 draft relief 只会略微改善公共卫生结果，而将啤酒和苹果酒的税率提高到与其他同等强度饮料的税率相同，将使每周的消费减少 2.5 个单位（17%），死亡人数减少约 74465 人。
基于酒精强度的酒精税收结构使税收政策能够有针对性地改善公共健康。然而，英国的改革不太可能显著改善健康结果，因为它们并没有全面提高税收。提高最受那些饮酒量过大的人喜爱的低税率啤酒和苹果酒的税率，可以实现更大的公共卫生效益，并减少健康不平等。
国家卫生与保健研究所以及英国预防研究伙伴关系。
