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Hiking the alcohol tax could help fight gonorrhea as effectively as distributing condoms

Justin Sullivan/Getty Images

Raising the alcohol tax may sound like a buzzkill to a lot of Americans, but the research increasingly shows it could have dramatic benefits to public health.

The latest study, from researchers at the University of Florida and University of North Texas Health Science Center, found that hiking the alcohol sales tax in Maryland helped reduce incidents of gonorrhea. After the state increased its alcohol sales tax rate from 6 to 9 percent in 2011, there was a 24 percent drop in gonorrhea rates over the next 1.5 years — preventing nearly 1,600 gonorrhea cases each year. According to researchers, there was no such drop in gonorrhea in comparable states.

"The observed alcohol tax effects (24 percent decrease in gonorrhea) are similar to effects of condom distribution (23 percent to 30 percent decrease)," the researchers found. "Moreover, condom distribution programs cost, whereas alcohol taxes generate, revenues."

There are some limitations to the study: Most importantly, it did not prove causation. It's possible that some other factor contributed to the drop in gonorrhea rates, not just the higher alcohol tax.

But there's reason to believe the alcohol tax played some role in the reduction of STIs (sexually transmitted infections), the researchers wrote: "Extensive literature demonstrates that increased alcohol taxes lower alcohol consumption and affect drinking patterns. Lower alcohol consumption caused by alcohol tax increases should, on average, translate to lower alcohol consumption prior to sex, reduced alcohol-related sexual risk-taking (i.e., sex, unprotected sex, and casual or new partners), and reduced population-level STIs. Additionally, lower alcohol consumption may reduce population STI rates by influencing other alcohol-related STI risk factors (e.g., partner violence, transactional sex, anal sex)."

Researchers found no similar drop for chlamydia rates, but they say that may be a result of demographic differences between the diseases and the brief time period analyzed. Still, other studies have found that alcohol taxes can affect all STI rates, not just gonorrhea. More broadly, stricter alcohol policies can produce other benefits for public health and safety.

Even before this study, there was a strong argument for higher alcohol taxes

A man drinks beer. Justin Sullivan/Getty Images

Alcohol is a serious public health problem: In the US, alcohol abuse causes 88,000 deaths each year, is linked to 40 percent of violent crimes, and led to more than 4.6 million emergency room visits in 2010. The latest study shines a light on just another way alcohol is bad for public health — and how a higher alcohol tax could help.

Many, many studies have found the benefits of the alcohol tax. A recent review of the research from David Roodman, senior adviser for the Open Philanthropy Project, made a case for a higher alcohol tax:

In the end, I believe the preponderance of the evidence says that higher prices do correlate with less drinking and lower incidence of problems such as cirrhosis deaths. And I see little reason to doubt the obvious explanation: higher prices cause less drinking. A rough rule of thumb is that each 1 percent increase in alcohol price reduces drinking by 0.5 percent. Extrapolating from some of the most powerful studies, I estimate an even larger impact on the death rate from alcohol-caused diseases: 1-3 percent within months. By extension, a 10 percent price increase would cut the death rate 9-25%. For the US in 2010, this represents 2,000-6,000 averted deaths/year.

This wasn't the first positive research finding in favor of raising the alcohol tax, but it was one of the most convincing. Roodman found not just that high-quality research supports a higher alcohol tax, but that the effects seem to grow stronger the higher the tax is.

So for the US, 10 percent higher alcohol prices could save as many as 6,000 lives each year. To put that in context, it would mean paying about 50 cents more for a six-pack of Bud Light, and probably save thousands of lives in the process. And this is a conservative estimate, since it only counts alcohol-related liver cirrhosis deaths — the number of lives saved would be higher if it accounted for deaths due to alcohol-related violence and car crashes.

Higher taxes aren't the only proposal to help deal with America's alcohol problem. A 2014 report from the RAND Drug Policy Research Center suggested that state governments could monopolize sales of alcohol through state-run shops, finding that states that did this kept prices higher, reduced access to youth, and reduced overall levels of use. And a 2013 study from RAND of South Dakota's 24/7 Sobriety Program, which briefly jails people whose drinking has repeatedly gotten them in trouble with the law if they fail a twice-a-day alcohol blood test, attributed a 12 percent reduction in repeat DUI arrests and a 9 percent reduction in domestic violence arrests at the county level to the program.

But to get any consideration for these types of proposals, policymakers and the public need to acknowledge that America does have an alcohol problem, which makes studies on the alcohol tax all the more important for exposing the issue.


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