NDLI: Estimating the public health impact of disbanding a government alcohol monopoly: application of new methods to the case of Sweden

Content Provider	Springer Nature : BioMed Central
Author	Stockwell, Tim Sherk, Adam Norström, Thor Angus, Colin Ramstedt, Mats Andréasson, Sven Chikritzhs, Tanya Gripenberg, Johanna Holder, Harold Holmes, John Mäkelä, Pia
Abstract	Background Government alcohol monopolies were created in North America and Scandinavia to limit health and social problems. The Swedish monopoly, Systembolaget, reports to a health ministry and controls the sale of all alcoholic beverages with > 3.5% alcohol/volume for off-premise consumption, within a public health mandate. Elsewhere, alcohol monopolies are being dismantled with evidence of increased consumption and harms. We describe innovative modelling techniques to estimate health outcomes in scenarios involving Systembolaget being replaced by 1) privately owned liquor stores, or 2) alcohol sales in grocery stores. The methods employed can be applied in other jurisdictions and for other policy changes. Methods Impacts of the privatisation scenarios on pricing, outlet density, trading hours, advertising and marketing were estimated based on Swedish expert opinion and published evidence. Systematic reviews were conducted to estimate impacts on alcohol consumption in each scenario. Two methods were applied to estimate harm impacts: (i) alcohol attributable morbidity and mortality were estimated utilising the International Model of Alcohol Harms and Policies (InterMAHP); (ii) ARIMA methods to estimate the relationship between per capita alcohol consumption and specific types of alcohol-related mortality and crime. Results Replacing government stores with private liquor stores (Scenario 1) led to a 20.0% (95% CI, 15.3–24.7) increase in per capita consumption. Replacement with grocery stores (Scenario 2) led to a 31.2% (25.1–37.3%) increase. With InterMAHP there were 763 or + 47% (35–59%) and 1234 or + 76% (60–92%) more deaths per year, for Scenarios 1 and 2 respectively. With ARIMA, there were 850 (334–1444) more deaths per year in Scenario 1 and 1418 more in Scenario 2 (543–2505). InterMAHP also estimated 10,859 or + 29% (22–34%) and 16,118 or + 42% (35–49%) additional hospital stays per year respectively. Conclusions There would be substantial adverse consequences for public health and safety were Systembolaget to be privatised. We demonstrate a new combined approach for estimating the impact of alcohol policies on consumption and, using two alternative methods, alcohol-attributable harm. This approach could be readily adapted to other policies and settings. We note the limitation that some significant sources of uncertainty in the estimates of harm impacts were not modelled.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-018-6312-x.pdf
Ending Page	16
Page Count	16
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-018-6312-x
Journal	BMC Public Health
Issue Number	1
Volume Number	18
Language	English
Publisher	BioMed Central
Publisher Date	2018-12-22
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health Alcohol monopoly Sweden Mortality Morbidity Privatisation Policy modelling Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

New Zealand’s new alcohol laws: protocol for a mixed-methods evaluation

Modelling the impact of alcohol consumption on cardiovascular disease mortality for comparative risk assessments: an overview

Investigating local policy drivers for alcohol harm prevention: a comparative case study of two local authorities in England

Cardiovascular diseases mortality and alcohol control policy in Lithuania: exploring a possible link

Do cardiovascular disease prevention programs in northern Sweden impact on population health? An interrupted time series analysis

Using the International Alcohol Control (IAC) policy index to assess effects of legislative change in Aotearoa New Zealand

Estimating the public health impact had tobacco-free nicotine pouches been introduced into the US in 2000

Alcohol free? An analysis of UK and Scottish Government obesity policies’ engagement with alcohol 1999–2023

Modelling the impact of sodium intake on cardiovascular disease mortality in Mexico

Estimating the public health impact of disbanding a government alcohol monopoly: application of new methods to the case of Sweden

Similar Documents

New Zealand’s new alcohol laws: protocol for a mixed-methods evaluation

Modelling the impact of alcohol consumption on cardiovascular disease mortality for comparative risk assessments: an overview

Investigating local policy drivers for alcohol harm prevention: a comparative case study of two local authorities in England

Cardiovascular diseases mortality and alcohol control policy in Lithuania: exploring a possible link

Do cardiovascular disease prevention programs in northern Sweden impact on population health? An interrupted time series analysis

Using the International Alcohol Control (IAC) policy index to assess effects of legislative change in Aotearoa New Zealand

Estimating the public health impact had tobacco-free nicotine pouches been introduced into the US in 2000

Alcohol free? An analysis of UK and Scottish Government obesity policies’ engagement with alcohol 1999–2023

Modelling the impact of sodium intake on cardiovascular disease mortality in Mexico

Estimating the public health impact of disbanding a government alcohol monopoly: application of new methods to the case of Sweden