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标题：The Economic Gains of Achieving Reduced Alcohol Consumption Targets for Australia
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作者：Anne Magnus ; Dominique Cadilhac ; Lauren Sheppard 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2012
卷号：102
期号：7
页码：1313-1319
DOI：10.2105/AJPH.2011.300453
语种：English
出版社：American Public Health Association
摘要：Objectives. To inform prevention policy, we estimated the economic benefits to health, production, and leisure in the 2008 Australian population of a realistic target reduction in per capita annual adult alcohol consumption. Methods. We chose a target of 6.4 liters annually per capita on average. We modeled lifetime health benefits as fewer incident cases of alcohol-related disease, deaths, and disability adjusted life years. We estimated production gains with surveyed participation and absenteeism rates. We valued gains with friction cost and human capital methods. We estimated and valued household production and leisure gains from time-use surveys. Results. A reduction of 3.4 liters of alcohol consumed annually per capita would result in one third fewer incident cases of disease (98 000), deaths (380), working days lost (5 million), days of home-based production lost (54 000), and a A$ 789-million health sector cost reduction. Workforce production had a A$ 427 million gain when we used the friction cost method. By contrast, we estimated a loss of 28 000 leisure days and 1000 additional early retirements. Conclusions. Economic savings and health benefits from reduced alcohol consumption may be substantial—particularly in the health sector with reduced alcohol-related disease and injury. Excessive alcohol consumption is a global public health issue. 1,2 In Australia, excessive alcohol intake is defined as consuming greater than 75 milliliters of alcohol per day for men and greater than 50 milliliters for women. 3 The average consumption of alcohol was 9.8 liters annually in 2005, 4 contributing a net 2.3% to the overall health burden, 5 trailing behind other modifiable risk factors of tobacco use, high blood pressure, cholesterol, body mass, and physical inactivity. The major avoidable consequences of both short- and long-term harmful alcohol consumption contribute to this burden in the forms of alcohol dependence, suicide and self-inflicted injuries, road traffic accidents, esophageal cancer, and breast cancer. 5 Although the consumption of alcohol at moderate levels has also been linked to positive health benefits including the prevention of cardiovascular disease among mature-aged persons, 6 the extent of such benefits remains controversial. 6,7 Australia has a strong history of alcohol consumption control. This includes 3 main approaches to the issue. First, there is a reliance on regulation introduced over the past decades to restrict sales of alcohol to underage (younger than 18 years) persons, to license alcohol sales outlets, to allow police to conduct random alcohol breath testing of drivers of motor vehicles (legal limit of blood alcohol is 0.05 g/100 mL⁸) and to restrict multiple forms of advertising of alcohol. Second, taxation of alcoholic products has been adopted to reduce demand. Third, social marketing campaigns (print and visual media) have been used to alert and inform consumers of alcohol about the dangers of driving under the influence of alcohol and binge drinking especially among young adults. 9 Together these measures have been used to establish a framework of successful measures to curb the avoidable harms of excessive alcohol consumption in the face of a culture of broad acceptance 9 (e.g., random breath testing has been shown to be successful in preventing fatal crashes during certain hours 10 ). More recently, the National Preventative Health Taskforce in Australia has driven renewed interest in extending regulation and taxation to facilitate further reductions in harmful drinking behavior and reduce the negative health consequences of high-risk alcohol consumption. 11 They identified the valuable role of regulation and taxation and recommended a number of measures to increase the preventive effort. This study is timely in that it quantifies the likely benefits of continued alcohol harm prevention on health, production (workforce and household), and leisure. Modeling has been used in the past to quantify gains arising from general population health improvements 12 following complete elimination of risk factor behaviors in Australia, including harmful drinking, 13 tobacco smoking, 13 and high body mass index (BMI; defined as weight in kilograms divided by the square of height in meters). 14 There is, however, no information about the impact of realistic reductions in harmful drinking behaviors in the literature. The consequential impact of improved health on each of paid and unpaid production and leisure has similarly not been estimated. The current prevalence of long-term harmful alcohol consumption is estimated to be 13% of Australian adults. 15 We sought to quantify the potential economic outcomes that could be expected if a realistic reduction in alcohol consumption were achieved (measured in liters of alcohol consumed per capita each year), which is an important consideration in light of the current political and policy interest in Australia and elsewhere. This study was part of a project funded by VicHealth (the Victorian Health Promotion Foundation), completed in 2009, to evaluate the health, economic, and financial benefits of reductions in prevalence of 6 important risk factors (alcohol, physical inactivity, high BMI, tobacco smoking, inadequate consumption of fruit and vegetables, and intimate partner violence). To date, outcomes from the tobacco smoking, six risk factors combined, and physical activity components of the study have been published. 16–18 The results of this study could readily be reexamined in other countries by adoption of similar methods, thereby adding to the economic arguments in support of public health prevention efforts.