The Issue

Alcohol sales increased by 2.9% in 2020, the largest annual increase in more than 50 years.

The Problem

Alcohol is the third leading preventable cause of death in the United States.1 It is associated with 140,000 alcohol-related deaths annually. Alcohol sales, a common proxy for alcohol consumption, increased more in 2020 than in the prior 50 years,2 contributing to substantial increases in alcohol-related emergency room visits and death.3

Alcohol use has been increasing for decades with older adults, women and minorities reporting sizable increases in alcohol consumption even as young people report historically low levels of alcohol consumption.4 These increases in alcohol consumption have been associated with substantial increases in emergency room hospitalizations and alcohol-related morbidity,5 such as cancer and cirrhosis of the liver, and a doubling of alcohol-related mortality.6

Unlike tobacco, which is also known to cause serious harm, alcohol use is promoted socially even as public health surveillance has long established the relationship between alcohol use, severe harms including increased mortality.7

Since the start of COVID, many state legislatures expanded the availability of alcohol by passing legislation that created greater access to alcohol including home delivery and by allowing alcohol sales in places other than restaurants, bars, and stadiums.8 At the federal level, Congress further reduced alcohol taxes making alcohol more affordable.9 The vote increases profits for large (often foreign) producers and further shifted the societal costs of damages caused by alcohol (lost productivity, treatment costs related to alcohol related diseases (e.g. cancer and liver disease), intentional and unintentional injury and, alcohol use disorders to states and local communities.10

The Vision

The Alcohol Action Network seeks to reduce alcohol harms in communities across the country by:

  1. Promoting proven, pro-health policies and providing alcohol policy practitioners with the tools they need to counter the alcohol industry’s dominance.

  2. Establishing innovative surveillance tools that help document local conditions and harms of recent policy changes.

  3. Creating national opportunities for peer-to-peer mentorship to improve practitioners’ ability to navigate common political challenges through bi-weekly meetings.

  4. Providing direct access to the best scientific evidence and to the researchers who conduct the studies.

  5. Documenting and raising awareness about emerging threats in the alcohol policy field to effectively promote pro-health policy changes.

The Solutions

The availability of alcohol is one of the strongest drivers of consumption and related harms. When alcohol is easier to obtain, people drink more of it. Addressing alcohol availability, inequities related to alcohol use, and building health equity, are key components of a public health strategy to address alcohol-related harms. We know that population-level interventions offer greater protection for more people at less cost than individual strategies.

Policies that states should consider enacting include these promising evidence-based strategies:

  • Increase alcohol taxes 

  • Increase alcohol prices

  • Curtail alcohol advertising

  • Limit alcohol availability (e.g. days or hours)

  • Resist privatization of alcohol sales in settings with current government control of retail sale 

  • Lower blood-alcohol limits for drivers

  • Enhance enforcement of laws prohibiting alcohol sales to minors

Alcohol use is the third leading cause of preventable death in the U.S., and is responsible for more than 140,000 deaths nationally per year.

References

1Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Deaths from Excessive Alcohol Use in the United States. Alcohol and Public Health. Published July 6, 2022.

2White AM, Castle IJP, Powell PA, Hingson RW, Koob GF. Alcohol-Related Deaths During the COVID-19 Pandemic. JAMA. 2022;327(17):1704. doi:10.1001/jama.2022.4308

3Esser MB, Idaikkadar N, Kite-Powell A, Thomas C, Greenlund KJ.Trends in emergency department visits related to acute alcohol consumption before and during the COVID-19 pandemic in the United States, 2018–2020. Drug and Alcohol Dependence Reports. 2022;3:100049. doi:10.1016/j.dadr.2022.100049

4Grucza RA, Sher KJ, Kerr WC, et al. Trends in Adult Alcohol Use and Binge Drinking in the Early 21st-Century United States: A Meta-Analysis of 6 National Survey Series. Alcohol Clin Exp Re. 2018;42(10):1939-1950. doi:10.1111/acer.13859

5Disease burden and costs from excess alcohol consumption, obesity, and viral hepatitis: fourth report of the Lancet Standing Commission on Liver Disease in the UK. The Lancet. 2018;391(10125):1022. doi:10.1016/S0140-6736(17)33253-1

6White AM, Castle IP, Hingson RW, Powell PA. Using Death Certificates to Explore Changes in Alcohol‐Related Mortality in the United States, 1999 to 2017. Alcohol Clin Exp Res. 2020;44(1):178-187. doi:10.1111/acer.14239

7Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention.Alcohol Use and Your Health. Alcohol and Public Health. Published April 14, 2022.

8Redford A, Dills AK. The political economy of drug and alcohol regulation during the COVID ‐19 pandemic. South Econ J. 2021;87(4):1175-1209. doi:10.1002/soej.12496

9Alcohol and Tobacco Tax and Trade Bureau, Director, Regulations and Rulings Division, Tax Reform – Craft Beverage Modernization Act (CBMA). Published September 30, 2021.

10Looney A. Who benefits from the “craft beverage” tax cuts? Mostly foreign and industrial producers. Brookings. Published online January 3, 2018.