Alcohol tax cuts and increase in alcohol-positive sudden deaths: a time-series intervention analysis

Aim: The impact of alcohol regulation changes in Finland during 2004 on alcohol-positive sudden deaths was analysed, focusing on: (1) removal of traveller's allowance quotas on alcohol imports from other European Union (EU) countries, (2) lowering of Finnish alcohol excise duty rates and (3) Estonia joining the EU. Design: The impact of these changes was estimated using an autoregressive integrated moving average (ARIMA) analytical technique. Post-mortem forensic toxicology data were analysed over a 15-year period to account for seasonal and long-term variation. In all, the data comprised a weekly series of 33 782 alcohol-positive cases (at least 0.20 mg/g alcohol in blood) and a control series of 37 617 alcohol-negative cases. Setting: Finland in 1990-2004. Findings: The liberation of traveller's allowances had no material impact on alcohol-positive sudden deaths, but the impact of alcohol tax cuts in March 2004 was significant, resulting in an estimated eight additional alcohol-positive deaths per week, which is a 17% increase compared with the weekly average of 2003. The impact associated with Estonia joining the EU was not statistically significant. In the models applied to the control series of alcohol-negative deaths, none of the impact coefficients was statistically significant. Conclusions: Alcohol tax cuts were associated with an increase in the number of sudden deaths involving alcohol. This parallels the reported increases in alcohol consumption and alcohol-related causes of death in 2004 in Finland.