The effects of alcohol price increases on mortality in Kazakhstan in 2008-2012

Kairat Davletov, Martin McKee, Salim Berkinbaev, B Amirov, P Inchin, Bernd Rechel

European Journal of Public Health, 2014

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DOI 10.1093/eurpub/cku162.034
Data confidence 70 medium
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Abstract

Issue/problem Earlier studies have established the crucial role of alcohol consumption in sharp fluctuations of cardiovascular (CVD) and other alcohol-attributable mortality in Russia in the 1980s and 1990s. Making alcohol more expensive has been identified as an effective strategy to reduce harm, but some studies have pointed out that this applies more to vodka and other strong spirits, and less to beer or wine. Description of the problem With the aim of examining the effect of price changes for vodka and beer on CVD and alcohol-attributable mortality in 2008-2012, we compared age-standardized CVD mortality for the age group 25-64, as well as mortality for all age groups for accidents, homicides and suicides in Kazakhstan during the period of 2008-2012, with changes in the price and sales of vodka and beer. Results (effects/changes) Age-standardized CVD mortality, both for men and women, declined dramatically between 2008 and 2012 (by 29%), from 390 to 277 per 100,000 population. There was also a decline in mortality from accidents and a more than 20% decrease of homicide and suicide rates. Declining mortality rates were preceded by price increases for vodka, with a more than two-fold decrease of sales. In contrast, there was only a slight increase in beer prices and sales of beer increased substantially. Lessons Our findings suggest that the sharp decline in CVD and alcohol-attributable mortality in Kazakhstan might be the result of price increases for vodka and consequently reduced vodka consumption. There seems to be a shift from vodka towards beer consumption and the government has introduced successfully different tax policies for different alcohol beverages. This lesson is important for all former Soviet countries, as previous declines in CVD mortality in some of them were not sustained over time. Furthermore, it is worth mentioning that, despite recent tax increases, the price of vodka in Kazakhstan is still much lower than in the other countries of the Customs Union with Russia and Belarus. Key messages Our study suggests that tax increases for strong spirits might be a very effective CVD prevention strategy in Kazakhstan. However, there is much scope for further policy action in this area.