Document Type : Commentary
Authors
1
Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
2
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
3
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
4
Institute of Medical Science, University of Toronto, Toronto, ON, Canada
5
Department of Psychiatry, University of Toronto, Toronto, ON, Canada
6
Program on Substance Abuse & WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
7
Center for Interdisciplinary Addiction Research (ZIS), Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
8
Faculty of Public Health, Mahidol University, Bangkok, Thailand
Abstract
Casswell et al examined two indicators for alcohol excise taxation: tax as a share of the lowest retail price (the tax-to-price ratio, T/P) and a reversely scaled measure of affordability—the percentage of gross national income (GNI) per capita required to purchase 100 drinks (the price-to-income ratio, P/I). They found that T/P did not predict P/I and recommended further research on measures of affordability. This commentary argues that this null finding may arise because two indicators alone cannot capture the complex relationships among price, taxation, consumer income, and drinking behaviour. In particular, industry pricing strategies, which can weaken any association between T/P and P/I, should be taken into account. We contend that in-depth analyses of affordability should consider the broader national context, including factors such as unrecorded consumption, tax design, delayed response to changes in taxation. Some of these factors are best studied longitudinally. Finally, methodological choices may also influence the observed relationships between taxation and affordability.
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