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Are the “Best Buys” for Alcohol Control Still Valid? An Update on the Comparative Cost-Effectiveness of Alcohol Control Strategies at the Global Level
Abstract
OBJECTIVE: Evidence on the comparative cost-effectiveness of alcohol control strategies is a relevant input into public policy and resource allocation. At the global level, this evidence has been used to identify so-called best buys for noncommunicable disease prevention and control. This article uses global evidence on alcohol use exposures and risk relations, as well as on intervention costs and impacts, to re-examine the comparative cost-effectiveness of a range of alcohol control strategies. METHOD: A "generalized" approach to cost-effectiveness analysis was adopted. A new modeling tool (OneHealth) was used to estimate the population-level effects of interventions. Interventions that reduce the harmful use of alcohol included brief psychosocial interventions, excise taxes, and the enactment as well as enforcement of restrictions on alcohol marketing, availability, and drink-driving laws. Costs were estimated in international dollars for the year 2010 and effects expressed in healthy life years gained. Analysis was carried out for 16 countries spanning low-, middle-, and high-income settings. RESULTS: Increasing excise taxes has a low cost (<I$0.10 per capita) and a highly favorable ratio of costs to effects (<I$100 per healthy life year gained in both low- and high-income settings). Availability and marketing restrictions are also highly cost effective (<I$100 in low-income settings and <I$500 in high-income settings). Enforcement of drink-driving laws and blood alcohol concentration limits via sobriety checkpoints had cost-effectiveness ratios in the range of I$1,500-3,000. Brief psychosocial treatments were <I$150 and
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“Legislative measures that reduce harmful behaviours such as excess alcohol consumption have been modelled as cost-effective in all WHO regions. 442”
From The Lancet Psychiatry Commission on youth mental health (2024) · cites this paper as [442]
In the citing paper
“A broad array of patient-level alcohol harm reduction interventions, such as brief interventions (for this paper, defined as any intervention ranging from advice to counseling, lasting less than 1 hour per session [7] up to 4 sessions [8], psychosocial interventions, and pharmacological treatments) have been found to be effective in high-resource settings [9,10].”
From Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary (2022) · cites this paper as [10]
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Metadata
- Authors
- Chisholm, D., Moro, D., Bertram, M., Pretorius, C., Gmel, G., Shield, K., & Rehm, J.
- Affiliations
- World Health Organization (CH)
- University of Cagliari (IT)
- Avenir Health (US)
- Centre for Addiction and Mental Health (CA)
- Venue
- Journal of Studies on Alcohol and Drugs
- Publisher
- Alcohol Research Documentation, Inc.
- Published
- 2018-07
- Volume
- 79
- Issue
- 4
- Pages
- 514-522
- ISSN
- 1937-1888 (ISSN-L)
- 1938-4114
- OpenAlex
- W2886141074
- Cited by
- 253
- References
- 0
- Citations by year
- 2026: 12 · 2025: 25 · 2024: 32 · 2023: 36 · 2022: 39 · 2021: 56 · 2020: 32 · 2019: 17 · 2018: 4
- FWCI
- 21.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Studies on Alcohol and Drugs (publishedVersion)
- PubMed (publishedVersion)
- Funders
- World Health Organization
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Public Health Policies and Epidemiology
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- cost-effectiveness, Best Buy, excise tax, alcohol marketing restrictions, alcohol availability restrictions, sobriety checkpoints, brief psychosocial intervention, hazardous drinking, healthy life years, non-communicable disease prevention
- MeSH terms
- Blood Alcohol Content, Alcohol Drinking, Automobile Driving, Cost-Benefit Analysis, Female, Humans, Male, Public Policy, Taxes, Global Health, Marketing
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