Research: Public health policies work – and probably help the economy too

Alcohol_y_TabacoNewly published research about the effects of anti-smoking policies have found such policies effectively incentivize the desired social behaviors, and it also suggests that they create more benefits than costs for society. While this study focused only on anti-smoking policies, the results are relevant to ongoing debates in Utah about loosening state alcohol control laws and, now, legalizing marijuana.

The study, published by the National Bureau of Economic Research, applied a benefit-cost analysis methodology to U.S. anti-smoking policies from 1964-2010. They found that: (1) these policies “reduce[d] total cigarette consumption by 28 percent,” and (2) the “consumer benefits from anti-smoking policies through 2010 is estimated to be $573 billion,” in 2010 dollars. The researchers further note that they were unable to come up with a similar estimate of the hard costs of these policies, but they “discuss evidence that suggests the consumer benefits substantially outweigh the costs.”

While the study’s finding about the net impact on the economy is unclear without a better cost estimate, the impact of anti-smoking policies on smoking behavior in this research seems quite significant and definitive. The lesson for policy-makers should be clear: public policy can significantly impact and incentivize the behavior of individuals on potentially addictive and socially harmful behaviors like smoking (or, I would add, drinking or illicit drug use) to the benefit of both society and, in some cases, the individuals themselves.

Does this reality of public policy justify government attempts to regulate any and every behavior “for the good of society”? Of course not, though fully fleshing out why not is a subject for another post. But does this reality support regulating – sometimes heavily – behaviors that harm society and freedom, such as smoking, drinking and illicit drug use? Indeed it does, and this new study is one piece of evidence among many illustrating why.

Ex-CDC chief: Policies that reduce alcohol availability reduce alcohol-related problems

Everyone_take_a_drinkIn an op-ed published Feb. 12 in The Salt Lake Tribune, Dr. James O. Mason challenged a previous Tribune editorial, which said, “No doubt Utah sees benefits from having a lower rate of alcohol consumption and fewer drinkers, but the state should give credit where it is due: its people, not its liquor laws.”

Disputing this assumption, Dr. Mason responded,

In other words, they [the S.L. Tribune editorial board members] hoped to convince readers that Utah’s lower rate of alcohol consumption has everything to do with religious demographics and little to do with Utah’s alcohol policies and laws. Legislators should understand the science behind this controversy before making any changes to Utah’s laws.

How can we measure the impact of religious culture versus alcohol laws in explaining Utah’s low rate of alcohol-related problems? Perspective might be gained by examining the state’s experience with tobacco control. In 1986, Utah’s adult smoking rate of 18.2 percent was the lowest in the nation. … Fast-forward to 2012 when the smoking rate had fallen to 10.6 percent. What explains how Utah’s smoking rate was cut, almost in half, within a 26 year period? Was it increased religious fervor? An influx of Mormons? No, the explanation lies elsewhere.

He then noted,

Between 1986 and 2012, Utah, like most other states, adopted a variety of evidence-based tobacco control strategies which were recommended by the Centers for Disease Control and Prevention (CDC). Experts from the CDC claimed comprehensive tobacco control policies would dramatically reduce smoking. The recommended strategies included increasing cigarette taxes, aggressive indoor clean air laws, youth access restrictions, access to smoking cessation services and anti-smoking media campaigns. Utah legislators took a gamble and followed the recommendations. What was the result? The smoking rate in Utah was cut almost in half. Public health policies, rather than religion, produced this decline.

Could it be that public health policies likewise contribute to Utah’s lower rates of alcohol problems? Informed legislators will get answers from experts employed at authoritative organizations. Numerous researchers’ careers have focused on which, and to what extent, various alcohol control policies work. They set a high bar for labeling a policy as “evidence-based” or “best practice.” The CDC’s online document, “Community Guides: What Works to Promote Health,” and the World Health Organization’s book, “Alcohol: No Ordinary Commodity” rate the relative effectiveness of select alcohol policies. These documents describe the rating methodology and carefully reference the studies used to generate their recommendations.


These reports don’t recommend prohibition, but they do convey the clear message that, collectively, policies which reduce alcohol availability such as the number and location of retail outlets, hours of sale and the price of drinks, substantially reduce the number of alcohol-related problems. Maybe Utah’s alcohol control policies aren’t so screwy after all. One prominent alcohol policy researcher called them the “envy of the nation.”

In conclusion, Dr. Mason asserted,

Utah legislators are being pressured by special interest groups to loosen the state’s alcohol regulations. Some claim economic gains will result with loosened policies. Rather, if loosened, the costs to society will far exceed projected economic gains. Legislators should be wary of industry lobbyists who, 30 years ago, tried to convince lawmakers that Salt Lake City could never get the Winter Olympics unless the state dismantled its alcohol policies. Those lobbyists were wrong. They are also wrong in claiming that Utah’s alcohol policies do nothing to reduce the negative health, social and economic impact of alcohol abuse. Thoughtful analysis by experts suggests that alcohol control policies work [emphasis added].

The op-ed also noted that Dr. Mason is a former executive director of the Utah Department of Health and a former director of the CDC.

Infographic: How many drinks per week?

The above chart contains some interesting – and eye-popping – information about American alcohol consumption.

First, 60 percent of Americans either don’t drink at all (30 percent) or, on average, have less than one drink per week (30 percent). But the top 10 percent of American drinkers? Let’s just say their livers might some day be used as an example of how not to treat your body.

What does this mean for public policy? For starters, it suggests that raising alcohol taxes is a fair and likely effective way to combat the social costs of alcohol consumption (e.g., traffic deaths, health problems, and economic harm due to decreased productivity).

Higher alcohol taxes are fair because they amount to a user fee – you only pay if you choose to drink – and because they have minimal impact on the vast majority of responsible drinkers who, in the end, will not drink an exorbitant amount of alcohol, and therefore will pay only a small amount of the increased tax.

And higher alcohol taxes are likely to be effective because, while they will have minimal impact on moderate and responsible drinkers, they will have a significant impact on the problem drinkers that consume mind-boggling amounts of alcohol (taking for granted that having more than 10 drinks per day on a regular basis is difficult for most people to comprehend).

Conservatives tend to hesitate at any call to increase taxes, and rightly so. But thoughtful conservatives also understand that not all taxes are made equal – some taxes are fairer than others; some taxes are less economically and socially harmful than others (and some, like alcohol taxes, can even be beneficial for society); and maintaining a reasonable level of taxes is necessary for good government.

Alcohol taxes – and specifically the policy of increasing alcohol taxes from current levels – fall into this category of a fair, beneficial (or at least minimally harmful), and reasonable tax, when given thoughtful consideration.

Click here to learn more about Sutherland’s position on alcohol policy in Utah.

Why a distilled-spirits lobbyist agrees with us on alcohol laws — Sutherland Soapbox, 9/23/14

Shot_glass_with_Fishermans_friendThis post is a transcript of a 4-minute weekly radio commentary aired on several Utah radio stations.

Utah and its elected officials are often lampooned for the alcohol/liquor laws and regulations of the state. The laws are usually portrayed as draconian, backwards and unnecessary. As most of you know, Sutherland Institute believes strong regulation of alcohol is a necessary component of a free and thriving civil society. Because of the unique nature of alcohol, its cost and availability should be much more regulated than soda or milk.

So last week, at the Utah Legislative Alcohol Policy Summit, it was very interesting for me to learn we had some very staunch allies in some unexpected places. I listened to a session headed by Victoria McDowell, CEO of the Presidents’ Forum of the Distilled Spirits Industry, which is an alcohol lobbying group that represents about 55 percent of all distilled spirits in the United States. You might know distilled spirits best as vodka, tequila, brandy, whisky and rum.

Throughout her presentation, McDowell described how her group is in favor of strong regulations and opposed to privatization. What could she be thinking? Everyone knows commodities and consumers do best with little to no regulations, right? Yes, we almost always agree with that sentiment. But alcohol is a very unique commodity. McDowell shared the experiences of Washington state, which privatized its alcohol sales in 2012 and has since experienced a host of problems. Listen as McDowell describes some of what has happened in Washington.

We don’t ever want to see another Washington state happen in another [alcohol] control state. Some very large retailers came in — Costco. Costco spent over $20 million to — it’s an initiative state so they got their initiative passed, and consumers were promised greater access, lower cost.

In fact, prices went up. More Washington state residents are going into Idaho or Oregon to buy their alcohol. The mom-and-pop stores, the smaller stores, are slowly dying out because they can’t compete with Costco, with the really big box retailers.

We’ve all probably read in the press about thefts — you know, distilled spirits being stolen by kids out of the grocery stores — because the grocery stores weren’t really prepared and equipped to sell distilled spirits — you know, spirits, I’m always saying, this is not milk and chips that we’re talking about.

Overall, when you see those promises that the states are going to get more money, so far, it hasn’t panned out. In fact, a couple of states who had privatized years ago [have] gone back to control because they never realized all the money they thought they were going to get.

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Dueling perspectives on the minimum legal drinking age

alcohol babyHere’s the opinion-based conjecture perspective (provided by Camille Paglia and Time):

A drinking age of 21 is responsible for …

  1. Making the U.S. like Third World countries
  2. The global drug trade
  3. Cruelty to young people
  4. College binge drinking
  5. Date rape
  6. Drug use among teenagers and homosexual men
  7. Unexplained suicides and massacres
  8. Prescription drug abuse
  9. The social disconnect of youth
  10. Hardcore sexting
  11. The collapse of “arts and letters”
  12. Tyrannical and dictatorial repression of civil liberties

Here’s the research-based fact perspective (provided by Duke University economist Philip J. Cook):

A drinking age of 21 is likely responsible for …

  1. Lowering rates of traffic accidents
  2. Reducing traffic deaths among teenagers and young adults
  3. Decreasing STD rates among adolescents
  4. Fewer instances of alcohol abuse by young people
  5. Lowering suicide rates for young men
  6. Improving economic productivity and outcomes due to fewer social problems from alcohol

Just a quick reminder of the need to keep public policy in the proper perspective.

City Weekly’s querulous ‘fact-check’ article is short on fact-checking

BardrinksIn response to a news release, with accompanying videos, from the LDS Church on Utah’s alcohol control policies, City Weekly published an article claiming to “fact check” the church statement. Reading through the article, the odd thing about it is that it didn’t really contain much fact checking. Rather, it reads more like a list of complaints about how the news release didn’t say what City Weekly wanted it to say. Let’s take City Weekly’s “fact checks” in turn.

“Fact check” No. 1: “Utah laws are ‘perhaps’ the reason why there are so few alcohol problems”

In one video, the church suggested that “perhaps the most important” factor in Utah’s low alcohol-related traffic deaths per capita are the state’s alcohol control laws. Note the word “perhaps,” suggesting one possibility or communicating that this is a statement of opinion.

Most reasonable people would read or hear that and realize that it was a suggestion or statement of opinion, not a definitive or factual statement. City Weekly, on the other hand, evidently felt compelled to “fact check” this statement, which amounted to providing a dissenting opinion from another organization…which of course is not fact-checking at all since opinion is not fact, no facts are being disputed, and no facts are being offered to correct any misstatement of fact. Maybe City Weekly wanted to remind people that there are various opinions on the question of why Utah’s alcohol-related traffic deaths per capita is so exceptional. But to call that “fact-checking” would be, ironically, factually inaccurate.

Fact check” No. 2: “Only jerks weird-shame Utah for its liquor laws”

The second complaint … sorry, “fact check” … that City Weekly wrote about was that the figure in a church video representing opposition to Utah’s alcohol laws did not have a face. The “fact check” is that “the voices calling for changes to Utah laws aren’t just faceless whiners b_____ about Utah’s liquor laws.” The article then went on to put faces, names, and/or affiliations to some of those “faceless whiners.”

Presumably, City Weekly would have the church video point out a specific person or group in its video, like City Weekly does in its “fact check.” However, this would also be a factually inaccurate representation of the “Zion Wall” opponents since it doesn’t fully represent all the voices opposing the policy. So this “fact check” is less about getting the facts straight than it is about complaining about how the video was done. Once again, not really fact-checking at all.

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Screaming ‘no’ to reform ignores facts, research on alcohol and driving

Alcohol_bottles_photographed_while_drunkEditor’s note: The Salt Lake Tribune published a version of this op-ed here. We are reposting this so that interested readers can view the citations.

Alcohol is a merciless killer. Every 53 minutes, alcohol-impaired driving kills someone on the roads in America, according to federal government data. Almost 10,000 lives lost unnecessarily each year. In 2011, 181 of these deaths were children under 14.

Controlling the production and use of alcoholic beverages saves innocent lives from such a tragic and premature end. These laws prevent traffic deaths by keeping impaired drivers off the road. They help safeguard innocent people from domestic violence and sexually transmitted diseases caused by alcohol-impaired decision making. And they protect the vulnerable and susceptible, such as children and recovering alcoholics, from the chains of alcohol abuse and addiction.

Yet despite all the benefits to society from alcohol control laws – grounded in common sense, sound research, and clear-minded observation – some people still fight efforts to improve Utah’s alcohol control laws.

Those who profit from looser liquor laws have come out screaming “NO!” in response to efforts to provide policymakers with research and facts regarding the National Transportation Safety Board’s recommendation that states should lower the limit for blood alcohol content (BAC) – for all drivers – from 0.08 percent to 0.05 percent.

Alas, their objections to this proposed improvement are refuted by decades of sound research. (Read on for citations.)

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‘Zion Curtain’ is a useful reminder

BardrinksThe following post is a transcript of a 4-minute weekly radio commentary aired on several Utah radio stations.

In Utah’s liquor wars, it’s no secret that Sutherland Institute supports current laws designed to decrease the sale and consumption of alcohol. I personally testified at a recent interim committee hearing on Utah liquor policy, from a conservative point of view,

Instead of entertaining jokes about Utah’s “Zion Curtain,” we’d be much better off searching for more ways to isolate the culture of drinking in this state – that is, if we’re serious about protecting the public interest. And despite feigned ignorance about culture and its effects, everyone knows what we mean. Specifically, a culture of drinking promotes liquor consumption just as a culture of dining promotes food consumption. The Zion Curtain law simply reminds us that a culture of drinking is different than a culture of dining.

Trust me when I tell you that I’ve heard every objection to those remarks that can possibly exit a reasonable person’s mouth – and many objections from unremarkably slurred voices. Where I seem to differ with my critics is that I believe freedom trumps individual liberty in some cases, and liquor, like the use of hard narcotics, is one of those cases. Again, as I testified, “We know that when someone is impaired or drunk, they’re not really free. It’s specious to argue that an individual liberty to consume as much liquor as you want, whenever and wherever you want, is some God-given principle in a free society.”

The biggest objections to my argument regard what I refer to as a “culture of drinking.”

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‘Catastrophically damaging’

Alcohol_bottles_photographed_while_drunkAccording to “economic development” advocates, here’s what “catastrophically damaging” looks like when it comes to drinking in Utah: a few moments of awkward conversation about Utah’s liquor laws when a waiter has to explain to a customer at a restaurant that he or she must order food to get an alcoholic drink.

According to conservatives, here’s what “catastrophically damaging” looks like when it comes to drinking in Utah: a family devastated when a child or parent is killed by a drunken driver; a marriage destroyed when dad comes home drunk and punches his wife over a minor (or major) disagreement; or a life tragically shortened because a family member’s drinking led to cirrhosis of the liver or one of America’s 20,000 alcohol-related cancer deaths.

Which one do you agree with?

Interim Day: Testimony before legislative committee regarding liquor policy

Photo credit: David Shankbone

Photo credit: David Shankbone

Testimony by Paul Mero before the Business and Labor Interim Committee on Wednesday, July 17, 2013.

Mr. Chairman and members of the committee,

State liquor policy has been consistent for decades. Utah is a control state. Our policy is to “reasonably satisfy the public demand” for alcoholic products and “protect the public interest.” The law even includes a provision about “the rights of citizens who do not wish to be involved with alcoholic products” (language justifying what has become known as the “Zion curtain”).

State policy is designed to “promote the reduction of the harmful effects” of liquor, to mitigate overconsumption and avoid the “consumption of alcoholic products by minors.” The policy even addresses all of the voices that wrongly equate the consumption of alcohol with economic development: The state “may not promote or encourage the sale or consumption of alcoholic products.” Arguing for liquor on the grounds that it increases economic development is promoting and encouraging its sale and consumption.

Every five years or so, this Legislature should revisit state liquor policy instead of allowing special interests to passive-aggressively chip away at it session by session. You either believe that there is a government role in protecting the public interest or you don’t.

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