Alcohol policy and gender: a modelling study estimating gender-specific effects of alcohol pricing policies

Abstract

Aims: To describe gender differences in alcohol consumption, purchasing preferences and alcohol-attributable harm. To model the effects of alcohol pricing policies on male and female consumption and hospitalizations.

Design: Epidemiological simulation using the Sheffield Alcohol Policy Model version 4.

Setting and participants: Adults aged 18+ years, England.

Interventions: Three alcohol pricing policies: 10% duty increase and minimum unit prices (MUP) of £0.50 and £0.70 per UK unit.

Measures: Gender-specific baseline and key outcomes data: annual beverage-specific units of alcohol consumed and beverage-specific alcohol expenditure (household surveys). Alcohol-attributable hospital admissions (administrative data). Key model parameters: literature-based own- and cross-price elasticities for 10 beverage-by-location categories (e.g. off-trade beer). Sensitivity analysis with new gender-specific elasticities. Literature-based risk functions linking consumption and harm, gender-disaggregated where evidence was available. Population subgroups: 120 subgroups defined by gender (primary focus), age, deprivation quintile and baseline weekly consumption.

Findings: Women consumed 59.7% of their alcohol as off-trade wine while men consumed 49.7% as beer. Women drinkers consumed fewer units annually than men (494 versus 895) and a smaller proportion of women were high-risk drinkers (4.8 versus 7.2%). Moderate drinking women had lower hospital admission rates than men (44 versus 547 per 100 000), but rates were similar for high-risk drinking women and men (14 294 versus 13 167 per 100 000). All three policies led to larger estimated reductions in consumption and admission rates among men than women. For example, a £0.50 MUP led to a 5.3% reduction in consumption and a 4.1% reduction in admissions for men but a 0.7% reduction in consumption and a 1.6% reduction in hospitalizations for women.

Conclusion: Alcohol consumption, purchasing preferences and harm show strong gender patterns among adult drinkers in England. Alcohol pricing policies are estimated to be more effective at reducing consumption and harm for men than women.

Keywords: Alcohol policy; gender; inequalities; modelling; policy appraisal; pricing; taxation.

Figure 1. Sheffield Alcohol Policy Model Overview

A: Policy to consumption model schematic B: Consumption to harm model schematic Key: Green - data sources, yellow - model inputs, blue – intermediate steps, pink – model outputs

Figure 2

Moderate, increasing risk and high-risk drinkers’ shares of the male/female population, of total alcohol consumption, of total alcohol expenditure and total alcohol-attributable hospital admissions, by gender. Example interpretation: Only 7% of all male drinkers are high-risk drinkers, but they account for 34% of men’s consumption, 26% of their spending, and 37% of their admissions.

Figure 3

Price distribution of alcohol purchases by gender, deprivation and drinker level, England 2016: top: total and bottom: relative distributions. Red and dark orange: units affected by MUP50. Red, dark and light orange: units affected by MUP70. Turquoise: units above minimum pricing thresholds.

Figure 4. Estimated absolute policy effects on consumption, spending and hospital admission rates, by gender and deprivation quintile (Q1 least deprived, Q5 most deprived)