Suicide is a pressing public health issue that deserves a thoughtful policy response. But we don’t often talk about regulating one of the biggest suicide risk factors: alcohol.
The use of alcohol and drugs is the most frequent risk factor for suicide after depression and mood disorders, according to the U.S. Centers for Disease Control and Prevention. Alcohol was a factor in approximately one-third of suicides in 2007, 62 percent of which involved people with blood alcohol levels higher than the legal driving limit of 0.08.
While mental health experts talk about the role of alcohol use in suicide rates, that conversation never seems to extend to policy or regulation. Now, new evidence from a review of existing study literature indicates that it should.
“There’s ample literature [on alcohol and suicide]. What’s missing is how alcohol policy affects suicide,” said study author Ziming Xuan, an assistant professor of community health sciences at Boston University’s School of Public Health.
Taxation as a weapon against alcohol-related suicide
Xuan decided to fill that gap by reviewing 17 studies on alcohol policies and suicide published between 1999 and 2014. He found that polices like alcohol taxation, limiting the number of stores that sell alcohol in a given area, increasing minimum drinking ages and restricting hours for alcohol sales were associated with lower suicide rates.
“If one can reduce the average alcohol consumption in a population level, then ideally we can shift the risk at a population level,” Xuan explained.
In other words, the more difficult it is to obtain alcohol, the less people buy and the fewer alcohol-related suicides occur.
Higher alcohol taxes had the greatest effect on reducing suicide among the alcohol restriction polices analyzed in the review, according to Xuan. Taxes are more effective at reducing excessive drinking than other policy measures, but Xuan said it’s not clear why exactly that is. And although taxes are most effective, enacting multiple types of policies in tandem could have the greatest impact in limiting alcohol’s availability.
Men have the most to gain from alcohol taxes
Xuan's study, which was published in the journal Alcoholism: Clinical and Experimental Research in October, showed men were more likely than women to benefit from alcohol taxes. This is probably because historically, men drink more than women. Men are twice as likely to binge drink as women, with about 23 percent of adults men reporting binge drinking five times per month at an average of eight drinks per binge, according to CDC.
That drinking gap is shrinking for younger Americans: Women born between 1991 and 2001 were about as likely to consume alcohol as men.
Still, suicide remains a heavily gendered problem. Men make up 80 percent of the nation’s suicides and are four times more likely to die by suicide than women.
Suicide is also growing. Between 1999 and 2014, suicide rates in the United States increased 24 percent, according to a CDC report published in April, making suicide the 10th most common cause of death nationwide.
Of course, alcohol is just one component of a larger picture. Suicide is a complex and multifaceted problem, with many risk factors, including mental health problems, drug use, access to firearms and co-occurring medical conditions.
Reducing population-wide alcohol consumption won’t solve our suicide problem, but Xuan’s review shows it could help. For instance, according to one 2003 study he considered, a 10 percent beer tax on was associated with a 2.4 percent drop in suicides among males ages 20 to 24.
The new review is an encouraging reminder that public health policies can make a difference, especially if coupled with easy-to-access resources for at-risk individuals.