Context
Excessive alcohol consumption is the third-leading cause of preventable death in the
U.S. This systematic review is one in a series exploring effectiveness of interventions
to reduce alcohol-related harms.
Evidence acquisition
The focus of this review was on studies evaluating the effects of the privatization
of alcohol retail sales on excessive alcohol consumption and related harms. Using
Community Guide methods for conducting systematic reviews, a systematic search was conducted in multiple
databases up to December 2010. Reference lists of acquired articles and review papers
were also scanned for additional studies.
Evidence synthesis
A total of 17 studies assessed the impact of privatizing retail alcohol sales on the
per capita alcohol consumption, a well-established proxy for excessive alcohol consumption;
9 of these studies also examined the effects of privatization on the per capita consumption
of alcoholic beverages that were not privatized. One cohort study in Finland assessed
the impact of privatizing the sales of medium-strength beer (MSB) on self-reported
alcohol consumption. One study in Sweden assessed the impact of re-monopolizing the
sale of MSB on alcohol-related harms. Across the 17 studies, there was a 44.4% median
increase in the per capita sales of privatized beverages in locations that privatized
retail alcohol sales (interquartile interval: 4.5% to 122.5%). During the same time
period, sales of nonprivatized alcoholic beverages decreased by a median of 2.2% (interquartile
interval: −6.6% to −0.1%). Privatizing the sale of MSB in Finland was associated with
a mean increase in alcohol consumption of 1.7 liters of pure alcohol per person per
year. Re-monopolization of the sale of MSB in Sweden was associated with a general
reduction in alcohol-related harms.
Conclusions
According to Community Guide rules of evidence, there is strong evidence that privatization of retail alcohol
sales leads to increases in excessive alcohol consumption.
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Article info
Footnotes
Author affiliations are shown at the time the research was conducted.
Names and affiliations of the Task Force members can be found at www.thecommmunityguide.org/about/task-force-members.html.
Identification
Copyright
Published by Elsevier Inc.
