Effect of Maryland’s 2011 Alcohol Sales Tax Increase on Alcohol-Positive Driving


      The 2011 Maryland alcohol sales tax increase from 6% to 9% provided an opportunity to evaluate the impact on rates of alcohol-positive drivers involved in injury crashes.


      Maryland police crash reports from 2001 to 2013 were analyzed using an interrupted time series design and a multivariable analysis employing generalized estimating equations models with a negative binomial distribution. Data were analyzed in 2014–2015.


      There was a significant gradual annual reduction of 6% in the population-based rate of all alcohol-positive drivers (p<0.03), and a 12% reduction for drivers aged 15–20 years (p<0.007), and 21–34 years (p<0.001) following the alcohol sales tax increase. There were no significant changes in rates of alcohol-positive drivers aged 35–54 years (rate ratio, 0.98; 95% CI=0.89, 1.09). Drivers aged ≥55 years had a significant immediate 10% increase in the rate of alcohol-positive drivers (rate ratio, 1.10; 95% CI=1.04, 1.16) and a gradual increase of 4.8% per year after the intervention. Models using different denominators and controlling for multiple factors including a proxy for unmeasured factors found similar results overall.


      The 2011 Maryland alcohol sales tax increase led to a significant reduction in the rate of all alcohol-positive drivers involved in injury crashes especially among drivers aged 15–34 years. This is the first study to examine the impact of alcohol sales taxes on crashes; previous research focused on excise tax. Increasing alcohol taxes is an important but often neglected intervention to reduce alcohol-impaired driving.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Miller T.R.
        • Gibson R.
        • Zaloshnja E.
        • et al.
        Underreporting of driver alcohol involvement in United States police and hospital records: capture-recapture estimates.
        Ann Adv Automot Med. 2012; 56: 87-96
        • Elder R.W.
        • Lawrence B.
        • Ferguson A.
        • et al.
        The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms.
        Am J Prev Med. 2010; 38: 217-229
        • Wagenaar A.C.
        • Livingston M.D.
        • Staras S.S.
        Effects of a 2009 Illinois alcohol tax increase on fatal motor vehicle crashes.
        Am J Public Health. 2015; 105: 1880-1885
        • Staras S.A.S.
        • Livingston M.D.
        • Wagenaar A.C.
        Maryland alcohol sales tax and sexually transmitted infections. A natural experiment.
        Am J Prev Med. 2016; 50: e73-e80
        • Esser M.B.
        • Waters H.
        • Smart M.
        • Jernigan D.H.
        Impact of Maryland’s 2011 alcohol sales tax increase on alcoholic beverage sales.
        Am J Drug Alcohol Abuse. 2016; 42: 404-411
        • Fell J.C.
        • Beirness D.J.
        • Voas R.B.
        • et al.
        Can progress in reducing alcohol-impaired driving fatalities be resumed? Results of a workshop sponsored by the transportation research board alcohol, other drugs, and transportation committee (ANB50).
        Traffic Inj Prev. 2016; 17: 771-781
        • Kerr W.C.
        • Patterson D.
        • Greenfield T.K.
        • et al.
        U.S. alcohol affordability and real tax rates, 1950–2011.
        Am J Prev Med. 2013; 44: 459-464
        • Chaloupka F.J.
        • Saffer H.
        • Grossman M.
        Alcohol-control policies and motor-vehicle fatalities.
        J Legal Stud. 1993; 22: 161-186
        • Chang K.
        • Wu C.
        • Ying Y.
        The effectiveness of alcohol control policies on alcohol-related traffic fatalities in the United States.
        Accid Anal Prev. 2012; 45: 406-415
        • Chetty R.
        • Looney A.
        • Kroft K.
        Salience and taxation: theory and evidence.
        Am Econ Rev. 2009; 99: 1145-1177
        • Cotti C.
        • Dunn R.A.
        • Tefft N.
        Alcohol-impaired motor vehicle crash risk and the location of alcohol purchase.
        Soc Sci Med. 2014; 108: 201-209
        • Gruenewald P.J.
        • Ponicki W.R.
        • Holder H.D.
        • Romelsjö A.
        Alcohol prices, beverage quality, and the demand for alcohol: quality substitutions and price elasticities.
        Alcohol Clin Exp Res. 2006; 30: 96-105
      1. Siegel M, Jernigan D. Database of brand-specific alcohol and prices alcohol content. Accessed May 15, 2016.

        • Xuan Z.
        • Chaloupka F.J.
        • Blanchette J.G.
        • et al.
        The relationship between alcohol taxes and binge drinking: evaluating new tax measures incorporating multiple tax and beverage types.
        Addiction. 2015; 110: 441-450
        • Burch C.
        • Cook L.
        • Dischinger P.
        A comparison of KABCO and AIS injury severity metrics using CODES linked data.
        Traffic Inj Prev. 2014; 15: 627-630
        • Berning A.
        • Smither D.D.
        Understanding the Limitations of Drug Test Information, Reporting, and Testing Practices in Fatal Crashes. DOT HS 812 072.
        U.S. Department of Transportation, National Highway Traffic Safety Administration, Washington, DC2014
      2. U.S. Bureau of Labor Statistics. Local area unemployment statistics. Updated 2014. Accessed January 7, 2015.

      3. U.S. Department of Commerce. Regional economic accounts: state personal income accounts. Updated March 24, 2016. Accessed May 4, 2016.

      4. National Institute of Alcohol Abuse and Alcoholism. Alcohol policy information system. Accessed March 5, 2015.

      5. Insurance Institute for Highway Safety. Safety belt laws. Updated 2014. Accessed November 6, 2014.

        • National Highway Traffic Safety Administration
        Digest of Impaired Driving and Selected Beverage Control Laws. 28th ed. U.S. Department of Transportation, National Highway Traffic Safety Administration, Washington, DC2013
        • Villaveces A.
        • Cummings P.
        • Koepsell T.D.
        • Rivara F.P.
        • Lumley T.
        • Moffat J.
        Association of alcohol-related laws with deaths due to motor vehicle and motorcycle crashes in the United States, 1980–1997.
        Am J Epidemiol. 2003; 157: 131-140
      6. Tax Foundation. State sales, gasoline, cigarette, and alcohol tax rates by state, 2000–2014. Updated 2014. Accessed November 13, 2014.

      7. U.S. Census Bureau. State and county quickfacts. Updated 2014. Accessed January 7, 2015.

      8. U.S Department of Transportation Federal Highway Administration. Highway statistics series. Updated 2013. Accessed November 13, 2014.

        • Lord D.
        • Mannering F.
        The statistical analysis of crash-frequency data: a review and assessment of methodological alternatives.
        Transport RES A-Pol. 2010; 44: 291-305
        • Kincaid C.
        Guidelines for selecting the covariance structure in mixed model analysis.
        Paper presented at: Thirtieth Annual SAS Users Group International Conference, Philadelphia, PA2005 April
        • Chaloupka F.J.
        • Laixuthai A.
        Do youths substitute alcohol and marijuana? Some econometric evidence.
        Eastern Econ J. 1997; 23: 253-276
        • Mast B.D.
        • Benson B.L.
        • Rasmussen D.W.
        Beer taxation and alcohol-related traffic fatalities.
        Southern Econ J. 1999; 66: 214-249
        • Morrisey M.A.
        • Grabowski D.C.
        Gas prices, beer taxes and GDL programmes: effects on auto fatalities among young adults in the U.S.
        Appl Econ. 2011; 43: 3645-3654
        • Young D.J.
        • Likens T.W.
        Alcohol regulation and auto fatalities.
        Int Rev Law Econ. 2000; 20: 107-126
        • Young D.J.
        • Bielinska-Kwapisz A.
        Alcohol prices, consumption, and traffic fatalities.
        Southern Econ J. 2006; 72: 690-703
        • Wagner A.K.
        • Soumerai S.B.
        • Zhang F.
        • Ross-Degnan D.
        Segmented regression analysis of interrupted time series studies in medication use research.
        J Clin Pharm Ther. 2002; 27: 299-309
        • Fell J.C.
        • Langston E.A.
        • Tippetts A.S.
        Evaluation of four state impaired driving enforcement demonstration programs: Georgia, Tennessee, Pennsylvania and Louisiana.
        Annu Proc Assoc Adv Automot Med. 2005; 49: 311-326
        • Whetten-Goldstein K.
        • Sloan F.A.
        • Stout E.
        • Liang L.
        Civil liability, criminal law, and other policies and alcohol-related motor vehicle fatalities in the United States: 1984–1995.
        Accid Anal Prev. 2000; 32: 723-733
        • Kisely S.R.
        • Pais J.
        • White A.
        • et al.
        Effect of the increase in “alcohol pops” tax on alcohol-related harms in young people: a controlled interrupted time series.
        Med J Aust. 2011; 195: 690-693
        • Saffer H.
        • Grossman M.
        Drinking age laws and highway mortality rates: cause and effect.
        Econ Inq. 1987; 25: 403-417
        • Meier P.S.
        • Purshouse R.
        • Brennan A.
        Policy options for alcohol price regulation: the importance of modelling population heterogeneity.
        Addiction. 2010; 105: 383-393
      9. National Highway Traffic Safety Administration. Prevalence of high BAC in alcohol-impaired driving fatal crashes. Updated 2012. Accessed August 3, 2013.

        • Blomberg R.D.
        • Peck R.C.
        • Moskowitz H.
        • Burns M.
        • Fiorentino D.
        The Long Beach/Fort Lauderdale relative risk study.
        J Safety Res. 2009; 40: 285-292
      10. U.S. Department of Commerce. Household income: 2013. Updated 2014. Accessed December 11, 2014.

      11. Comptroller of Maryland. Consumer FAQs about alcoholic beverages. Updated 2013. Accessed August 1, 2014.