The role of alcohol control policies in the reversal of alcohol consumption levels and resulting attributable harms in China

• Published in: Alcohol (Fayetteville, N.Y.) N.Y.), 2024-12, Vol.121, p.19-25
• Main Authors: Rehm, Jürgen, Shield, Kevin, Hassan, Ahmed S., Franklin, Ari
• Format: Article
• Language: English
• Subjects: Accidents, Traffic - mortality; Accidents, Traffic - prevention & control; alcohol; alcohol control policies; Alcohol Drinking - adverse effects; Alcohol Drinking - legislation & jurisprudence; Alcohol Drinking - prevention & control; Alcohol use; Alcoholic beverages; Alcoholic Beverages - economics; Alcoholic Beverages - legislation & jurisprudence; anti-corruption campaign; attributable mortality; China; China - epidemiology; Disease; Driving Under the Influence - legislation & jurisprudence; Driving Under the Influence - prevention & control; Economic growth; economy; GDP; Gross Domestic Product; Health care policy; Health Policy - legislation & jurisprudence; Humans; Mortality; Per capita; Public health; Purchasing power parity; Taxation; Taxes
• ISSN: 0741-8329; 1873-6823; 1873-6823
• DOI: 10.1016/j.alcohol.2024.07.002

Yearly adult per capita consumption of alcohol in China between 2016 and 2019 decreased by 2.4 L of pure alcohol, or 33%. According to the World Health Organization, this decrease in consumption was accompanied by reductions in alcohol-attributable mortality of 23% between 2015 and 2019. This paper examines the contribution of alcohol control policies in China to these public health gains. A systematic search of the literature was conducted on alcohol control policies and their effectiveness in China as part of a larger search of all countries in WHO Western Pacific Region. In addition to articles on empirical evidence on the impact of such alcohol control policies, we also searched for reviews. The plausibility of changes of traditional alcohol control policies (taxation increases, availability restrictions, restriction on advertisement and marketing, drink-driving laws, screening and brief interventions) in explaining reductions of consumption levels and attributable mortality rates was explored. There was some progress in the successful implementation of strict drink-driving policies, which could explain reductions in traffic injuries, including fatalities. Other traditional alcohol control policies seem to have played a minimal role in reducing alcohol consumption and attributable harms during the time period 2016–2019. However, an anti-corruption campaign was extensive enough to have substantially contributed to these reductions. The campaign prohibited the consumption of alcoholic beverages in everyday life of government officials and thus contributed to a de-normalization of alcohol. While this anti-corruption campaign was the only policy to potentially explain marked decreases in levels of alcohol consumption and attributable mortality, more detailed research is required to determine exactly how the campaign achieved these decreases. •China had decreases of alcohol consumption and attributable mortality since 2016.•Cardiovascular and digestive diseases were the main causes of death responsible.•None of the classic alcohol control policies seem to be able to explain these decreases.•Economic explanations also fail to explain the changes.•A massive anti-corruption campaign denormalized alcohol use and offers a likely explanation.