The scream test

Imagine two policies.

Policy A would have government nationalise all liquor companies and distribute their product, for free, for anybody who wants some, with costs borne out of general taxation. There would be no compensation of the liquor companies.

Policy B would strengthen alcohol intervention programmes for prisoners with alcohol abuse problems. They'd spend a fair bit on it and work hard with prisoners, both while in prison and during their re-integration back into the community, to help them to avoid falling back into substance abuse.

Now Alcohol Action NZ proposes a "scream test" to tell whether some proposed policy would reduce alcohol harm. In their model, industry profits are increasing in the harm imposed by alcohol, and industry screams when profits are threatened. Anything that reduces harm reduces profits, so the scream test tells us which policies are likely to reduce harm.

I suggest instead that industry would scream a lot about Policy A, and would likely support Policy B. I also suggest that Policy A would increase harm and Policy B would reduce harm. Note further that National is already implementing something like Policy B - kudos to them. I've yet to hear screams from industry.

The scream test is a bad one. Profits are perhaps increasing in total consumption, but they're likely decreasing in alcohol's harms not only because of the policy reaction function but also because moderate consumers' consumption is likely decreasing in perceptions of harm.

The one spot where Sellman's scream test could be right would be policies potentially hitting the very heaviest consumers. There are discrepancies between median reported consumption figures and total alcohol available for consumption suggestive of that there is a small group consuming booze by the barrel. Policies disproportionately hitting that group could potentially reduce both harm and profits. But I hardly expect that mandatory 1 am bar closing times fit the bill.

Keeping it 18

New Zealand's reduction in the alcohol purchase age from 20 to 18 did not substantially worsen outcomes for youths. Alcohol consumption did not increase among 18 and 19 year olds subsequent to the change. Consumption, binge drinking, and accident rates among 15-17 year olds seems to have fallen since the reduction in the purchase age as well.

Stefan Boes and Steven Stillman's paper using regression discontinuity design and difference-in-difference measures on the alcohol purchase age, previewed here, is now up as an IZA working paper. Their abstract:

This paper examines the impact of a reduction in the legal drinking age in New Zealand from 20 to 18 on alcohol use, and alcohol-related hospitalisations and vehicular accidents among teenagers. We use both a difference-in-differences approach and a regression discontinuity design (RDD) to examine the impact of the law change. Our main findings are that lowering the legal drinking age did not appear to have led to, on average, an increase in alcohol consumption or binge drinking among 15-17 or 18-19 year-olds. However, there is evidence that the law change led to a significant increase in alcohol-related hospital admission rates for 18-19 year-olds, as well as for 15-17 year-olds. While these increases are large in relative magnitude, they are small in the absolute number of affected teenagers. Finally, we find no evidence for an increase in alcohol-related vehicular accidents at the time of the law change for any teenagers. In an important methodological contribution, we show that one approach commonly used to estimate the impact of changing the legal drinking age on outcomes, an RDD that compares individuals just younger than the drinking age to those just older, has the potential to give misleading results. Overall, our results support the argument that the legal drinking age can be lowered without leading to large increases in detrimental outcomes for youth.

The difference-in-difference measures in particular show lowered consumption among 15-17 year olds.

Finer-grained data on traffic accidents showed no increase with the purchase age reduction. There were more youth hospital admissions for alcohol use disorders subsequent to the law change. But while the increase is large in percentage terms, the baseline risk is low. Boes and Stillman estimate an additional 2.2 to 3.4 alcohol use disorder hospital admissions per month among 15-17 year olds, 2.1 to 2.6 per month among 18-19 year olds, and 1.0 to 1.5 per month among 20-21 year olds in the period immediately following the law change. They note that seasonal variation in admission for flu and asthma are three and twenty times larger than the variation attributed to the reduction in the alcohol purchase age.

They also make an important point on method, and I thank Steven for having explained this one to me slowly; hopefully I've understood it properly. Now recall that they found no effect of the law change on traffic accidents: changing the alcohol purchase age from 20 to 18 did not increase the accident rate among youths. Nevertheless, results from a regression discontinuity design comparing accident rates among kids just under the alcohol purchase age with those just over the alcohol purchase age shows an increase in accidents on reaching the alcohol purchase age after the law change. Why could there be an effect in RDD but not overall? Either the RDD is picking up the effect of the alcohol purchase age on the cohort of inexperienced drinkers who change their behaviour on reaching 18 and experience worsened outcomes, or it's picking up a particular changed behaviour around the time of the birthday. We would have overestimated the effects on traffic accidents for 18-19 year olds by extrapolating from the discontinuity around the 18th birthday.

But, we only know this because New Zealand actually had the policy change so we can compare actual outcomes with those estimated by the RDD. Now, suppose you're in a country that hasn't reduced its drinking age and you want to estimate what the effect of decreasing the drinking age might be. If you ran an RDD looking at the effect of reaching the age of majority on traffic accidents, took the break around the birthday as being the effect of being able to drink, then extrapolated that effect back across the cohort of younger drinkers who would be eligible to drink under a different minimum legal drinking age, you could pretty easily be overestimating the likely effect of a real change in the alcohol purchase age. The RDD picks up the effect of reaching the legal drinking age rather than the effect that would obtain by lowering the legal drinking age.

They conclude:

Overall, our results support the argument being made by groups like Amethyst Initiative and Choose Responsibility (see http://www.choose responsibility.org/proposal/) that the legal drinking age can be lowered without leading to large increases in detrimental outcomes for youth. The current age limit of 21 in the US is higher than in Canada, Mexico and most western European countries. The arguments against lowering the drinking age typically include the idea that even, if a new steady-state with a lower drinking age might be beneficial, the transition to that new steady-state might be very costly. The evidence in our paper from a country with drinking habits very similar to the US suggests that this does not have to be the case.

It is pretty tough to maintain a position that youth drinking is any kind of worsening problem in New Zealand.

Earlier this month, Auckland University's Youth Survey came out. Binge drinking rates among high school students have almost halved since 2001. The NZ Herald highlighted a few other trends from the survey hardly consistent with any kind of growing youth crisis. David Farrar linked up the current survey numbers with prior year figures to show decreases in all measures of youth alcohol consumption.

Creighton on individual choice

I'm going to have to finally start paying for The Australian if Adam Crieghton keeps coming out with columns like this. 

German doctors were the first to discover a link between tobacco smoking and cancer in the 1930s. National Socialism declared cancer "the number one enemy". Along with a passion for the natural environment, the Fuhrer hated smoking -- a relic of the sort of decadent liberal lifestyle that undermined the health of the "volk".

In measures foreshadowing Australia's own "pioneering" efforts to reduce smoking, Nazi Germany cracked down on cigarette advertising, banned smoking at work, in government offices, and ultimately on buses and trains too.

The Reich itself exhorted Germans to change: "Food is not a private matter" and "You have a duty to be healthy" blared from government placards.

Today's healthy living crusaders, roused into excitement by any tax or ban that might ostensibly improve people's health, most obviously do not adhere to the other heinous tenets of National Socialism. But they do share its bizarre and sometimes shrill desire to curtail others' eating and leisure habits, supposedly in the interests of the individuals concerned and the greater public good.

"Everywhere in the West public health doctrine has drifted from public-good concerns, such as contagious diseases, toward a frontal attack on individual choices and politically incorrect lifestyles," writes Canadian economics professor Pierre Lemieux of University of Quebec.

Hitler's Institute for Tobacco Hazards Research helped calculate the "national economic cost of smoking". But its figures were probably as fraudulent as those routinely concocted today.

I know about Godwin's Law. But counting "reduced productivity" from smoking as a social cost makes most sense where the underlying model is that you belong to the State.

I'll quibble with a couple more minor points. 

First, Creighton notes that economists sometimes recommend tobacco or alcohol excise taxes because consumption is relatively insensitive to price. That's one read of the general Ramsey optimal-tax literature. But I'm pretty sure that the proper reading of Ramsey is that, because we cannot tax leisure, optimal tax policy will tax more heavily those things more complementary to leisure than to labour. It's less the absolute price elasticity of demand that matters than the cross-elasticity with labour and leisure choices. 

Second, Creighton suggests that government enthusiasm for taxing tobacco rather than alcohol despite that nasty drunks impose more costs on others than do nasty smokers stems from pure classicism and elitism. That could be the case - we tend to impose excise on products imposing fiscal externalities that also draw social disapproval. But I would note that light to moderate drinkers are most sensitive to price. They impose little to no harm on others. And they even have reduced overall mortality rates. Heavy drinkers are rather less responsive to prices. Hiking alcohol taxes does more to turn moderate drinkers into light drinkers than it does to turn heavy drinkers into moderate drinkers. If anything, the evidence suggests that heavy drinkers save up for a few binge events rather than curb consumption from the peaks: they drink less on low-drinking days rather than cutting back on their worst excesses. Prices are blunt instruments for dealing with alcohol related harm in the same way that petrol excise is a blunt instrument for dealing with speed-related car crashes.

Update: In comments below, a few folks have gone a bit farther than I would in opposing tobacco control policy. Rather than get involved there, I'll just put a statement up here.

First, there is no chance that there is any slippery slope connecting tobacco control policy to eugenics or other parts of the Nazi programme.

However, I agree with DragonFly in comments below that there is an underlying mindset that is common to both movements. To view it as a cost to the State that you make choices that burden the State through lower tax revenues requires that, deep down, you think we're all kinda owned by the State. It's the view that says we have a responsibility not to ourselves, but to the State, to choose more healthy behaviours even if we would prefer to consume less health and more fun. It's the vision that says there's one right way of living, irrespective of your own hopes and dreams. To me, that's the vision of human nature that was given fullest policy fruition in Nazi Germany. I do not think that public health paternalism in any way leads us to Nazi Germany. I do think that it will continue pushing on every margin of socially disapproved behaviours that provide individuals, primarily from the lower classes, with pleasure in exchange for risk. Tobacco, alcohol, fast food, soda.

But it's not a view that started with them. You can see it in Thomas Carlyle's view that blacks could never be made fully human unless they had the benefit of slaveowners to guide them towards work with the lash. There's a right way of living, and we'll force you to it with the lash if necessary.

Economics was called the Dismal Science by Thomas Carlyle because, in his view, we would deny blacks the opportunity to become human through the use of the lash. Mill's opposition to Carlyle was grounded as much in his view that slavery was repugnant as in his view that we should all be treated as equally capable of choosing our own vision of the good life. Perhaps comprehensive public education could help us in making better choices as we ourselves see things, or for teaching us about the higher-order pleasures. But fundamentally, the good is subjective and individual. And if I, with full knowledge, choose to consume less health and more fun, then it is too great an infringement on individual liberty to compel me to choose otherwise. Economics starts here: methodological individualism. There is no good outside of what we believe to be good, no value that exists outside the system. And where we disagree on what is good, and where we are not harming any other in our personal pursuit of that good, there is nobody who can stand above us and tell us we have wrongly chosen.

Sometimes, prices are blunt

Where the social harms from alcohol consumption are nonlinear and excise is constrained to be linear, any excise tax will wind up being a pretty blunt way of trying to internalise harms. An excise tax that raises revenue sufficient to cover the total social cost imposed will necessarily overtax light and moderate drinkers while undertaxing those imposing larger social harms, if we expect that it's the heavy drinkers who impose large social costs on others rather than just large health costs on themselves.

Reasonable policy tries instead to focus on the relevant margins. An alcohol excise tax sufficient to internalise the external harms imposed by heavy drinkers will impose very strong penalty on moderate drinkers. Instead, policy should combine a rather lower excise component with penalties attached directly to the actions that impose external harms: penalties for being drunk and disorderly; penalties for driving while intoxicated; making alcohol use an aggravating factor in sentencing for other crimes.

A new bit of evidence that prices are a blunt instrument in dealing with harms imposed by heavy drinkers. I've typically cited Wagenaar's metastudy showing that heavy drinkers are roughly 60% as price responsive as moderate drinkers: a 10% price increase has drinkers in total reduce consumption by 4.4% but has heavy drinkers reduce consumption only by 2.8%. The University of Maryland's Jon Nelson has a new study out focusing on a smaller proportion of the population of estimates, but the ones with the finer-grained individual data that allows for demographic breakdowns. The abstract summarises things:

Gender differences in drinking patterns are potentially important for public policies, especially policies that rely extensively on higher alcohol taxes and prices. This paper presents a systematic review of alcohol prices and gender differences in drinking and heavy drinking by adults and young adults. Starting with a database of 578 studies of alcohol demand and other outcomes, 15 studies are reviewed of adult drinking including discussion of samples, measurement issues, econometric models, special variables, and key empirical results. A similar discussion is presented for eight studies of drinking by young adults, ages 18–26 years. Four conclusions are obtained from the review. First, adult men have less elastic demands compared with women. Second, there is little or no price response by heavy-drinking adults, regardless of gender. Third, although the sample is small, price might be important for drinking participation by young adults. Fourth, the results strongly suggest that heavy drinking by young adults, regardless of gender, is not easily dissuaded by higher prices. Policy implications, primary study limitations, and suggestions for future research are discussed.

Nelson here provides more of a literature review than a metastudy that would provide a new summary elasticity measure. A couple other interesting findings:

• Bans on alcohol on university campuses do rather more to deter moderate drinking than to stop heavy drinking;
• The number of licenced outlets near campus has little effect on drinking or on heavy drinking among young adults.

Group One Carcinogens, revisted

Cancer is scary, so the usual lot are again pumping the alcohol-cancer link.

The Cancer Society of New Zealand says Kiwis are only now sobering up to the link between alcohol and cancer, just as we did more than 30 years ago with smoking and lung cancer.

Strong links between drinking more than two or three units a day have been established to deadly digestive tract cancers including mouth, throat, larynx and oesophageal cancers.

There are also strong links between alcohol and bowel, breast and prostate cancers.

The warning comes on as some Kiwis sign up for Dry July, a month without drinking alcohol. Those taking part are encouraged to sign up sponsors in support of cancer services.

 ...

Dr Jan Pearson, of the Cancer Society, said it was time Kiwis started talking about the risks of excessive drinking.

"We are probably at the stage now that we were at 30 years ago with tobacco," she said.

...

Otago University public health professor Tony Blakely said alcohol "absolutely" contributed to cancer rates.

"Alcohol has more obvious impacts on injuries, deaths, social bedlam, unwanted pregnancies and suicides," he said.

...

Christchurch Professor Doug Sellman, of the National Addiction Centre, said that 25 per cent of alcohol-related deaths "are actually cancer deaths.

"The ethanol in alcohol is a group one carcinogen, like asbestos," he said.

First, they're right: alcohol is a known Group 1 carcinogen, along with diesel exhaust, ciclosporin, estrogen-based oral contraceptives and menopausal therapy, risky sex (Hep B & C, HPV, HIV), the sun, mineral oils, salted fish, wood dust, painting, boot & shoe manufacture and repair, plutonium, and rather a few other things.

Alcohol has a bundle of positive and negative health effects. At low doses, for most people, the positive dominates. That's why we get a J-curve with about a 16% reduction in the risk of all-source mortality around one standard drink per day. After about 3-4 standard drinks per day, you start  exceeding non-drinkers' mortality risk. Unless you have a strong family history of particular diseases that are positively or negatively affected by alcohol, it makes far more sense to watch the aggregate J curve than to follow the disease-by-disease effects.

Update: Here's Thomas Lumley over at StatChat:

The phrase “group one carcinogen” is only relevant in an argument over whether the risk is zero or non-zero. Its use in other contexts suggests that someone doesn’t know what it means, or perhaps hopes that you don’t.

Dave Guerin at Ed.co.nz summarises:

1. Dodgy Advocacy Otago Uni’s Profs Doug Sellman and Tony Blakely commented on alcohol and cancer, with Sellman saying that the “alcohol in ethanol is a group one carcinogen”. This is a great example of Sellman’s dodgy advocacy work. Canterbury’s Eric Crampton points out a few other group 1 carcinogens (the sun, salted fish, wood dust), while Auckland’s Prof Thomas Lumley points out that being in group 1 simply means that a cancer risk has been established, high or low. Lumley went on to say that using the group 1 term in most contexts “suggests that someone doesn’t know what it means, or perhaps hopes that you don’t”. Quite.

Previously:

• A few things Alcohol Action NZ won't tell you about alcohol
• Group One Carcinogens
• The J-Curve
• The J-Curve: Science vs Politics
• Moderate drinking and health
• Moderate drinking and health - more evidence
• NZ's Ministry of Health and the J-Curve
• Differential standards of evidence
• Nanny's drinking problem

Data?

I'm curious where Jennie Connor's gotten her numbers for this one:

University of Otago Preventive and Social Medicine head Prof Jennie Connor, who is the chairwoman of a university group set up to tackle problem drinking, said students were drinking more heavily than they did 10 years ago.

''In the last 10 years, there has been an increase in how much they drink and the frequency of heavy episodes of drinking.''

''A larger proportion of all students drink and drink heavily. Not just at Otago but at all universities, and probably in the general population of young people,'' she said.

The main driver of the change in drinking culture was the introduction of wine and beer sales in supermarkets and the lowering of the purchase age from 20 to 18.

''A whole new drinking culture has grown up around heavy drinking outside of a pub environment,'' he said.

She was not quite so enthusiastic about getting more students to drink in pubs, but accepted there were more ''social aspects'' that came with that.

''There is no evidence that drinking in pubs is safer, and most assaults that happen outside the home happen near pubs - the violence is usually outside rather than inside, when intoxicated people who don't know each other mix together. 'Supervision' by pub staff is usually minimal at best,'' she said. [emphasis added above]

I have no data on drinking by students at Otago, and it's very likely that Jennie would have that kind of data if it existed. But she's asserting that a larger proportion of students, and likely of young people in general, are drinking and are drinking heavily. And I do know the data on that one.

The MoH survey released a couple of months ago showed strong decreases in youth drinking. The survey said:

"The largest drop in past-year drinking was among youth aged 15-17, whose rate fell from 75% in 2006/07 to 59% in 2011/12."

Hazardous drinking dropped among youths who do drink. As fewer kids drink at all, the proportion of kids in total reporting hazardous drinking is well down. The trend from 1996/1997 through 2006/2007 was pretty flat, then dropped substantially through 2011/2012.

And Jennie knows about that survey. She was quoted on it when it came out. She said:

"I was quite alarmed by the results. In particular, in the age 18 to 24, one in four women are drinking in a hazardous fashion. And for the men, it's even higher - it's over 40 percent. So I think we should be very concerned about that."

She there didn't talk about the time trend, but the time trend was the big story in that survey. Here are the Selected Key Findings; I've bolded the relevant time-series youth-related ones.

Selected key findings

• In 2011/12, most adults had consumed alcohol in the past 12 months (80%). This is fewer than in 2006/07 (84%). Decreases in past-year drinking were generally seen across all age groups, but particularly among 15–17 year olds.
• Among people who had consumed alcohol in the past 12 months (‘past-year drinkers’), one in five (19%) had hazardous drinking patterns. This is about 532,000 people.
• Since 2006/07, the level of hazardous drinking among past-year drinkers has significantly decreased for men (from 30% to 26%), but not among women (13% to 12%).
• People aged 18–24 years (particularly men) are at higher risk of hazardous drinking. Among past-year drinkers, about 44% of men and 26% of women aged 18–24 years have hazardous drinking patterns. However, the rate of hazardous drinking has decreased significantly in past-year drinkers aged 18–24 years from 2006/07 (49%) to 2011/12 (36%).
• Māori have similar rates of past-year drinking as the total population, but have higher rates of hazardous drinking. Rates of hazardous drinking among Māori adults have decreased since 2006/07, (from 33% in 2006/07 to 29% in 2011/12).
• While Pacific adults are less likely to drink alcohol, those who do are more likely to have hazardous drinking patterns (35%) than adults overall (19%).
• People living in more deprived areas are less likely to have consumed alcohol in the past 12 months, but are more likely to have hazardous drinking patterns (18%), than people living in less deprived areas (11%).  

Perhaps Connor has a new survey that I've not heard about.

As for any links to the alcohol purchase age...

Local rent creation: alcohol edition

I'm not sure that Wellington Council, and the other local bodies, are setting out to create rents for property owners in soon-to-be-designated "fun" districts, but that's what they're soon to achieve.

The alcohol reform legislation pushed alcohol regulation back to local bodies; local busybodies have consequently gotten busy lobbying local councils to restrict hours of operation and number of licencees. This was pretty predictable. Industry has an easier time pointing out problems with proposed regulations to central government than fighting all the local low-opportunity-cost types at all the various local Councils. 

Dominic over at The Ladder (HT: @EpicBeer , see also TVHE) absolutely nails the economics of the latest round of local proposals. Wellington Council is considering a local alcohol policy that would designate a nightlife zone with 3 am closing times while setting earlier closing times elsewhere in town. Dominic's substantial points:

• Courtenay Place, the proposed designated nightlife zone, is only the current nightlife hotspot. Cities evolve and so does nightlife; when one district starts stagnating, a new one emerges. The zoning would lock the current pattern in place forever. In fact, Courtenay Place is on the downturn:

  The trouble is that nightlife districts have a life cycle. They don’t spring up and stay interesting and youthful forever. They stagnate and get superseded by other districts. That stagnation happened about ten years ago in Courtenay Place. It's now a big brewery-controlled, noisy, cigarette smoke-filled (that's right) ghetto. The trouble is that no-one has told the Council or the Hospitality Association. Courtenay Place has become a model for everything that can go wrong in a nightlife district. Do I need to make the case here? I hope not.

  We've seen the same movement around Christchurch, even pre-earthquake. The Strip was the place when we'd moved here, but was on the downturn when the quakes hit. And since the quakes, Riccarton, Papanui, Sydenham and Woolston have picked up. They wouldn't have if Christchurch had the kind of regulation that Wellington is proposing. And if you imagine that a Council couldn't be daft enough to continue enforcing a nightlife-zone after an earthquake demolished the nightlife zone, you haven't been following post-Quake Christchurch closely enough.


• The nightlife-zoned areas will, by virtue of regulatory protection, get substantial rents. These will be capitalised into the price of properties in that district.

  But the Council, who seem to think the scenes in Courtenay Place late on Fridays and Saturdays represent “vibrancy”, and the Hospitality Association, led by individuals who, I believe, own businesses in Courtenay Place, are planning a regime that will penalise anyone trying to establish a business anywhere else – businesses that might give discerning consumers an alternative to the chaos on Courtenay Place. It may not be what the Council intended, but it’s what’s called an unintended consequence. It’s what happens when you draw lines on a map and create differences between the two sides.
  
  Of course not all the results will penalise businesses outside the strip. If you’re a Courtenay Place property owner learning that your tenants have privileges with respect to liquor licensing, you’re going to put their rent up. I look forward to hearing the Hospitality Association complaining about sky-rocketing rents in the street in about a year’s time.

  Dominic is absolutely correct here. If we've learned anything from Public Choice, it should be that we really really really shouldn't go about conferring rents in this way. Current owners will get a one-off bump in property values, but then will only be earning normal returns on that capital value. And they will scream if you ever try deregulating it.

Christchurch is considering the same kind of lunacy in its local alcohol policy deliberations: they want to push all the nightlife into the now-deserted downtown. In doing so they will severely punish everyone who got off their arses in the last couple of years and helped make Christchurch less awful by getting new venues going in new areas. 

Admiral Akbar Tullock screams at you, "IT'S A TRANSITIONAL-GAINS TRAP!!" It's happened before: just look at New Jersey and Manitoba. 

Please listen to Admiral Tullock. Before it's too late.

I concur

After noting that Turkey's alcohol restrictions around bar and off-licence closing hours are pretty obviously religiously motivated, Bill Kaye-Blake makes a few observations about alcohol and policy:

Once you start working through the various economic analyses and the associated social and medical literature, a few things become clear:

• people drink booze because they like to, or because it makes things less bad. Either way, it makes them happier than the baseline
• alcohol is a ‘problem’ for a minority of people and/or on occasion. A few people are dipsos; the average adult occasionally gets blotto. Making the problem out to be more than that is disingenuous
• price is a stupid way to deal with the externalities. First, by definition addicts are insensitive to price. Secondly, the behavioural response of binge drinkers to increased prices is to cut out the moderate drinking sessions, not the harmful ones
• the research that shows otherwise is flawed. Crampton’s done the heavy lifting, so go see his work, but I’ll back him up. Poor assumptions, begging the questions, faulty parameters — embarrassing, really.

Just because the alcohol activists in New Zealand aren’t banner-waving members of the CWTU doesn’t make their desire to impose their preferences on the rest of the population any better. We can see it clearly on the other side of the world. Let’s be clear about it at home, too.

I'll only dissent only very slightly by way of clarification. Addicts are only relatively insensitive to price. They still respond to price, just less so than moderate drinkers. And so price-based policies have greater marginal effect on moderate drinkers than on heavy drinkers.

Meanwhile, and as expected, New Zealand's anti-alcohol brigade is using the very large weapon given them in the alcohol reform legislation to push for local teetotalitarianism.

Alcohol wage puzzles: Churchill-Stalin edition

There's a longstanding alcohol wage puzzle: drinkers earn more than non-drinkers even after correcting for a bunch of stuff. Chris Auld found that moderate drinkers earn 10% more than non-drinkers and that heavy drinkers earn 12% more than non-drinkers; plenty of other studies have found similar effects.

One not-unreasonable explanation is that drinking together builds trust among co-workers, making them jointly more productive (and higher paid) despite the occasional productivity-reducing hangover.*

Radio New Zealand provides a nice bit of anecdotal evidence.

Josef Stalin and Winston Churchill had an all-night drinking session in Moscow that lasted until 3am during World War II.

Relations between the Russian and British leaders were stiff until Churchill arranged a late-night banquet in August 1942 with Stalin, according to files held by Britain's National Archives.

The event was recorded by Foreign Office permanent under-secretary Sir Alexander Cadogan.

The mood was "merry as a marriage-bell," he added, though Churchill was complaining of a "slight headache" when Cadogan came to find him at 1am.

The two men did not engage in much military talk during the meeting, which went on until 3am.

The evening was dubbed a success by Cadogan, as the two men got on.

"Certainly Winston was impressed, and I think the feeling was reciprocated," he wrote in a letter.

"We broke up soon after 3(am), giving me just time to get back to the hotel, pack, and leave for the aerodrome at 4.15(am)."

The BBC reports the letter was among almost 600 government files dating from World War II and the early years of the Cold War, released by the National Archives.

Do all-nighters really end at 3am?

I wonder whether the anti-alcohol activists of 1942 would have bemoaned the wartime losses caused by Churchill's slight hangover the next day while ignoring that getting on well with the Soviets was rather more important.

* Note that Google Insights for Search provides reasonable evidence that hangovers are concentrated on the weekend. I mean, look at this and tell me that the folks who take average weekly hangovers as a measure of productivity losses aren't just a bit mischievous.

Comorbidity and costs

Another for the "underlying variables very likely cause both substance abuse AND negative outcomes" file, via +Ole Rogeberg . It appears that novelty-seeking and conduct disorder strongly predict future alcohol, tobacco, and other drug use among youths.

They suggest that early identification of those likely to be at risk and subsequent management of conduct disorders and of novelty-seeking behaviour might reduce the risk of substance abuse.

Behavioral or pharmacological treatment of disruptive disorders in children and adolescents is likely to have lasting effects across multiple disruptive psychopathologies due to the common thread that underlies ADHD, CD [Conduct Disorder], and NS [Novelty Seeking] — the inability to plan out actions, inhibit actions, and consider the implications of actions (impulsivity) (Miller, Stephen, & Tudway, 2004). For instance, preliminary findings from our lab recently determined that higher levels of CD and ADHD symptoms are associated with higher levels of initial sensitivity (e.g., subjective and autonomic experiences, such as reports of pleasure, liking the taste, nausea, heart rate) to alcohol and tobacco during adolescence, which suggests that these individuals may be primed to be more responsive to substances of abuse (Bidwell et al., 2012; Palmer et al., 2012; Wills et al., 1994).

Think back to how social cost studies tend to attribute the costs of substance abuse. They begin by defining as counterfactual the average outcomes for all individuals of similar age and gender; the monetised difference in outcomes between average non-abusers and substance-abusers is taken as social cost.

But those likely to become heavy substance-abusers would not have had average outcomes had drugs, alcohol, or tobacco never existed.

The relevant counterfactual group are those who were at similar risk of becoming substance abusers and who managed to avoid it. And even that will lead to overestimates because the general-purpose technology that lets those lucky individuals avoid substance temptations would itself drive outcomes.

It's entirely likely that substance abuse aggravates things for those with disruptive psychopathologies and that the costs they impose on others are consequently higher than they would have been. But substance abuse is only responsible for part of that cost - not for the whole she-bang.

It's also worth pointing out that this new study tilts the scales further in favour of Ole Rogeberg in his argument with the Dunedin folks about cohort selection effects. I still wish that Dunedin could be convinced to put up a GSS-style front end for their data so that other researchers could check results while not compromising privacy.

Liquor traps

Gordon Tullock warned us that once substantial rents accrue to some regulatory provision, it gets hard to change the regulation even if it is spectacularly inefficient. He illustrated the case with New York's taxicab medallion system: the restriction on the supply of cabs doesn't help the drivers but instead drives up the price of the asset in fixed supply, the medallion itself. Abolishing the medallions would bring prices down for dispersed consumers but would impose substantial capital losses on the medallion-holders.

There is a way out of transitional gains traps: tax the winners to pay off the losers. But it's awfully hard to implement. Opaque transfers are opaque for a reason: voters do not understand them and regularly oppose things that would make them better off. Tullock's biggest lesson then is that we should never ever get into transitional gains traps in the first place as they are just so very hard to escape.

Today's edition: liquor permits. Cities like restricting the number of liquor outlets, reckoning that they can thereby reduce the number of problems caused by drunks. If the restriction is binding, then the licence to sell alcohol becomes an asset for the owner. If the restriction is really binding, it can be a really valuable asset. Witness Flemington, New Jersey [ht @MarketUrbanism]:

Local officials who want a more lively town center and a development team seeking to restore a landmark hotel were hoping to put a new watering hole on Main Street. Then they ran smack into New Jersey's strict, Prohibition-era alcohol laws, which restrict the number of liquor licenses per town. Flemington had just three—two belonging to establishments in strip malls and one for a Veterans of Foreign Wars hall.

Having a decent bar, it turns out, is helpful to reviving small downtowns, development experts say. So, in February, the developers came up with a novel but expensive solution, buying the Italian restaurant that owned a license and eventually transferring it to the downtown hotel. The price: about $1 million for the permit alone.
...
The Union Hotel owners' arduous journey to opening a bar is emblematic of a conundrum facing small downtowns across New Jersey. In a state making efforts to reverse decades of sprawling suburban development, a shortage of liquor licenses has emerged as a hurdle to rejuvenating Main Streets, according to development consultants and planning groups.
...
The ramifications have been felt across the state. Local officials in Glassboro, N.J., a South Jersey borough of about 18,000 people, said their $300 million public-private downtown development plan has been set back because it only has seven liquor licenses, with one changing hands recently for $700,000, said Joe Brigandi, the borough administrator. It has made it difficult to attract a new downtown restaurant, he said.

Meanwhile, Manitoba's emergence from the liquor dark ages is hindered by the existing rent-holders. The Winnipeg Free Press's Bartley Kives* documents the insanity of the prior liquor regulations, with 12 different highly prescribed liquor licences that often require venues provide services of negative value to their customers. Live music requirements ban the use of DJs for some licencees, for example.  But Kives also sees the transitional gains trap:

And more politically, the province isn't prepared to undermine entrepreneurs who've invested heavily in restaurant-lounge concepts such as Earls, Moxies and the Keg, which have proven extremely successful in recent years.

"We're not going to step all over people who've invested in infrastructure," said Chomiak, referring to independently owned restaurants as well as the chains.

In Manitoba, Earls-style venues have stolen the club-going clientele away from hotel beverage rooms, suggested Jim Baker, president and CEO of the Manitoba Hotel Association.

Decades ago, hoteliers opposed liquor-regulation reform in fear of losing market share to stand-alone venues. Today, hoteliers are more concerned about the prospect of legalizing alcohol-delivery services -- which would harm beer vendors -- than they are with the idea of more small clubs serving alcohol in downtown Winnipeg.

Baker said he would also like to see the province ease up on regulations governing minors in beverage rooms, especially in rural areas where banquets and fundraisers would present a business opportunity if people under 18 were allowed on-site.

"There's a need to see how these people can use the larger rooms for other purposes," said Baker, who cautiously supports the idea of regulatory reform. "We want to be part of this discussion."

Hotel, restaurant and club owners are also united in their desire to see liquor inspectors ease up on the enforcement of minor infractions such as improper paperwork. That sort of cultural change is coming as part of the creation of a new regulatory agency, Chomiak said.

There's a great Masters thesis to be written applying the Peltzman model of regulation and deregulation to liquor law in Manitoba.

New Zealand has been a minor oasis of sanity relative to these kinds of cases. Australia, as I understand things, has sufficiently restrictive liquor permitting laws in some parts of the country that people buy hotels just to be able to run the permitted liquor outlet attached to the hotel. I worry that NZ's move to greater local control of licensing options will wind up letting local activists restrict the supply of new licences, to the hoozahs of existing permittees, and move us into the trap. Read New Jersey and Manitoba as cautionary tales.


* When I was in Manitoba, I remember Kives having had the entertainment beat (though I could have that wrong; it was a long time ago). Now, every time there's a great piece in the Winnipeg Free Press, it's from Kives (and here and here). I wonder how long it'll be 'till he's scooped up by one of the national papers.

Our manufactured drinking crisis

Boy, they keep looking for dark linings to silver clouds, don't they?

Here's Jennie Connor on the latest findings from the Ministry of Health hazardous drinking survey. She says,

"I was quite alarmed by the results. In particular, in the age 18 to 24, one in four women are drinking in a hazardous fashion. And for the men, it's even higher - it's over 40 percent. So I think we should be very concerned about that."

So, what's so alarming? Let's look at the survey.

First, note that hazardous drinking patterns are defined as a score of 8 points or more on the 10-question Alcohol Use Disorders Identification Test. Here is an online version of the test. I score a six for having a glass of wine or beer with dinner every night, having seven or more standard drinks less than once per month, and for having a feeling of guilt or remorse after drinking* less than once per month. It isn't hard to score an 8; that's why so many people score an 8.

Now, what do the time trends look like? Here are the charts from the document.

Figure 1 shows us that the number of non-drinkers has increased since 2006/2007. Among adults, the proportion who consumed alcohol in the past year dropped from 84% to 80%. They note that the drop was larger in youth cohorts: "The largest drop in past-year drinking was among youth aged 15-17, whose rate fell from 75% in 2006/07 to 59% in 2011/12."

Recall that I've previously argued that there is no evidence of any crisis in youth drinking, that Steve Stillman has found the same thing using more rigorous method than my ocular least squares, and that the monster-shouters have shouted a lot about how we need to up the alcohol purchase age to 20. 

Now on to hazardous drinking. In all the tables below, you'll note that the rates are defined as a proportion of those who drink, not as a proportion of everybody. This matters when the proportion of non-drinkers is rising. If you're comparing 2011/2012 rates to 2006/2007, and you want to normalise to total population rather than to the population of drinkers, you have to multiply by 0.8 for 2011/2012 and by 0.84 for 2006/2007. In other words, the drop in hazardous drinking is even larger when we measure it as a fraction of the total population rather than as a fraction of all drinkers.

The Ministry of Health also is very clear that the tables above understate the drop in hazardous drinking if we're interested in it as a proportion of the overall population. They write:

Since 2006/07 the level of hazardous drinking among male past-year drinkers has fallen from 30% to 26%. Among female past-year drinkers, the level of hazardous drinking has not changed significantly between 2006/07 (13%) and 2011/12 (12%).

Among all adults (not just past-year drinkers), the rate of hazardous drinking fell significantly since 2006/07 for men (from 26% to 22%) and for women (from 11% to 9%).

When we break things down by age and gender, the highest rates are among young men.

But when we look at the trend, it's dropped substantially among 18-24 year olds since 2006/2007. And, again, this understates the true drop because the proportion of past-year drinkers has dropped.

And recall that there had been no increase in hazardous drinking among 15-24 year olds from 1996/1997 through 2006/2007. Our youth drinking crisis? Flat from 1996/1997 through 2006/2007, then a substantial drop.

If we look at income patterning, richer people are more likely to have consumed alcohol in the last year but, conditional on consuming alcohol, poorer cohorts are more likely to report hazardous drinking. Netting the two effects, MoH reports, "As a proportion of all adults, about 18% of those living in the most deprived areas and 11% of those in the least deprived areas had hazardous drinking patterns."

The cross-sections tell us where potentially problem drinking is currently concentrated. But the big picture really shows declines in potentially harmful drinking. If the anti-alcohol brigade had managed to get a purchase age increase in 2009, they'd be claiming these results as strong evidence of their success, while insisting that much more is still needed.

Why isn't the anti-alcohol lobby celebrating these results instead of saying how alarming they are? Do they somehow need for there to be a crisis?


* Note, it's after drinking, not because of drinking. I have a glass of wine or beer with dinner just about every night. Do you go a month without regret?

Inelastic demand

Gorbachev's crackdown on alcoholism reduced heavy drinking in the former Soviet Union. He combined some measures directly targeting heavy drinkers with price increases and supply reductions. Bhattacharya and coauthors wrote:

The results suggest little evidence that our summary measure of campaign intensity operates either through differential supply shifts or through differential price increases. However, we are hesitant to draw conclusions given the limitations of the state vodka production and alcohol price index data noted earlier. We emphasize that this is an important area for further research.

I wasn't surprised that Bhattacharya wasn't able to find price effects on heavy drinking; I expected that the Soviet campaign's effectiveness came rather from bans on workplace drunkenness and mandatory treatment for alcoholism. Why? It's hard to target heavy drinkers with price measures.

I've previously cited Wagenaar's metastudy showing that heavy drinkers are only about 60% as responsive to prices as are moderate drinkers. Jon Nelson adds to this literature looking in particular at the differential price responsiveness of heavy and moderate drinkers. He concludes that Wagenaar was too optimistic about the degree to which heavy drinkers respond to price measures. After an extensive literature review, Nelson concludes:

The review found only two of nineteen empirical studies where there was a significant and substantial price/tax response by heavy-drinking adults (ages > 26 years), and even these two studies present mixed results. On the other hand, many studies show that moderate-drinking adults have significant and substantial price/tax elasticities, including both studies for Australia (Brynes et al., 2012; Harris et al., 2006) and several of the US studies. The review of cirrhosis mortality found only two of nine studies obtained significant negative price/tax effects, but prices in these studies might be proxies for other (omitted) alcohol policies or drinking sentiment generally. The other cirrhosis studies contain mixed results or are sensitive to econometric specifications. Several limitations of the studies should be kept in mind, which also provide a basis for future research in this area.

...
In summary, a review of two sets of related studies casts doubt on public policies that rely extensively on price controls or higher alcohol taxes as a means to reduce abusive drinking by adults, adverse health outcomes, and related social costs. The price/tax elasticity for heavy drinkers appears to approach zero in most instances. This result is robust across countries, time periods, drinking measures, and model specifications. Improvements in price data in empirical studies might remove some uncertainty associated with this evidence. 

Nelson cites one new piece the I'd missed: Ayyagari et al, newly out in Health Economics. They used finite mixture models on individual-level data on heavy drinking incidence from the HRS (older adults, large sample) and found that their dataset effectively consisted of two groups of people. The largest group didn't drink very much, averaging 0.13 drinks per day, but was very responsive to prices. The smaller group averaged 1.86 drinks per day and really didn't seem to vary consumption with prices. The neat trick in Ayyagari et al is that when they pooled the two groups, they got about the same estimate that everybody tends to get: aggregate elasticity of around -0.4. Studies that pool results from heavy and moderate drinkers make a bit of a hash of things if we're trying to assess whether price measures curb the harms from heavy drinking. They conclude:

There is growing political support for increased alcohol taxes; however, we are cautious about predicting welfare gains to alcohol tax hikes with regard to older individuals.25 Revenue may be raised at the cost of welfare loss for many older individuals but with little reduction in externalities. Heavier drinkers are more likely to impose negative externalities than the lighter drinkers. However, our results indicate that the heavier drinking group is insensitive to price; thus, higher taxes would be unlikely to reduce negative externalities for older drinkers.26 In contrast, for the largest group of individuals, composed of moderate-to-low drinkers, the higher tax will reduce their alcohol consumption, resulting in a utility loss and loss of potential health benefits of alcohol (Thun et al., 199727), yet it is unlikely to reduce externalities.

Especially sensitive to price increases were lower income moderate drinkers.

At least Gorbachev had some idea that curbing harms from heavy drinking required something other than price and supply controls, though I do not endorse his methods.

Be very wary of policy recommendations that cite aggregate effects of prices on quantities consumed when harms are non-linear in consumption and when the heaviest consumers are least responsive to price measures.

A successful anti-alcohol policy

If your starting position is a totalitarian society in which on-the-job drunkeness has little penalty and is one of the ways of avoiding the world in which you live, alcohol consumption will be high. If that totalitarian society starts easing up on the totalitarianism on other margins while clamping down hard on alcohol consumption, using the tools of a totalitarian society to do it, you can achieve large reductions in alcohol consumption and reduce mortality rates. If your totalitarian society then collapses and imposes a whole lot of uncertainty on people who had previously had we-pretend-to-work jobs for life, while getting rid of the totalitarian forms of alcohol control, alcohol consumption then goes back up and so does mortality.

That's my take-away from the new Bhattacharya et al piece on Gorbachev's anti-alcohol campaign. [Ungated version via SSRN]

Alcohol consumption in the Soviet Union prior to Gorbachev's campaign exceeded 14 litres per capita - New Zealand hovers around 9 - 10 litres. Gorbachev's campaign included:

• Reductions in state production of alcohol in a country where state production was the only legal production;
• Restrictions on alcohol sales: no sales of vodka or wine before 2PM on business days, restaurants couldn't sell hard liquor, an increase in the drinking age to 21. Prohibition on sales near factories, schools, hospitals and airports; [airports?]
• Two 25% price increases;
• Penalties for public drunkenness; new alcohol-related offences. Heavy fines for being drunk at work: one to two times the average weekly wage. Large fines or imprisonment for home production or for possession of home brew equipment;
• Subsidisation of substitutes for alcohol: leisure facilities and the like;
• Propaganda and health education campaigns; "bans on glamorous media depictions of drinking";
• Creation of a national temperance society;
• Compulsory treatment for alcoholism; physician-supervised treatment for up to five years.

Official alcohol sales dropped but home production increased substantially; total alcohol consumption was estimated to have dropped from 14.56 litres to 11.46 litres. They note that sales of glass cleaners and alcohol-based glue increased substantially, as did theft of industrial alcohol. 

There were substantial declines in death rates and alcohol-related harms during the campaign, which brought Russian consumption down to a level more than ten percent higher than current New Zealand consumption. 

Notably, it looked like heavy drinkers' consumption was more affected than that of moderate drinkers: I strongly expect that the penalties for public drunkenness, penalties for being drunk on the job, and compulsory treatment were here doing the bulk of the work, though the authors correctly note that their data doesn't really let them tell which elements of the campaign were most effective. 

They conclude:

Overall, a key implication of our main findings is that Russia’s transition to capitalism and democracy was not as lethal as commonly suggested (Stuckler, King, and McKee 2009). However, our findings also do not necessarily imply that alcohol prohibition raises welfare (in Russia or elsewhere), even if it saves lives. Health is only one argument of welfare, and health-improving restrictions on individual choices can cause harm as well as do good.

More on the alcohol crisis

Joanna Mathers reports in the New Zealand Herald that beer consumption has more than halved since 1973: from 181 litres per adult to 79 last year; she says total beer consumption is the lowest it's been since the Second World War.

Alas, I'm not able to find Stats NZ data giving total alcohol consumption per capita going back that far - the series giving pure-alcohol equivalents goes back to 1986. But I've been able to find a now-discontinued series giving volume of beer, wine and spirits available for consumption, per head, from 1935 to 1981. The series is ALC006AA, if you're searching.

It's a bit tough to get a per capita alcohol consumption measure out of this. First, I have no clue what the denominator is in "per head". If it's per person over the age of 20, because that was the alcohol purchase age, then the figures count towards adult consumption all underaged consumption and consequently overstates adult consumption. If it's per capita, then it allocates some adult consumption to infants and understates adult consumption.

Further, I don't know the average alcohol content of the beer and wine consumed. We can make some assumptions there though. I'll assume that beer is 5% alcohol by volume, that wine is 14% alcohol by volume. The series notes tell us that spirits are measured in proof litres, so that helps.

For the period 1986 onwards,* I use the alcohol available for consumption per person aged 18+ measure from Statistics New Zealand: since the change in the alcohol purchase age didn't seem to change consumption among those aged 18-20, I expect this is about the right measure. But, if the pre-1981 data used 20+ as denominator, the later series is slightly understated relative to the former.**

Under those assumptions, this is what we get.

I'm not sure I believe the numbers pre-1950. But, what crisis New Zealand had with alcohol consumption seems to have taken place in the 1980s through about 1992. From 2000 onward, we're where we were in the mid-to-late 1970s. I'm not sure how far back in time the crisis-shouters want to push us.

Note that income matters a lot too: we're richer than we used to be, so we can afford more cars, bigger houses, and more and better booze. I expect that some of the leveling-off in total consumption coincides with the rise of craft brewing and shifts towards drinking less but better beer.

If there is a current crisis, it isn't in the aggregate consumption data unless you want to say we've been in a crisis since the 1970s. It's hard to find evidence of any current crisis in other data:

• Potentially hazardous drinking prevalence is the same 2006/2007 as it was 1996/1997;
• Youth drinking seems no worse now than before the purchase age change;
• Stillman's difference-in-difference numbers have the same result.
• My talk at Canterbury covering this and more.

I'm glad that the Herald is reporting on the drop in beer consumption. Putting it in the context of recently flat aggregate alcohol consumption would have made it clearer that the drop is partially due to aggregate consumption drops since the early 80s, and partially due to category shifts to other beverages. 

* The alcohol per capita series ALC005AA only starts in 1986.

** Go and play in Infoshare [get "Industry Sectors", then ALC] and compare the 18+ and 20+ series; they're not far off from each other. In an earlier post, I used 15+ because that's the measure used in some international comparisons and I was noting international comparisons.

Minimum prices and mortality risk

The latest Stockwell piece on alcohol minimum pricing and alcohol-related fatalities seemed a bit fishy.

I was mostly worried about how they ran a panel study that had zero cross-sectional variation in their main regressor of interest and where the main source of time series variation was CPI adjustments to measured prices, but it looked like there were plenty of other holes for truck-driving expeditions.

George Mason statistician Rebecca Goldin goes for a scenic tour, noting another rather serious problem. Standard t-statistics don't really do the job if you're pouring over multiple lags to look for effects. She writes [ht Forbes]:

What’s troubling here is that they break the data down into many quarters and categories, run multiple statistical tests, but don’t adjust for multiple testing. This results in a table spotted with statistically significant results even as basic statistics tells us this method will produce spurious results.

A close look at the table is suggestive that spurious results are indeed at hand. This table looks at 16 quarters following a minimal price increase, and whether there is a correlated increase or decrease in deaths among acute, chronic or wholly attributable alcohol deaths. The authors point to a statistically significant decrease in wholly attributable deaths in the quarter that a price increase was implemented, as well as in the second and third subsequent quarters. (but not in the first quarter, nor the 4th-15th quarters).

But it also shows a significant increase in acute deaths in the third and fifth quarters after a price increase, and then a statistically significant decrease in acute deaths in the 8th quarter after the price increase. Chronic deaths saw statistically significant decreases in the 8th, 9th and 13th quarter after a price increase, but not in the other 13 quarters. This all suggests that the results could be, at least in part, the result of simply running a lot of tests on a lot of data – and without adjusting for multiple tests, randomness can creep in. Though the results do lean toward decreased death, picking out the most extreme of the results (as the media and the authors of this study did) may be misleading. In fact, if the 1,388 wholly alcohol attributable deaths occurred evenly over the quarters, these numbers refer to trends in about 87 deaths each quarter – trends that would be highly sensitive to a small number of deaths.

So while there seems to be an overall trend of decreased death with increased prices, the failure to account for multiple testing means there could be true correlation or there could be just a statistical fluke.

Eventually, somebody's going to take a proper shotgun to the stuff Stockwell's been up to. When Chris Auld was doing their econometrics, I didn't worry about their empirical results. Things seem to have gone a bit adrift since then.

Some useful context

I'm sure it's only the confines of a short radio news blurb that had Radio New Zealand miss a bit of context in this story. The full text of the RNZ bulletin:

The Government is being urged to consider whether it is time to ban alcohol advertising and sponsorship of sport.

Kerry O'Brien, a behaviour studies expert at Monash University, told an alcohol marketing conference in Wellington on Thursday, that alcohol advertising is everywhere in both New Zealand and Australia.

He said sport is a major way in which the alcohol markets its product to young people and current advertising codes aren't protecting children.

Mr O'Brien said new research shows if adults receive alcohol sponsorship in their sports club, their children may also be influenced.

Ok, an expert addressing an alcohol marketing conference wants to ban advertising. What kind of conference? Alcohol marketing. Could be some industry thing, could be an academic thing, who knows. Sounds pretty neutral and impartial though.

Here's Alcohol Action New Zealand's blurb on their conference:

THE PERILS OF ALCOHOL MARKETING - Thursday 7th March 2013 at Te Papa, Wellington

The upcoming conference titled The Perils of Alcohol Marketing is shaping up really well, with excellent keynote speakers confirmed - Professor Sally Casswell, Massey University Auckland, Professor Janet Hoek, University of Otago, Dr Kerry O'Brien, Monash University, and Associate Professor Antonia Lyons, Massey University. This will be the first conference post the Alcohol Reform Bill and focusing on this fundamental commercial issue of alcohol marketing is very apt. The draft programme is available to view and download below.

We welcome abstracts for short presentations (3-5 minutes) that illustrate the most "evil" examples of alcohol marketing. Feel free to submit an abstract that focuses on one pertinent example or, alternatively, one that skims over multiple examples. Please see the call for papers application form below.

Don't miss this critical conference on alcohol marketing - New Zealand's most socially damaging drug. Register now by completing and returning the registration form below.

So a conference, titled "The Perils of Alcohol Marketing", and hosted by Doug Sellman's Alcohol Action New Zealand, specifically went out asking people to submit abstracts illustrating "the most "evil" examples of alcohol marketing" and had a keynote speaker who thinks alcohol marketing should be banned.

Here's the conference flier:

NZ continues to be one of the most unregulated societies in the OECD for the supply and sale of alcohol. Alcohol is our most socially damaging drug yet the global alcohol industry enjoys enormous freedom to market alcohol to New Zealanders - as if it were an ordinary commercial product. 

The Conference will feature: 

Stimulating and informative keynote presentations from experts on alcohol and alcohol
marketing: Prof Jennie Connor, Prof Janet Hoek, Prof Sally Casswell, and A/Prof Antonia
Lyons. Dr Kerry O’Brien from Australia’s Monash University is a special overseas guest.
A series of short presentations illustrating the most “evil” examples of alcohol marketing.
A political panel with representatives from the main parliamentary parties outlining their
respective party policy on how to deal with “The Perils of Alcohol Marketing”, in the light of the Law Commission’s recommendation to dismantle it over a five year period. 

The draft programme included:

• Otago's Jennie Connor on Alcohol Harms
• Otago's Janet Hoek asking whether responsible alcohol marketing is a "public health oxymoron?"
• SHORE's Sally Casswell asking "Where would alcohol companies be without alcohol marketing?" 

A bit of context can sometimes be of assistance. 

A real alcohol crisis [warning: may not actually contain crisis]

I'd suggested last year that there's no alcohol crisis in New Zealand.

A lot of the public health crowd disagreed with me rather vehemently, even suggesting that my position was based on that I'd done one bit of work funded by the alcohol industry.

Well, it turns out that there could be a crisis. Here are the latest figures from Statistics New Zealand:

The volume of alcoholic beverage available for consumption in New Zealand fell 3.3 percent in 2012, Statistics New Zealand said today. The decrease was due to a fall in the volume of beer, down 20 million litres. This fall was partly offset by a 4.3 million litre rise in the volume of wine.

“Although the volume of alcoholic beverages available was down more than 3.0 percent, the amount of pure alcohol fell only 0.6 percent,” industry and labour statistics manager Louise Holmes-Oliver said. “This was due to change in the types of beverages available."

An increase in the volume of higher-alcohol beverages such as wine, spirits, and spirit-based drinks accounts for the smaller fall in pure alcohol available. The volume of high-alcohol beer (over 5.0 percent) also increased. In contrast, all other beer categories available for consumption have decreased.

The volume of pure alcohol available for consumption per person aged 15 years and over fell 1.7 percent, to 9.3 litres in 2012. This is equivalent to an average of 2.0 standard drinks daily per person (aged 15 years and over).

Alcohol statistics are a measure of how much alcohol is available for consumption, rather than actual consumption.

The Radio NZ report is slightly inaccurate: we didn't have a 15 million litre drop in alcohol production; we had a 15 million litre drop in the volume of alcoholic beverage available for consumption. New Zealand produces a lot of wine for export and imports a lot of spirits: volume available for consumption accounts for that.

A 1.7% drop in pure alcohol available for consumption may be a crisis though, depending on how sensitive a trigger you have for such things. I'm very likely engaging in a bit of hyperbole in calling a 1.7% per capita drop a crisis. But if we have a bit of mean reversion next year, any guesses whether a 1.5% increase would be called a crisis?

Here's the time path. Some crisis.

The anti-alcohol brigade are shifting their efforts to local politics since the alcohol reform bill widened scope for local government control of alcohol use. When your local busybody starts lobbying for earlier closing times, fewer bars, fewer off-licence agents, restrictions on alcohol in supermarkets, or broader areas where open liquor is banned, and present data that pick 1998 as starting point to get a seemingly neutral "over the last 15 years", please do point your Council to the Stats NZ series.

Underlying type

Does alcohol or drug use lead to a whole pile of other risk-taking activities, does some common underlying risk preference determine both substance abuse and other risky behaviours?

The Dunedin Longitudinal Survey group finds evidence that women with more sexual partners are more likely to later report substance dependence disorders than those with fewer partners. Women having had more than 2.5 sexual partners per year between the ages of 18-20 are 9.6 times more likely to report substance dependence disorders at age 21, adjusted for prior disorder incidence. Women aged 26-31 having had more than 2.5 partners per year are 17.5 times as likely to report substance dependence disorder at age 32. Similar patterns held among males, although the risk ratios were much smaller. 

The explanation for the relationship is likely to be complex. Four possibilities are proposed. First, sexual risk taking and substance use may be part of the cluster of risk taking behaviors common in adolescence and young adulthood (Arnett, 1992; Boyer et al., 2000; Caspi et al., 1997; Desiderato & Crawford, 1995; Donovan & Jessor, 1985; Taylor, Fulop, & Green, 1999). For instance, people who are impulsive may be more likely to engage in both activities and, consequently, more likely to become substance dependent. Second, occasions of substance use are opportunities for sexual behavior because of its disinhibitory effects and lack of accurate perception of risk (Crowe & George, 1989; Fromme, D’Amico, & Katz, 1999). Weinhardt and Carey (2000) have suggested, in a review of event-level research on this topic, that the association, especially with condom use, is also complex. Thirdly, shared context may be an important factor, insomuch as young people are likely to meet new sexual partners in situations where alcohol is served. These settings might encourage sexual behavior and facilitate multiple partnering.

The fourth intriguing possibility is that it is something about having multiple sex partners itself which puts people at risk of substance disorder. For instance, it may be due to the impersonal nature of such relationships. Or, it might be that multiple failed relationships create anxiety about initiating new relationships. Self "medication" with substances may be one way of dealing with this interpersonal anxiety (Khantzian, 1997; Stoner, George, Peters, & Norris, 2006).

They also note the studies showing that alcohol use correlates with more risky sexual practices; I didn't see reference to the one suggesting drinking was associated with more positive consequences of sex.

I'd also worry about cohort attrition effects: if men and women who are more psychologically stable are more likely to get married before the age of 30, then the pool of women reporting >2.5 sexual partners per year* between the ages of 26-31 is probably different from the pool of women reporting the same numbers in their early 20s [recall that the Dunedin study follows a cohort born in 1972-1973]. 9.5% of women reported 2.5+ partners per year at 18-20; that dropped to 4.5% by age 21-25 and to 1.7% - 8 women - by age 26-31.

I wish that the Dunedin study had some calibrated measure of risk tolerance, like the Holt and Loury measure, as well as a measure of individual discount rates. I would love to see pinned down what portion of risk-taking behaviour comes down to heterogeneity in individual risk tolerance, what portion comes down to that things with longer term costs might be disproportionately preferred by those who avoid the tyranny of the later-self, and what portion might be due to amplification effects where doing one risky thing actually does make you more likely to do another risky thing.

But the takeaway here is that studies suggesting drinking is associated with riskier sexual activity might well worry about reverse causation or common underlying causes.

* No, you can't have half a sexual partner. They're asked number of partners and that's averaged across the age range for that respondent.