Re: Effect of policy, economics, and the changing alcohol marketplace on alcohol related deaths in England and Wales
I read and reread the article as published in the hard copy of the BMJ . It may be that there may be some points were lost in the translation from the detailed original article which I have not read. (There is no Fig.5 in the BMJ referred to twice).
1. The article bases the alcohol consumption on the HMRC Duty and tax receipts so the study assumes that there have been no changes in coding/classifications in the tax receipts over the period of the study which might affect the data.
2. The article does state that in the '90s, the economy boomed, which led to an increase in alcohol consumption. As stated, it can take 10 years of drinking to develop liver cirrhosis - would that not account for the peak in 2008 of alcohol related deaths particularly liver disease. Fig 2 - there is also a peak in 2002 consumption correlating with 2012 deaths.
3. Based on Fig 2 , the deaths from Acute Alcohol poisoning have remained fairly constant which is what I would have expected to decrease suddenly in 2008, if there was a direct link to the 2% above inflation escalator.
4. Looking at Fig 1 and Fig 2, I would expect there is going to be another peak in alcohol - related liver deaths around 2018.
5. The article states that the" threshold /minimum pricing is a fiscal policy ", then " "European Court of Justice ruled in favour of a minimum pricing provided that the Scottish government can show it is more effective than fiscal alternatives". If the min pricing is a fiscal policy what are the fiscal alternatives?
I read this as a non specialist /having been out of clinical medicine for 20 years and only in the hardcopy BMJ format and found it fascinating. I would be grateful for any feedback.
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Re: Effect of policy, economics, and the changing alcohol marketplace on alcohol related deaths in England and Wales
I read and reread the article as published in the hard copy of the BMJ . It may be that there may be some points were lost in the translation from the detailed original article which I have not read. (There is no Fig.5 in the BMJ referred to twice).
1. The article bases the alcohol consumption on the HMRC Duty and tax receipts so the study assumes that there have been no changes in coding/classifications in the tax receipts over the period of the study which might affect the data.
2. The article does state that in the '90s, the economy boomed, which led to an increase in alcohol consumption. As stated, it can take 10 years of drinking to develop liver cirrhosis - would that not account for the peak in 2008 of alcohol related deaths particularly liver disease. Fig 2 - there is also a peak in 2002 consumption correlating with 2012 deaths.
3. Based on Fig 2 , the deaths from Acute Alcohol poisoning have remained fairly constant which is what I would have expected to decrease suddenly in 2008, if there was a direct link to the 2% above inflation escalator.
4. Looking at Fig 1 and Fig 2, I would expect there is going to be another peak in alcohol - related liver deaths around 2018.
5. The article states that the" threshold /minimum pricing is a fiscal policy ", then " "European Court of Justice ruled in favour of a minimum pricing provided that the Scottish government can show it is more effective than fiscal alternatives". If the min pricing is a fiscal policy what are the fiscal alternatives?
I read this as a non specialist /having been out of clinical medicine for 20 years and only in the hardcopy BMJ format and found it fascinating. I would be grateful for any feedback.
Competing interests: No competing interests