What happened to alcohol consumption and problems in the nordic countries when alcohol taxes were decreased and borders opened?

Aims: The study tests the effects of reductions in alcohol taxation and increases in travellers’ allowances on alcohol consumption and related harm in Denmark, Finland, and southern Sweden.  In late 2003 and early 2004, taxes on alcoholic beverages were reduced in Denmark and Finland, and the abolition of quantitative quotas on alcohol import for personal use from other European Union countries made cheaper alcohol more available in Denmark, Finland, and Sweden.

Method: Analyses of routine statistical register data and summaries of results from longitudinal and repeated cross-sectional population surveys and other previous analyses, with northern Sweden as a control site for secular trends.

Results: Contrary to expectations, alcohol consumption—as based on register data—increased only in Finland and not in Denmark and southern Sweden, and self-reported survey data did not show an increase in any site.  In Finland, alcohol-attributable harms in register data increased, especially in people with low socio-economic status.  Few such effects were found in Denmark and southern Sweden.  Neither did results for self-reported alcohol-attributable problems show any general increases in the three sites.  These results remained after controlling for regression to the mean and modelling of drop-outs.

Conclusions: Harms measured in register data did tend to increase in the short term with the policy change, particularly in Finland, where the tax changes were broader.  But reducing price and increasing availability does not always increase alcohol consumption and harm.  Effects are dampened in affluent societies, and other factors may intervene. The results for Finland also suggest some limits for general population surveys in testing for relatively small policy effects.