Further description: A consequential impact tax or public health supplement would involve adding a tax to alcohol products as a way to offset their public health harm and the overall revenue could be hypothecated for specific purposes.

What we know: Hatchard et al., (2023) indicates that the implementation of cross-cutting consequential impact tax or Public Health Supplement would increase overall state revenue which could be hypothecated for a specific purposes to benefit health. Hatchard et al., (2023) cited a paper that indicated a UK consequential impact tax could generate £2.5 billion annually, which would enable its National Health Service to better tackle costs of consumption, with potential positive equity impacts too (see Greenshields 2014 in Hatchard et al., 2023).

Examples of implementation: Scotland implemented a Public Health Supplement, which raised £95.9m over three years, but it did not ultimately include the initially proposed hypothecation element of the policy (see Hellowell, Smith and Wright 2016 in Hatchard et al., 2023).

Types of identified taxes: sales tax, excise tax.

What we know: Sales and excise taxes on alcohol products have been shown to be generally beneficial and highly cost-effective with a range of health improving outcomes and reductions to health inequalities (Anderson et al., 2018; Vellakkal et al., 2022; Fitzgerald et al., 2016; Naik et al., 2019; Hatchard et al., 2023). Increased taxation and pricing of alcohol products has been associated with reductions in consumption and alcohol-related mortality and morbidity (Anderson et al., 2018; Vellakkal et al., 2022; Fitzgerald et al., 2016; Naik et al., 2019; Hatchard et al., 2023) including lower motor vehicle mortality rates, premature mortality, suicide and cirrhosis mortality (Naik et al., 2019) and reduced alcohol-related violence and assaults (Fitzgerald et al., 2016). The effect size has been known to vary based on temporality, location and population factors (Siegfried and Parry, 2019) as well as the degree of taxation, with greater promise shown for taxes of at least 10% (Naik et al., 2019).

What we know: In low-and-middle income country contexts, community level interventions showed positive impacts on attitudes and behaviours and helped increased feelings of community empowerment around addressing local norms around alcohol use (Walmisley et al., 2024).

What we know: Introducing and expanding sobriety checkpoints and random breath testing for alcohol has been shown to be effective for reducing alcohol-related injuries and fatalities (Anderson et al., 2018; Burton et al., 2017).

What we know: Examinations of the efficacy of mass media campaigns on alcohol-related harms appear to have mixed effects. One review suggested that mass media campaigns can be effective at reducing drink-driving and associated harms and increasing knowledge and awareness around alcohol consumption but not necessarily have significant effects on behaviour (Burton et al., 2017). Another review reported that the evidence of efficacy for mass media campaigns to reducing the risk of alcohol-related injuries or fatalities was suggestive but inconclusive (Siegfried and Parry, 2019). Industry-sponsored campaigns were found to have no benefits (Burton et al., 2017).