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. 2026 Apr;150:105191. doi: 10.1016/j.drugpo.2026.105191

Impact of alcohol excise taxation and structural reforms on per capita consumption in Thailand, 1995–2021: an interrupted time-series analysis

Nyi Nyi Zayar a,1, Polathep Vichitkunakorn a,b,c,1, Wichai Aekplakorn d, Surasak Chaiyasong e, Daniela Correia f,g,h, Ahmed S Hassan i,j,k,⁎, Kyaw Ko Ko Htet a, Jiraluck Nontarak l, Roengrudee Patanavanich d, Pol Rovira m, Kevin Shield i,j,k,n, Bundit Sornpaisarn i,k, Udomsak Saengow o,p, Wit Wichaidit b,q, Sawitri Assanangkornchai a,2,4, Jürgen Rehm f,i,j,k,m,n,r,s,t,2,3
PMCID: PMC13022754  PMID: 41722211

Highlights

  • •

    Thailand has implemented multiple alcohol excise taxation increases and two major structural reforms over a 25-year period.

  • •

    Most changes did not cover all alcoholic beverage categories.

  • •

    Frequent alcohol tax increases sustained reduced levels of population alcohol use.

  • •

    Well designed and implemented structural reforms of alcohol excise taxation in Thailand showed a greater impact than a single tax rate increase.

  • •

    Combined, these taxation rate and structure changes are estimated to have lowered APC, on average, by more than 0.5 L (litres) per year in Thailand, and by 2 L in APC in the last year of the observation period, and will also lead to a reduction in attributable harms.

Keywords: Alcohol, Taxation, Alcohol consumption per capita, Interrupted time-series analyses, Thailand, Long-term impact, Economic growth

Abstract

Background

Alcohol taxation is a highly effective alcohol control policy, but adjustments for inflation and affordability are essential to sustain its impact. Between 1996 and 2017, Thailand implemented 11 excise tax increases and two structural reforms. This study examines the combined effects of these changes on alcohol consumption over time.

Methods

Interrupted time-series analyses, adjusting for autocorrelation and seasonality, were conducted using monthly recorded adult alcohol per capita consumption (APC) data from January 1995 to December 2021. We assessed the impact of tax increase policies that affected more than 15 % of the total alcohol market, and two structural reforms. Increases in 1997–98 were combined due to their temporal proximity.

Results

Excise tax increases in January 1997, March 2001, and September 2007 were associated with reductions in APC of 9.7 % (95 % CI: 4.1 %, 15.0 %), 4.8 % (95 % CI: -0.9 %, 10.2 %), and 6.7 % (95 % CI: 0.6 %, 12.3 %), respectively. Structural reforms in 2013 and 2017 had on average larger effects, reducing APC by 9.3 % (95 % CI: 1.1 %, 16.8 %) and 23.0 % (95 % CI: 14.5 %, 30.6 %), respectively. Modelling indicates that without these taxation policies, total recorded APC between 1995 and 2021 could have been on average 0.56 litres (L) higher in each year, and 1.99 L higher by 2021.

Conclusion

Alcohol excise taxation (i.e., excise tax increases and structural reforms) significantly reduced APC in Thailand. Future taxation policies should include automatic adjustments for changes in inflation and/or disposable household income to sustain their long-term public health impact.

Background

Alcohol taxation is considered one of the most effective and cost-effective alcohol control policies (Babor et al., 2023; Chisholm et al., 2018; Gapstur et al., 2025). The World Health Organization (WHO) has listed increases in alcohol excise taxation as one of its “best buys” for reducing mortality from non-communicable diseases (World Health Organization, 2024c). Taxation works via increases in prices and subsequent reductions in sales of alcoholic beverages (Guindon et al., 2022), which consequently lead to a decrease in the level of consumption and all alcohol-attributable causes of death, including injuries, and infectious diseases (Rehm et al., 2017). Ultimately, well-planned increases in excise taxation reduce all-cause mortality (Rehm et al., 2024a; Vaitkevičiūtė et al., 2023).

The impact of taxation is often measured over the short term (e.g., for the year following the taxation increase), since its impact often decreases over time due to inflation and increases in disposable income (e.g., Wagenaar et al., 2009). To be effective over longer periods, alcohol excise taxation must, therefore, either be automatically adjusted to inflation and/or household income (World Health Organization, 2023) or increased at relatively short time intervals. However, few countries implement such regular automatic adjustments (World Health Organization, 2024b), and the process of regular taxation increases is even rarer, leading to an overall increase in affordability of alcoholic beverages over time, particularly in low- and middle-income countries (Blecher et al., 2018; Neufeld et al., 2022).

Alcohol excise taxation in Thailand

There are two major aspects of alcohol excise taxation which can impact on price, and thus on level of consumption: taxation structure, and the tax rate (Sornpaisarn et al., 2017; World Health Organization, 2023). For tax structure, we consider which attributes of alcohol taxes are based on, how the final tax will be determined, and where it will be collected. Tax rates determine the level of taxation.

For our study, we identified changes in rates and tax structure of the excise taxation on alcoholic beverages in Thailand based on three prior studies (Fiscal Policy Office - Ministry of Finance (Thailand), 2009; Sornpaisarn & Kaewmungkun, 2014; Thawichasri, 2019). Overall, Thailand has changed its taxation level and structure relatively often over the last decades. From 1996 to 2012, there were 11 alcohol tax increases in Thailand, of which six affected more than 15 % of the overall alcohol market in Thailand. The overall alcohol market was determined by total alcohol production data in Thailand as well as imports and the share of the different alcoholic beverage categories were quantified by the amount of pure alcohol it contained (Sornpaisarn & Kaewmungkun, 2014). In addition, Thailand’s alcohol excise tax structure has been changed twice during the observation period, first in 2013 and then again in 2017 (Thawichasri, 2019). The previous alcohol excise tax method employed by the Thai government, implemented in 1980, was an ad valorem tax with a minimum specific floor. This tax method was called the “two-chosen one” since, for each alcoholic beverage, taxes were calculated based on both methods (i.e., alcohol-content-based specific tax and ad valorem tax, based on the ex-factory price), the resulting higher tax between the two was applied (World Health Organization, 2023). This method to assess the level of alcohol excise taxation was changed to a “two-chosen-one format under the mixed taxation system” in 2013, and changed again to a mixed ad valorem and specific taxation format (called “one-plus-one” in Thailand) in 2017 (World Health Organization, 2023). Both methods are explained in more detail in Appendix Supplementary Table 1.

The reason behind these changes, as per the official announcement, was to improve and update the alcohol excise tax system to better control alcohol consumption and to generate more alcohol tax revenue (Ministry of Finance (Thailand), 2017; Thaipublica, 2013). However, most of the changes in tax rates seem to be motivated by other reasons, e.g., the protection of domestic alcohol products (Sornpaisarn & Kaewmungkun, 2014). As a result, differential tax rates between and within major alcohol categories persisted (Sornpaisarn & Kaewmungkun, 2014), likely resulting in substitution consumption towards lower-taxed alcohol products (see Table 1 for examples), reducing the effectiveness of its alcohol consumption control at the population level, as well as generating less revenue than possible (World Health Organization, 2023).

Table 1.

Distribution of alcoholic beverages market share by category and major excise taxation changes in Thailand, 1995–2021.

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Aim of this analysis

The aim of this analysis is to provide an overview of the impact of changes in alcohol excise taxation on the population level of alcohol consumption, with a primary emphasis on estimating the cumulative effect of taxation changes over time. The insights gained from this study are vital for informing future public health strategies and optimizing alcohol control measures not only in Thailand but also in other low- and middle-income countries facing similar challenges.

Methods

As part of the ASEAN project (Rehm et al., 2025a), we conducted interrupted time-series analyses on monthly measures of recorded adult alcohol per capita consumption (APC; for categories of population alcohol consumption, see Poznyak et al., 2013; Rehm et al., 2007), analyzing multiple taxation increases aimed at lowering it (Beard et al., 2019; Jiang et al., 2022). The time-series data for monthly APC from January 1995 to December 2021 was obtained from the Excise Department, Ministry of Finance, Thailand (for specifics about the data source, see Saengow et al., 2024).

Modelling changes in alcohol excise taxation in Thailand

As influencing factors, we modelled only changes to the tax rates of alcoholic beverages that affected at least 15 % of the total alcohol beverage market (measured in litres pure ethanol) in Thailand in the year the tax change was implemented (Table 1). A somewhat arbitrary value of 15 % was chosen to avoid creating too many dummy variables, often in temporal proximity, and have a large enough effect size to impact the population level of consumption. In addition to examining increases in alcohol excise taxation rates, the two major structural changes to the taxation system were included in the time-series modelling (for details, see (Thawichasri, 2019)). Appendix Supplementary Table 1 gives details on dates and changes for all policies, while Table 1 gives an overview of the major policies included in the model based on the above criteria.

Statistical models

As indicated above, interrupted time series analyses were conducted using generalized least squares (GLS) models (Beard et al., 2019; Jiang et al., 2022). The effects of alcohol taxation policy changes were estimated by introducing seven dummy variables:

  • •

    Dummy 1: Tax increases in 1997 and 1998 were combined here as they both affected less than 20 % of the alcoholic beverage market in Thailand, and were in close temporal proximity;

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    Dummy 2: Tax increases in 2001 affected most categories of spirits (except white spirits), beer, and wine;

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    Dummy 3: 2007 taxation increase affecting white spirits, mixed spirits, and brandy

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    Dummy 4: Tax increase in 2009; affecting white spirits, mixed spirits, and brandy

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    Dummy 5: Tax increase in 2012; affecting white spirits, mixed spirits, and brandy

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    Dummy 6: Structural reform in 2013 (“two-chosen-one” format under the mixed taxation system)

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    Dummy 7: Structural reform in 2017 (a combination of specific and ad valorem tax systems)

All dummy variables were assumed to start in the month of implementation when changes were enacted before mid-month, or in the following month if they were instituted after mid-month. In the first month, the value 1 was assigned, which was successively decreased in each following month to account for increases in disposable income. The immediate change in level of alcohol consumption was based on theoretical considerations and on prior literature (Rehm et al., 2023b).

As indicated above, we assumed that increases in tax rates decayed each month over time, by 10 % per year, based on inflation (Bank of Thailand, 2025) and increases in household income (CEIC Data, 2025; Trading Economics, 2025). The 10 % value per year was set as an average value, as in the time between 2000 and the end of 2019 (last year before the global COVID-19 pandemic), household incomes in Thailand increased on average by 11 % per year (Trading Economics, 2025), with inflation of core consumer price amounting to less than 2 % on average (Bank of Thailand, 2025). We modelled each dummy variable to continue until the next major change in excise taxation took place.

Further, since most of the taxation changes in Thailand did not cover the full alcohol market, there were shifts in the composition of categories due to cross-price elasticities—i.e., while the price for some categories increased during taxation, the market share decreased in favor of other categories not affected by taxation increases, rendering them relatively cheaper (see Table 1 for examples of decreasing market shares after taxation increases and increasing shares of beverage types without increasing tax rates).

In addition to major changes in alcohol excise taxation, the following covariates were included in the model:

  • The major alcohol policy of 2008 (i.e., the Alcoholic Beverage Control Act of 2008 (Royal Government Gazette (Thailand), 2008)) introduced comprehensive restrictions on availability and marketing but no direct financial measures (for background, see (Sornpaisarn & Rehm, 2020)).

  • The COVID-19 pandemic (for Thailand the health impacts as measured by fatalities were mainly between April 2021–end of December 2021) (World Health Organization, 2024a).

  • GDP (gross domestic product at current market prices (millions of baht)) quarterly data obtained from the Office of The National Economic and Social Development Council, Thailand (Office of the National Economic and Social Development Council (NESDC), 2025).

The residual autocorrelation was controlled by autoregressive and moving average terms, and seasonal adjustment by Fourier terms. These are outlined in more detail in Appendix 1 and Appendix Supplementary Figure 1. The actual (black) and fitted level (red) of alcohol consumption from January 1995 to December 2021 is shown in Appendix Supplementary Figure 2. To illustrate the impact of the various taxation measures on consumption, the estimated trends were compared to the expected trends, predicted solely on economic growth (as operationalized by GDP).

We conducted various sensitivity analyses. The dependent variable was not log-transformed in the first sensitivity analysis, while 0/1 dummy variables for 2008 Alcohol Policy (lasting for 60 months), economic recession (based on OECD data), and a continuous variable for time in months (count variable starting from 1) were introduced, respectively, in the other three sensitivity analyses. The logarithmized APC produced better normal distribution of residuals than those from the untransformed APC. Therefore, logarithmized APC was adopted in the main analysis.

Data analysis was conducted using R software (version 4.5.1 (R Core Team, 2024). GLS models were fitted using a “nlme” package (Pinheiro & Bates, 2023), and plots were generated using a “ggplot2” package (Wickham, 2016).

Results

Overall, the statistical model fitted the data well with an explained variance of 79.1 %. Increases in the excise tax rate for alcoholic beverages and the two structural changes in alcohol excise taxation were associated with decreases in population-level alcohol consumption, as measured by recorded APC (Table 2).

Table 2.

Impact of major increases in alcohol excise taxation on per capita sales of alcoholic beverages in Thailand 1995 to 2021 (interrupted time-series analysis).

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From January 1995 to July 1996, monthly recorded alcohol sales rose steadily from 0.34 to 0.38 litres (L) and then remained stagnant through December 1996. Between January 1997 and March 2001, when two major tax rate increases (Dummy 1: October 1997 and February 1998) affected more than 15 % of the alcohol market, APC declined by 9.68 % (0.03 average L/month), but began to rise again in January 1999 through March 2001. From April 2001 (Dummy 2) to August 2007, APC showed a slight upward trend (average level: 0.40 L/month) despite tax increases in 2001, which reduced consumption by 4.8 % though this was not statistically significant.

From September 2007 (Dummy 3) to April 2009 average APC was 0.45 L/month, even after a significant decline of 6.71 % following policy changes. From May 2009 (Dummy 4) to August 2012 and between September 2012 (Dummy 5) to August 2013, average recorded APC rose to 0.53 and 0.57 L/month, respectively, and no significant impact from policies were seen. However, tax structure changes in 2013 and 2017 were both significantly associated with sustained reductions of recorded APC by 9.25 % and 22.97 %, respectively.

The actual (black) and fitted (red) levels of alcohol consumption from January 1995 to December 2021 are shown in Appendix Supplementary Figure 2, while Fig. 1 compares the actual and counterfactual scenarios assuming no change in alcohol taxation over the period but adjusting GDP based on Model 1. Without the introduction of any taxation policies, the total recorded APC between 1995 and 2021 could have been on average 0.6 L higher each year (overall 14.6 L of APC were averted during the observation period), based on estimates from our counterfactual modelling. At the end of the period, recorded APC in Thailand was 2 L lower compared to a counterfactual scenario in which no changes to alcohol excise taxation took place.

Fig. 1.

Fig. 1 dummy alt text

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Actual trend of alcohol per capita consumption (APC) and estimated counterfactual trend assuming no change in alcohol taxation in Thailand.

The results of all sensitivity analyses on the effects of taxation are summarized in Appendix Supplementary Table 2 and showed high consistency between models. Tax changes in Dummy 1 and Dummy 3 were statistically significant in four out of five models, including the base model. Tax structure change in 2013 demonstrated its significance in two models (including the base), while the 2017 change was significant in all five models. Moreover, the direction and the effect sizes of all models led to the main conclusion that increases in alcohol excise taxation, and the changes in tax structure were associated with marked decreases in the level of alcohol consumption.

Explained variance was 79.1 % in all logarithmized models and 76.2 % in the model using the original scale of the dependent variable. We selected the first logarithmized model as the main model, as it showed better normal distribution of the dependent variable and the lowest AIC. We also decided against introducing a time variable into the main model, as it showed high multicollinearity with GDP due to overall consistent economic growth in Thailand.

Discussion

Four of the seven major increases in alcohol excise taxation were associated with significant decreases in recorded APC; of the three non-significant changes, two were decreases and one was an increase. In particular, the structural changes to the tax system of 2013 and 2017 were associated with marked and sustained decreases in recorded APC of 9.3 % and 23.0 %, respectively. Thus, the changes in alcohol excise taxation were effective in decreasing population consumption (Fig. 1) and contributed to keeping the overall level of alcohol consumption in Thailand relatively stable since 2010, especially when compared to neighboring ASEAN countries such as Viet Nam, Cambodia, or Lao PDR (Rehm et al., 2026 (in press); Rehm et al., 2024b; Sornpaisarn et al., 2020). As has been shown before, without alcohol control policies, economic growth in non-Muslim majority countries was strongly associated with increases in the level of alcohol consumption (Rehm et al., 2026 (in press); Rehm et al., 2025c).

Interestingly, the Alcoholic Beverage Control Act of 2008 (Royal Government Gazette (Thailand), 2008), despite being a significant piece of legislation aimed at regulating alcohol, did not demonstrate a statistically significant impact on monthly APC in our analysis. This result is unexpected given the Act’s comprehensive scope, which integrated restrictions on advertising, sales locations, and hours, and designated drinking areas. One possible explanation is that excise taxation typically exerts broader and more immediate effects because it alters prices for all consumers, across all regions and demographic groups. In contrast, the Act’s non-price measures—such as advertising bans—may act over time and may disproportionately affect only certain subpopulations (e.g., younger and/or more media-exposed individuals), reducing the likelihood of detecting a population-level impact via monthly APC trends. Moreover, many provisions may have reinforced existing regulations or produced gradual, cumulative effects that were not captured by sharp shifts in monthly consumption data. Enforcement and compliance with certain aspects of the Act may also have varied across regions, further weakening any potential population-level effects on recorded consumption that our model could detect.

Overall, taxation increases were often limited to certain beverages and the alcohol market changed markedly several times. For instance, the most drastic shift was for white spirits, which went from half of the market share in 1999 to having no market share in the year 2000 and back again to over 50 % by 2004. The reason for this drastic decrease and increase was a change in production from state-owned factories to private enterprises (which had to pay taxes). This production change was administratively delayed, and together with huge stockpiling by consumers to avoid the impact of the new taxation, the market share of white spirits was reduced to 0 for a year (see Table 1; for further explanations and implication for monthly time series, see (Saengow et al., 2024; Sornpaisarn & Kaewmungkun, 2014)).

It should not come as a surprise that the two structural changes of the taxation system were associated with the largest and sustained decreases in APC. The other changes to alcohol excise taxation in Thailand were all limited to certain product categories, in general a compromise between the interests of the ministries of health/public health, finance, and agriculture with strong influence by the economic stakeholders (Sornpaisarn & Kaewmungkun, 2014). These compromises resulted in loopholes where specific product categories were spared from taxation and subsequent price increases, leading to a reshuffling of the market shares as well as to smaller scale decreases in overall consumption.

Future changes should strive to avoid the most problematic shortcomings of these limited increases of the alcohol excise taxation affecting only one or two categories. First, if the goal is to reduce alcohol consumption and attributable mortality and productivity losses, then all categories of alcoholic beverages should be affected, without any loopholes. Also, if there are other goals, such as preventing the initiation of drinking among young people (Sornpaisarn et al., 2015) or the prevention of heavy drinking (Sharma et al., 2014), it must be assured that no unintended consequences for other groups result. This may involve integrating increases in alcohol excise taxation with other policies (Gapstur et al., 2025; Rehm et al., 2023a). Also, to achieve the best results for public health, in a thriving economy with high yearly growth, it would be best not to negotiate for increases every year with uncertain results, but rather to link taxation rates to economic indicators such as inflation and/or disposable household income.

Finally, it is worth noting that well-conducted increases in alcohol excise taxation not only decrease the level of alcohol consumption, mortality and hospitalizations of populations, but such increases may also yield significant financial revenue for countries (Rehm et al., 2025b, 2025d).

Limitations

One of the limitations of the current analysis is that monthly data were only available for recorded consumption. Thus, we cannot exclude the possibility that total APC stayed the same or even increased after the taxation changes came into effect if unrecorded consumption (see (Lachenmeier et al., 2021) for a definition) increased while recorded consumption decreased. In fact, such arguments have frequently been made by economic operators against taxation increases (World Health Organization, 2023). For Thailand, as for any other country, no monthly data on unrecorded consumption are available. However, the WHO estimates yearly unrecorded consumption based on all available data from Thailand and neighboring countries, which showed no substantial increases for the years with major taxation changes (see Appendix Supplementary Figure 3 based on (United Nations: Department of Economic and Social Affairs, 2025)). In this respect, the situation in Thailand seems to corroborate the results from a recent review on taxation and unrecorded consumption, which found no systematic increases following taxation increases (Rehm et al., 2022). A second potential limitation concerns the number of time points between different taxation increases, which was often small, limiting statistical power (Beard et al., 2025). This is even more of a problem if taxation increases were at least in part compensated for by consumers switching to other beverages that were not affected by increased excise taxation. In this sense, the results of our analyses, which measured the overall level of recorded APC, are conservative. Another potential limitation is that our results were based on statistical analysis of ecological data, which cannot fully establish causality as other factors could have impacted consumption at the same time (Shadish et al., 2002). However, it would be difficult to find alternative explanations for the effect of all seven dummy variables tested. In other words, while different events or developments for one time-point can be found, alternative explanations for a cumulative decrease of all significant time points examined seem very unlikely. We therefore conclude that the impact of changes to excise taxation is causal.

Conclusions

Both increases in excise taxation rates and changes in taxation design decreased population-level alcohol consumption and alcohol-attributable harm in Thailand (Nontarak et al., 2025; World Health Organization, 2024b). This was the case even though these changes were often limited to certain alcoholic beverage categories, and some consumers switched to drink categories that had no taxation or price increases. Future taxation reforms in Thailand should be designed to have an impact on all beverage categories in order to reap the full benefits of taxation on reducing population consumption and improving health. Finally, such reforms should also have built-in mechanisms for automatic adjustment for inflation and/or disposable household income in order to ensure that the positive public health impact of such reforms persists (World Health Organization, 2023).

Ethics approval and consent to participate

Not applicable. This is a re-analysis of published aggregate data and is thus exempt from ethical approval.

Consent for publication

Not applicable, as no individual-level human data are given.

Role of the funding sources

The study sponsors had no role in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication.

Funding

This work was supported by the Centre for Alcohol Studies, Prince of Songkla University, Thailand, grant number CAS-A1-67-002 (to SA) and by WHO Western Pacific Region (2024/1505643-0; PO 203515367) to JR. JR was also supported by the Canadian Institutes of Health Research (FRN 477887).

CRediT authorship contribution statement

Nyi Nyi Zayar: Writing – review & editing, Visualization, Formal analysis. Polathep Vichitkunakorn: Writing – review & editing, Conceptualization. Wichai Aekplakorn: Writing – review & editing, Data curation. Surasak Chaiyasong: Writing – review & editing. Daniela Correia: Writing – review & editing, Formal analysis. Ahmed S. Hassan: Writing – review & editing, Formal analysis, Data curation. Kyaw Ko Ko Htet: Writing – review & editing, Formal analysis. Jiraluck Nontarak: Writing – review & editing, Formal analysis. Roengrudee Patanavanich: Writing – review & editing, Data curation. Pol Rovira: Writing – review & editing, Formal analysis. Kevin Shield: Writing – review & editing, Formal analysis. Bundit Sornpaisarn: Writing – review & editing, Data curation. Udomsak Saengow: Writing – review & editing. Wit Wichaidit: Writing – review & editing, Data curation. Sawitri Assanangkornchai: Writing – review & editing, Funding acquisition, Conceptualization. Jürgen Rehm: Writing – review & editing, Writing – original draft, Funding acquisition, Formal analysis, Conceptualization.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

The authors would like to thank Astrid Otto for English copy-editing and referencing.

Footnotes

Supplementary material associated with this article can be found, in the online version, at doi:10.1016/j.drugpo.2026.105191.

Contributor Information

Ahmed S. Hassan, Email: ahmeds.hassan@mail.utoronto.ca.

Sawitri Assanangkornchai, Email: savitree.a@psu.ac.th.

Jürgen Rehm, Email: jtrehm@gmail.com.

Appendix. Supplementary materials

mmc1.docx (445.1KB, docx)

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