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. Author manuscript; available in PMC: 2017 Oct 1.
Published in final edited form as: Alcohol Clin Exp Res. 2016 Sep 12;40(10):2043–2055. doi: 10.1111/acer.13203

Table 1.

List of studies on the association between alcohol policies and suicide mortality, 1999–2014

Year Author(s) Journal Sample Location Study
Period
Alcohol
Policies
Outcome Design Main Findings
1999 Birckmayer
&
Hemenway
AJPH Decedents
aged 18–20
U.S. 48
states
1970–1990 MLDA; beer
excise tax
Number of
suicides
Repeated
cross-sectional
The suicide rate of 18- to 20-year-
old youths living in states with an
18-year MLDA was 8% higher than
the suicide rate among 18- to 20-
year-old youths in states with a 21-
year MLDA (p<0.01).
2002 Escobedo &
Ortiz
Accid Anal
Prev.
Decedents New Mexico
(U.S.)
1990–1994 Liquor store
outlet density
County-
specific
suicide
rates
County panel
data
Greater availability of liquor outlets
was associated with higher suicide
rates (p=0.03).
2003 Markowitz
et al
J Ment
Health
Policy
Econ
Youth
decedents
aged 10–24
U.S. states 1976–1999 Beer excise tax;
outlet density;
blood alcohol content (BAC);
zero tolerance.
Suicide
rates
State panel
data
Increases in the excise tax on beer
were associated with a reduced
number of male suicides, but has no
impact on female suicides. Suicides
by males aged 20–24 are positively
related to the availability of alcohol
and negatively related to the
presence of a 0.08 BAC
law and zero
tolerance laws for youth impaired
driving. Female suicides were not
impacted by the availability of
alcohol.
2004 Carpenter JPAM Youth
decedents
aged 15–29
U.S. states 1981–1998 Adoption of
Zero Tolerance
Laws
Suicide
rates
State panel
data
The presence of a zero tolerance
policy was associated with a 10.3%
reduction in suicides among 15–17-
year-old males and a 7.7%
reduction in suicides among 18–20-
year-old males, and both were
significant. No effects were found
among 21–29-year-old males, and
no consistent effects were found
among females.
2005 Yamasaki et
al
Psychol
Rep
Decedents Switzerland 1965–1994 Alcohol specific
tax
Suicide
rates
Time series
analysis
The tax on alcohol was positively
correlated with male suicide rate in
an autoregressive model (p<0.01),
but no association was detected for
female suicide rate.
2006 Värnik et al Addiction Decedents Estonia Before,
during and
after a
major
Soviet
anti-
alcohol
reforms in
1985
Reduction of
state alcohol
production and
sales by some
60%; raising
prices by 45%;
propaganda
campaign to
change
attitudes;
improving
alcoholism
treatment;
punishing
alcohol misuse
BAC level
among
decedents
Pre-post
comparison
During the reforms, BAC-positive
suicides decreased by 39.2% for
males and 41.4% for females, and
the largest fall occurred at the BAC
2.5‰ plus level for both sexes.
However, after the reform ended,
suicide rates started to rise.
2007 Zalcman &
Mann
Contemp
Drg Probl
Decedents Alberta,
Canada
1976–1999 Three stages of
privatization of
retail sale:
opening of
privately owned
wine stores in
1985; opening
of privately
owned cold
beer stores and
selling spirits
and wine in
hotels in rural
areas in 1989;
privatization of
all liquor stores
in 1994
Suicide
rates
Interrupted
time series
design
Significant increase in male and
female suicide rates were found
after both 1985 and 1989
privatization, and significant
increase in male suicide rate was
found in 1994, but not among
female.
2009 Johnson et
al
ACER Decedents California
(U.S.)
1995–2000 Outlet density Suicide
rates
Repeated
cross-sectional
at zip code
level
Completed suicide rates were
higher in zip code areas with
greater local and lagged bar
densities, and those with greater
local but not lagged off-premise
outlet densities. Completed suicide
rates were lower in zip code areas
with greater local restaurant
densities. Completed suicide rates
were lower among blacks and
Hispanics, but higher among rural,
older, low income whites.
2009 Pridemore
&
Snowden
AJPH Decedents Slovenia 1997–2005 New national
alcohol policy in
2003 that
limited alcohol
availability with
MLDA and
hours of sale
Monthly
suicide
counts
Interrupted
time series
design
There was a significant overall
decrease in the number of monthly
suicides following the policy’s
implementation. A significant
association was detected among
men, but not women.
2009 Carpenter
and Dobkin
AEJ:
Applied
Economics
Decedents
aged 19–22
U.S. states 1997–2004 MLDA Suicide
rates
Regression
discontinuity
design
The suicide rate increased by over
16 percent at age 21.
2011 Son &
Topyan
Eur J
Health
Econ
Decedents U.S. states 1995–2004 State excise
taxes
Number of
suicides
State panel
data
Wine excise taxes were negatively
associated with suicides rates, but
no association was detected for
spirit tax or beer tax.
2012 Grucza et al ACER Decedents U.S. states 1990–2004 MLDA Suicide
(Y/N)
Repeated
cross-sectional
Significant policy-by-sex
interactions were observed: women
exposed to permissive drinking age
laws were at higher risk for suicide,
with stronger effect for those born
after 1960; no significant effects
were observed for women born
prior to 1960. No overall effect or
effect on men was observed.
2012 Sauliune et
al
Alcohol
Alcoholism
Decedents
aged 15–64
Lithuania 2006–2009 Implementation
of
comprehensive
alcohol control
policy in 2007-
2008 that
increased excise
taxes and
restricted
alcohol
advertising,
availability,
drunk driving,
and illegal
imports and
sales
Years of
potential
life lost
(YPLL)
due to
alcohol-
related
suicide
Pre-post
comparison
Years of potential life lost due to
alcohol-related suicides showed
significant increase among males,
but was stable among females.
2013 Pridemore
et al
AJPH Decedents Russia 2000–2010 Policies
restricting sales
volume and
quality,
requiring
registration of
production and
distribution,
requiring new
fee, equipment
costs and new
excise tax stamp
Number of
suicides
Interrupted
time series
design
No impact of on female suicide
mortality but a reduction of about
9% in male suicides (p=0.01).
2013 Zupanc et
al
Eur Addict
Res
Decedents Slovenia Before,
during and
after
policy
change in
2003
New national
alcohol policy in
2003 that
limited alcohol
availability with
MLDA and
hours of sale
BAC level
among
decedents
Pre-post
comparison
Among BAC-positive suicide victims,
BACs were lower after the policy
change compared to those tested in
the period before the change.
2014 Berman AJPH Alaska
native men
aged 15–34
in rural
communities
Alaska
(U.S.)
1980–2007 Dry status (1 =
sale and
importation or
possession
prohibited, 0 =
any other
status); any
local
option adopted
(1 = yes, 0 = no)
Number of
suicides
Repeated
cross-sectional
Suicide rates were higher in
communities prohibiting alcohol
importation under state law, but the
effect was not significant after
controlling for other
community characteristics.
2014 Giesbrecht et
al
Addiction Decedents U.S. states
(14 states)
2003–2011 Outlet density Alcohol
Involveme
nt (Y/N)
among
suicide
decedents
Repeated
cross-sectional
Higher off-premises alcohol outlet
density was associated with greater
proportions of alcohol-related
(BAC>0) suicides among men. There
was a significant interaction
between off-premises alcohol
availability and American
Indian/Alaska Native race such
that this subgroup had highest BAC
positivity. On-premises density was
also significantly associated with
BAC >0 and BAC ≥0.08 among male
decedents.