. 2022 Jun 28;117(12):3004–3023. doi: 10.1111/add.15966

TABLE 3.

International Center for Alcohol Policies (ICAP)—Jon Nelson's reviews: study characteristics, main findings and limitations

Author, year; review type, research question	‘a priori’ design; search; study selection; data extraction	Quality assessment	Main findings	Limitations/risks of bias
Nelson, 2013 ‐ Health Econ Rev [22]; ‐ Meta‐analysis ‐ Price and income elasticities for alcohol beverages (beer, wine, spirits)	‐ ‘a priori’ design: no ‐ search comprehensive: yes ‐ grey literature: yes ‐ year of last search: 2012 ‐ no. of studies included: 182 (LMIC: 16) ‐ duplicate study selection and data extraction: no	Some studies excluded because of poor reporting (e.g. missing standard errors), or poor methods ‘linear model or poor data’; quality of included studies not generally assessed (no formal quality assessment approach/tool used); unclear which study was excluded and why.	Pooled total own‐price elasticities, trimmed samples (95% CI) − fixed effects: ‐ beer: −0.26 (−0.46, −0.06) ‐ wine: −0.34 (−0.54, −0.14) ‐ spirits: −0.49 (−0.69, −0.29) ‐ alcohol: −0.46 (−0.66, −0.26) − random effects ‐ beer: −0.35 (−0.39, −0.31) ‐ wine: −0.58 (−0.64, −0.52) ‐ spirits: −0.64 (−0.70, −0.58) ‐ alcohol: −0.58 (−0.64, −0.52) Total own‐price elasticities, full samples, medians ‐ beer: −0.32 ‐ wine: −0.57 ‐ spirits: −0.67 ‐ alcohol: −0.54	Substantial overlap with Nelson, 2013 ‐ Journal of Wine Economics and Nelson, 2014 ‐ J Health Econ [23, 25]. No formal quality assessment conducted; opaque selection of individual studies' estimates; unclear if short‐run and long‐run estimates have been pooled together; heterogeneity not formally assessed; efforts to minimize the potential effect of alcohol prices on alcohol use apparent; data/results do not support all conclusions.
Nelson, 2013 ‐ J Wine Econ [23]; ‐ Meta‐analysis; meta‐regression ‐ Price and income elasticities for wine and spirits	‐ ‘a priori’ design: no ‐ search comprehensive: yes ‐ grey literature: yes ‐ year of last search: 2012 ‐ no. of studies included: 125 (LMIC: 6) ‐ duplicate study selection and data extraction: no	Some studies excluded because of poor reporting (e.g. missing standard errors), or poor methods ‘linear model or poor data’; quality of included studies not generally assessed (no formal quality assessment approach/tool used); unclear which study was excluded and why.	Pooled total own‐price elasticities, full samples (95% CI) − Fixed effects: ‐ wine: −0.63 (−0.65, −0.61) ‐ spirits: −0.48 (−0.50, −0.46) − Random effects: ‐ wine: −0.62 (−0.74, −0.50) ‐ spirits: −0.65 (−0.73, −0.57) Pooled total own‐price elasticities, trimmed samples ‐ same as Nelson, 2013 (Health Econ Rev)	Substantial overlap with Nelson, 2013 ‐ Health Econ Rev [22]. No formal quality assessment conducted; opaque selection of individual studies' estimates; unclear if short‐run and long‐run estimates have been pooled together; heterogeneity not formally assessed; efforts to minimize the potential effect of alcohol prices on alcohol use apparent; data/results do not support all conclusions.
Nelson, 2014 ‐ J Health Econ [25]; ‐ Meta‐analysis; meta‐regression ‐ Price and income elasticities for beer	‐ ‘a priori’ design: no ‐ search comprehensive: yes ‐ grey literature: yes ‐ year of last search: 2012 ‐ no. of studies included: 114 (LMIC: unclear) ‐ duplicate study selection and data extraction: no	None	Pooled total own‐price elasticities (95% CI) − fixed effects: ‐ beer, full sample: −0.23 (−0.24, −0.22) ‐ beer, trimmed sample: −0.20 (−0.39, −0.31) − random effects: ‐ beer, full sample: −0.35 (−0.21, −0.19) ‐ beer, trimmed sample: −0.23 (−0.27, −0.19)	Substantial overlap with Nelson, 2013 ‐ Health Econ Rev [22]. No formal quality assessment conducted; opaque selection of individual studies' estimates; unclear if short‐run and long‐run estimates have been pooled together; heterogeneity not formally assessed; efforts to minimize the potential effect of alcohol prices on alcohol use apparent; data/results do not support all conclusions.
Nelson, 2013 ‐ Econ Anal Pol [36]; ‐ Narrative review ‐ Effectiveness of pricing policies at reducing alcohol use and related harms in heavy drinkers	‐ ‘a priori’ design: no ‐ search comprehensive: yes ‐ grey literature: yes ‐ year of last search: 2012 ‐ no. of studies included: 19 (LMIC: 1) ‐ duplicate study selection and data extraction: no	Some limitations were generally discussed. No formal quality assessment approach/tool used.	Only broad results presented. Results generally not clearly synthesized. ‐ heavy drinking unlikely to be associated with prices or taxes (2/19 studies found statistically significant and substantial price/tax response by heavy drinking adults); ‐ prices/taxes likely associated with moderate drinking; ‐ prices/taxes possibly associated with heavy drinking among youth.	No formal quality assessment conducted; no differentiating between types of elasticities; tax and price interventions not separated; limited generalizability to LMIC.
Nelson, 2014 ‐ Health Econ [37]; ‐ Narrative review ‐ Effectiveness of pricing policies at reducing alcohol use by sex	‐ ‘a priori’ design: no ‐ search comprehensive: yes ‐ grey literature: yes ‐ year of last search: 2012 ‐ no. of studies included: 21 (LMIC: 5) ‐ duplicate study selection and data extraction: no	Some limitations were generally discussed. No formal quality assessment approach/tool used.	Results not clearly synthesized. Study's conclusion: ‐ adult men had less elastic demands compared with women; ‐ there was little or no price response by heavy‐drinking adults, regardless of sex; ‐ although the sample was small, price might be important for drinking participation for younger adults; ‐ results were mixed but strongly suggested that heavy drinking by young adults, regardless of sex, was not easily dissuaded by higher prices.	No formal quality assessment conducted; unclear exclusion criteria; data/results do not support all conclusions; limited generalizability to LMIC.
Nelson, 2015 ‐ Health Econ Rev [43]; ‐ Narrative review ‐ Effectiveness of pricing policies at reducing binge drinking by age	‐ ‘a priori’ design: no ‐ search comprehensive: yes ‐ grey literature: yes ‐ year of last search: 2012 ‐ no. of studies included: 65 (LMIC: 0) ‐ duplicate study selection and data extraction: no	Some limitations were generally discussed. No formal quality assessment approach/tool used.	Effects of prices/taxes on binge drinking, among youth, young adult and adult population varied between studies. Overall, very heterogeneous and mixed evidence: ‐ for youth 3/18 studies found statistically significant protective effects on heavy drinking from price/tax interventions, 10 null results, and others mixed; ‐ for young adults 1/5 studies that pooled men and women found statistically significant protective effects, 2/7 found significant protective effects for men, and 2/4 found significant protective effects for women; ‐ for adults 5/19 studies indicated statistically significant protective effects and 4/19 suggest mixed results.	No formal quality assessment conducted; unclear exclusion criteria; data/results do not support all conclusions; limited generalizability to LMIC.
Nelson, McNall, 2017 ‐ Eur J Health Econ [44]; ‐ Narrative review ‐ Evidence from natural experiments on the effectiveness of pricing policies at reducing alcohol use	‐ ‘a priori’ design: no ‐ search comprehensive: no ‐ grey literature: yes ‐ year of last search: not reported ‐ no. of studies included: 29 (LMIC: 0) ‐ duplicate study selection and data extraction: yes	Some limitations were generally discussed. No formal quality assessment approach/tool used.	The review assessed the impact of tax/price policy changes in five countries (Denmark, Finland, Hong Kong, Sweden, and Switzerland). Results not clearly synthesized; little to no discussion of effect sizes; of the 29 studies included, 13 used Nordic Tax Study (NTS) data: ‐ binge drinking was reduced in 4/18 studies included; young adults and youth responded to changes in 4/14 studies, and changes seemed to have had little effect on older adults.	Search strategy not comprehensive; no formal quality assessment conducted; poorly justified or unclear exclusion criteria; data/results do not support all conclusions; limited generalizability to LMIC.

Author, year; review type, research question

‘a priori’ design; search; study selection; data extraction

Quality assessment

Main findings

Limitations/risks of bias

Nelson, 2013 ‐ Health Econ Rev [22];

‐ Meta‐analysis

‐ Price and income elasticities for alcohol beverages (beer, wine, spirits)

‐ ‘a priori’ design: no

‐ search comprehensive: yes

‐ grey literature: yes

‐ year of last search: 2012

‐ no. of studies included: 182 (LMIC: 16)

‐ duplicate study selection and data extraction: no

Some studies excluded because of poor reporting (e.g. missing standard errors), or poor methods ‘linear model or poor data’; quality of included studies not generally assessed (no formal quality assessment approach/tool used); unclear which study was excluded and why.

Pooled total own‐price elasticities, trimmed samples (95% CI)

− fixed effects:

‐ beer: −0.26 (−0.46, −0.06)

‐ wine: −0.34 (−0.54, −0.14)

‐ spirits: −0.49 (−0.69, −0.29)

‐ alcohol: −0.46 (−0.66, −0.26)

− random effects

‐ beer: −0.35 (−0.39, −0.31)

‐ wine: −0.58 (−0.64, −0.52)

‐ spirits: −0.64 (−0.70, −0.58)

‐ alcohol: −0.58 (−0.64, −0.52)

Total own‐price elasticities, full samples, medians

‐ beer: −0.32

‐ wine: −0.57

‐ spirits: −0.67

‐ alcohol: −0.54

Substantial overlap with Nelson, 2013 ‐ Journal of Wine Economics and Nelson, 2014 ‐ J Health Econ [23, 25].

No formal quality assessment conducted; opaque selection of individual studies' estimates; unclear if short‐run and long‐run estimates have been pooled together; heterogeneity not formally assessed; efforts to minimize the potential effect of alcohol prices on alcohol use apparent; data/results do not support all conclusions.

Nelson, 2013 ‐ J Wine Econ [23];

‐ Meta‐analysis; meta‐regression

‐ Price and income elasticities for wine and spirits

‐ ‘a priori’ design: no

‐ search comprehensive: yes

‐ grey literature: yes

‐ year of last search: 2012

‐ no. of studies included: 125 (LMIC: 6)

‐ duplicate study selection and data extraction: no

Pooled total own‐price elasticities, full samples (95% CI)

− Fixed effects:

‐ wine: −0.63 (−0.65, −0.61)

‐ spirits: −0.48 (−0.50, −0.46)

− Random effects:

‐ wine: −0.62 (−0.74, −0.50)

‐ spirits: −0.65 (−0.73, −0.57)

Pooled total own‐price elasticities, trimmed samples

‐ same as Nelson, 2013 (Health Econ Rev)

Substantial overlap with Nelson, 2013 ‐ Health Econ Rev [22].

Nelson, 2014 ‐ J Health Econ [25];

‐ Meta‐analysis; meta‐regression

‐ Price and income elasticities for beer

‐ ‘a priori’ design: no

‐ search comprehensive: yes

‐ grey literature: yes

‐ year of last search: 2012

‐ no. of studies included: 114 (LMIC: unclear)

‐ duplicate study selection and data extraction: no

None

Pooled total own‐price elasticities (95% CI)

− fixed effects:

‐ beer, full sample: −0.23 (−0.24, −0.22)

‐ beer, trimmed sample: −0.20 (−0.39, −0.31)

− random effects:

‐ beer, full sample: −0.35 (−0.21, −0.19)

‐ beer, trimmed sample: −0.23 (−0.27, −0.19)

Substantial overlap with Nelson, 2013 ‐ Health Econ Rev [22].

Nelson, 2013 ‐ Econ Anal Pol [36];

‐ Narrative review

‐ Effectiveness of pricing policies at reducing alcohol use and related harms in heavy drinkers

‐ ‘a priori’ design: no

‐ search comprehensive: yes

‐ grey literature: yes

‐ year of last search: 2012

‐ no. of studies included: 19 (LMIC: 1)

‐ duplicate study selection and data extraction: no

Some limitations were generally discussed. No formal quality assessment approach/tool used.

Only broad results presented. Results generally not clearly synthesized.

‐ heavy drinking unlikely to be associated with prices or taxes (2/19 studies found statistically significant and substantial price/tax response by heavy drinking adults);

‐ prices/taxes likely associated with moderate drinking;

‐ prices/taxes possibly associated with heavy drinking among youth.

No formal quality assessment conducted; no differentiating between types of elasticities; tax and price interventions not separated; limited generalizability to LMIC.

Nelson, 2014 ‐ Health Econ [37];

‐ Narrative review

‐ Effectiveness of pricing policies at reducing alcohol use by sex

‐ ‘a priori’ design: no

‐ search comprehensive: yes

‐ grey literature: yes

‐ year of last search: 2012

‐ no. of studies included: 21 (LMIC: 5)

‐ duplicate study selection and data extraction: no

Some limitations were generally discussed. No formal quality assessment approach/tool used.

Results not clearly synthesized. Study's conclusion:

‐ adult men had less elastic demands compared with women;

‐ there was little or no price response by heavy‐drinking adults, regardless of sex;

‐ although the sample was small, price might be important for drinking participation for younger adults;

‐ results were mixed but strongly suggested that heavy drinking by young adults, regardless of sex, was not easily dissuaded by higher prices.

No formal quality assessment conducted; unclear exclusion criteria; data/results do not support all conclusions; limited generalizability to LMIC.

Nelson, 2015 ‐ Health Econ Rev [43];

‐ Narrative review

‐ Effectiveness of pricing policies at reducing binge drinking by age

‐ ‘a priori’ design: no

‐ search comprehensive: yes

‐ grey literature: yes

‐ year of last search: 2012

‐ no. of studies included: 65 (LMIC: 0)

‐ duplicate study selection and data extraction: no

Some limitations were generally discussed. No formal quality assessment approach/tool used.

Effects of prices/taxes on binge drinking, among youth, young adult and adult population varied between studies. Overall, very heterogeneous and mixed evidence:

‐ for youth 3/18 studies found statistically significant protective effects on heavy drinking from price/tax interventions, 10 null results, and others mixed;

‐ for young adults 1/5 studies that pooled men and women found statistically significant protective effects, 2/7 found significant protective effects for men, and 2/4 found significant protective effects for women;

‐ for adults 5/19 studies indicated statistically significant protective effects and 4/19 suggest mixed results.

No formal quality assessment conducted; unclear exclusion criteria; data/results do not support all conclusions; limited generalizability to LMIC.

Nelson, McNall, 2017 ‐ Eur J Health Econ [44];

‐ Narrative review

‐ Evidence from natural experiments on the effectiveness of pricing policies at reducing alcohol use

‐ ‘a priori’ design: no

‐ search comprehensive: no

‐ grey literature: yes

‐ year of last search: not reported

‐ no. of studies included: 29 (LMIC: 0)

‐ duplicate study selection and data extraction: yes

Some limitations were generally discussed. No formal quality assessment approach/tool used.

The review assessed the impact of tax/price policy changes in five countries (Denmark, Finland, Hong Kong, Sweden, and Switzerland). Results not clearly synthesized; little to no discussion of effect sizes; of the 29 studies included, 13 used Nordic Tax Study (NTS) data:

‐ binge drinking was reduced in 4/18 studies included; young adults and youth responded to changes in 4/14 studies, and changes seemed to have had little effect on older adults.

Search strategy not comprehensive; no formal quality assessment conducted; poorly justified or unclear exclusion criteria; data/results do not support all conclusions; limited generalizability to LMIC.